The horizon of health care is rapidly changing. Historically, physicians acquired management roles because they had inherent business skills; physician executives often received business training on an ad-hoc basis. Increasingly, the system requires physicians with advanced skills in business, finance and organization management. Dual degree programs in medicine and business have emerged to fill the training gap. The students enrolling in these programs are a unique group. Their motivations for electing business training and their career choices provide indicators concerning the future of medical practice. As one student commented: “I decided I want to have a broader scope in my medical career and take leadership roles in addition to practicing medicine. I am interested in changing what is going on in health care….I think it will be very interesting to follow the combined degrees [students] and to see if the combined program really does enhance what we have talked about – the concern for patients and making sure they are the primary focus of the business of health care.”