Title VII innovations in American medical and dental education: responding to 21st century priorities for the health of the American public

The Title VII Training in Primary Care Medicine and Dentistry grant program has been an engine for innovation by providing funds to develop and implement new curricula, new models of care delivery, and new methods of fellowship and faculty development. During period one, 1963-1975, the disciplines of family medicine and physicians assistants (PAs) first received funding to establish residency programs in family medicine and student training for PAs. Other innovations included interdisciplinary training and curricula in substance abuse and nutrition. During period two, 1976-1991, Title VII funds supported implementation of general dental residency programs. In family medicine, general internal medicine, and general pediatrics, ambulatory care training was expanded with a focus on community-oriented primary care and preventive medicine, as well as curricula in ethics, distance learning, behavioral health, and what is now called evidence-based medicine. During period two, Title VII also helped build the infrastructure of primary care through funding to recruit faculty, to expand training sites into community settings, and to incorporate topics relevant to primary care. During period three, 1992-present, innovations shifted to areas of clinical relevance or national priority, training in the care of vulnerable populations, and design of educational strategies to eliminate health disparities, often through collaborative partnerships between medicine, dentistry, and public health. This article focuses on three areas that reflect much of the current work of Title VII grantees: clinical skills and practice improvement, interdisciplinary models of training and patient care, and care of vulnerable and underserved populations.This article is part of a theme issue of Academic Medicine on the Title VII health professions training programs.