There has been a long-accepted axiom in the world of education that the first phases of any learning experience set the style and pattern for all the subsequent experiences. The character of the first few days or weeks in the classroom might well determine the tenor of an entire term for a course. Start well, continue and end well. It may even be that this pedagogical theorem derives from the old household adage that the first few years of a youngster's training really makes the man. Thus, the first days, the beginning months, the early years set the motif for what is to follow. If that educational principle also holds true for internal medicine, then an examination of the first years of training in internal medicine merits our review. What clinical activity makes up these initial experiences should be designed so as to best fit the internist's long-term career pattern.