This chapter examines the Robert Wood Johnson Foundation Clinical Scholars Program from its inception in 1972. The program was designed to produce scholarly physician-leaders with the understanding and the skills necessary to have a major influence on health care policy, and to help create and build health services research. It was and still is a two-year fellowship for physicians who have already completed their initial clinical training. To date, the program has had over 900 graduates. The authors describe the clinical scholars, who they are and what they have become; their impact on health policy, program sites and other fellowships; and the impact the program has had on the Foundation. Changes in medical care and in society at large presented new challenges, as Clinical Scholars entered its fourth decade. In 2002, the Foundation considered the future of the program and an evaluation of it was conducted by the University of California, San Francisco or UCSF. The program has been and continues to be impressive. The authors explain the changes that were made as a result of the evaluation and conclude that well-trained physicians, well-versed in policy process have made an impact on health care policy and will continue to do so.