The Health Systems Independent Study Project (HSISP) at the Oregon Health & Science University residency program was reviewed in the current study. HSISP is an innovative example of the changing health systems curriculum for medical residents. As part of the HSISP, residents pursue independent study, with the assistance of a mentor, on a specific area of interest in the field of health care systems and population-based medicine. Twenty-eight residents completed 40 hours of practice-based work over an eight-week period between January 2001 and June 2003. The majority (64%) of these residents then completed an open-ended questionnaire about their experience.