The dean of a developing medical school must plan now to train young men and women who will not have completed their residencies until a full decade has elapsed. Anyone who ponders the amazing developments in both biological science and social change during the past five years must share the dismay and humility we face as we accept the challenge of predicting the next ten. The possibility of major breakthroughs in our understanding and ability to cope with problems in cancer, heart disease, stroke, diabetes, to mention but a few, is matched by major changes in automation and computers and the possibility of equally dramatic revolutions in the social aspects of medicine. The last Congress passed five specific measures, namely, Titles XVIIIA, XVIIIB, and XIX of Medicare, the Regional Medical Programs and Comprehensive Health Planning, each of which suggests a specific set of philosophies and goals toward the improvement of