Training occurs at two sites, the University of Illinois Hospital and the Jesse Brown Veterans Administration Hospital. Both provide primary and tertiary care to a large number of patients, many of whom look to the residents as their primary health care providers. House staff spends approximately 50% of their time at each site and maintain a continuity outpatient practice at each site. The faculty and all departmental conferences are fully integrated across both institutions. In both the inpatient and outpatient settings, residents have substantial primary decision-making responsibility and develop strong relationships with their patients. The full-time on-site teaching faculty, the inpatient ward service teaching model, and the outpatient dedicated preceptor model provide optimal supervision and guidance, yet encourage the independent thinking that derives from playing a major role in patient care.