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One of the most important problems the discipline of internal medicine must resolve is how it will maintain its traditional level of educational excellence and yet greatly change its impact on the provision of health care throughout the nation. The source of the problem is well known to all: many people say that they cannot find a doctor who will provide them with personalized care in an easily accessible manner. The federal and state legislatures have heard these complaints. About five years ago, the remnants of a fading corps of general practitioners recognized the opportunity for return and redesigned a type of rotating service training program with emphasis on ambulatory services that would produce what is now called a family practitioner. A joining of forces between the legislators and the family practitioners resulted in the emergence of a large number of legislatively mandated departments of family practice in university medical