Changing patterns of medical practice are placing greater emphasis on ambulatory medicine and primary care practice, including office-based preventive medicine, reduction of cardiovascular risk factors, issues in women's health, management of chronic disease, application of behavioral medicine skills to ambulatory medical patients and the rational use of diagnostic tests and new medications. Designed for practicing internists, family practitioners, gynecologists, nurse practitioners, physician assistants, and all other health professionals interested in providing high quality primary care, this course will provide opportunities to enhance competence and improve performance. The course will focus on the skills and strategies needed in day-to-day office practice. The curriculum will feature in-depth discussion of challenging cases in preventive medicine, common problems in ambulatory care, and a broad selection of acute and chronic illnesses. This year’s course will also highlight key issues in dermatology, neurology, geriatrics, and clinical nutrition. An audience response system will facilitate discussion of challenging clinical cases. The course is presented by the UCSF Division of General Internal Medicine of the Department of Medicine and is sponsored by the Office of Continuing Medical Education, University of California, San Francisco.