As health care services shift to the ambulatory and community setting, health professions educators must consider revamping educational programs to reflect the new venues of care. This transformation extends far beyond the location of services. The dynamic between the health care provider and the patient shifts to provider and customer. Services should be geared to the concerns of the individual and tailored to meet the realities of the person's life. This is true in all settings; and particularly true in the city. This article discusses the unique challenges of the urban environment and the benefits students gain by having clinical experiences based the city and working with members of these communities.