The Comprehensive Care Program at Columbia University College of Dentistry works on the basic principle that the dental clinic should be committed to serving the patient's oral health care needs rather than learning material for dental students. In this environment, discipline-driven requirements were eliminated from the students’ fourth-year experience, which currently represents a large component of the overall clinical experience. Instead, other methods of evaluation were used to assess student competency, including student clinic attendance, completion of care, outcomes of care, student portfolios, and a series of seminars including literature review and case presentations that complement student clinical learning.