Third year medical students typically learn through supervised patient interaction in a clinical setting, often based in academic or hospital-based training sites. As one of the five medical schools in the Philadelphia area, PCOM strives to find the best training sites for its students in a number of specialties. Due to the increasing number of students in the region as well as a decreasing number of available training sites (as a result of reduced hospitalization rates and lengths of stay), finding suitable training sites for students has been a challenge. In order to better meet the academic needs of our students, new educational models are required. These models need to address a number of key challenges. 1.Inconsistent clinical exposure to patients whose demographics and presenting problems vary by site. 2.Inconsistent training and quality of clinical preceptors at each of the clinical sites. 3.Insufficient clinic training sites to accommodate expanding class size.