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The nuclear shell model has perhaps been the most important conceptual and computational paradigm for the understanding of the structure of atomic nuclei. While the shell model has been used predominantly in a phenomenological context, there have been efforts stretching back more than half a century to derive shell model parameters based on a realistic interaction between nucleons. More recently, several ab initio many-body methods—in particular, many-body perturbation theory, the no-core shell model, the in-medium similarity renormalization group, and coupled-cluster theory—have developed the capability to provide effective shell model Hamiltonians. We provide an update on the status of these methods and investigate the connections between them and their potential strengths and weaknesses, with a particular focus on the in-medium similarity renormalization group approach. Three-body forces are demonstrated to be important for understanding the modifications needed in phenomenological treatments. We then review some applications of these methods to comparisons with recent experimental measurements, and conclude with some remaining challenges in ab initio shell model theory.