The Interdisciplinary Generalist Curriculum (IGC) Project came at a pivotal time in curriculum development at the University of California, San Francisco, School of Medicine. In the three years prior to the project, the curriculum committee had considered implementation of early longitudinal clinical experiences. This had not been proposed as a primary care experience. Introduction of generalist skills, with the goal of increasing numbers of students choosing generalist residencies, presented significant challenges at this tertiary care and research-oriented medical school. The new IGC course, Foundations of Patient Care, consists of on-campus lectures, small-group sessions, physical examination skills instruction and a six-quarter preceptorship. As proposed, the school increased teaching of generalist skills and competencies and developed a large pool of primary care preceptors. There was no change in the number of graduates choosing primary care. The strong collaboration that resulted from the development of this new course served as a catalyst for major curricular reform now under way at this medical school.