Unique in the history of academic medicine in the 20th century was the 1993 merger of two medical schools, Hahnemann University and The Medical College of Pennsylvania, to create Allegheny University of the Health Sciences, the largest private medical school in the United States. During the early, most critical phase of the merger process, the two faculties were brought together to plan and submit an application for The Robert Wood Johnson Foundation's Generalist Physician Initiative (GPI). This action had a profound and lasting impact on the merger of the two schools and the educational enterprise that subsequently evolved. The GPI grant was awarded to the merged school in the midst of this complex merger rife with major changes, all with their attendant fears and frustrations. During and just after the merger, at a time when faculty and staff were somewhat uncertain about the direction of the university, the GPI provided a focus with a clear set of goals and objectives. Despite the unprecedented changes occurring in the organization and personal and professional concerns, faculties from the two institutions were able to join in pursuing the generalist initiative and its associated curriculum reform. This single, pervasive effort was a significant factor in forming a unified faculty of a united school of medicine. This sense of unity was put to the test when, in July 1998 the university, along with its affiliated hospital system, filed for bankruptcy. The goals of this extraordinary action were to sell the hospitals to another organization, thereby removing from the university the burden of supporting hospital-based clinical programs and allowing the university to emerge as a freestanding academic institution focusing on its core mission of education and the principles embodied in the GPI.