On July 1, 2010, the Johns Hopkins Hospital will launch an innovative combined internal medicine–pediatrics (MP) residency program in Baltimore, MD, to prepare physicians to care for inner-city families and to lead urban primary care during the next century. Ultimately, this program will produce physician leaders who can serve as system-level agents of change while providing effective, longitudinal, comprehensive, coordinated, person-focused care for the inner-city patient… ...Unlike other areas, cities face a workforce crisis, while simultaneously contending with health problems that face the inhabitants of the inner city. These include chronic disease, substance abuse, poverty, behavioral issues, psychiatric illness, and health care disparities. Lack of access to primary care exacerbates these issues, and addressing them requires leaders in primary care.