This article looks toward the future of medical school courses in professional skills and perspectives by addressing the extent to which they are a valid model for educating physicians of the 21st century, highlighting what medical educators can learn from the experiences at a sample of four medical schools, and suggesting ways to strengthen this curricular genre. Each of the four courses described in this special feature strives to provide exposure and experience in behavioral science, medical ethics, physician-patient communication, health promotion and disease prevention, physical examination, clinical reasoning, and health services and financing. It is likely that students who will be practicing medicine in the 21st century would also benefit from more attention to personal awareness and professional growth. Several lessons can be drawn from the experiences with these courses: although complex, they are directed by very small groups of faculty; they require large numbers of teaching faculty; it is difficult to establish equal footing with basic science courses; evaluation of students' progress is a major challenge; it is important to clearly articulate course components; the emphasis must extend beyond the first two years; and ongoing student and faculty input is essential. The authors suggest that conducting outcome assessments, creating a more humane culture of medical education, and supporting course faculty are key to a stable future for these courses and a solid education for the students.