In 1999, a faculty committee at Vanderbilt University School of Medicine reviewed the mission and goals of the school and determined that graduates should receive initial preparation to develop scholarly careers in medicine. The authors describe the design of a scholarly projects course, the Emphasis Program, which is required of all students in the first two years of medical school. Each student undertakes a mentored project in one of nine areas of scholarship related to medicine. Curricular time is devoted to the program during the first two academic years, and students also spend eight weeks working on their projects in the intervening summer. The program includes a core didactic curriculum on topics common to all areas of scholarly work, such as biostatistics and study design. Implemented with the entering class of 2004, 467 students had completed the program as of May 2010, and only two students have been unable to complete projects in the allotted time. The majority of graduating seniors reported that they felt this was a valuable aspect of their medical education. Whereas the program offers a broad spectrum of scholarship opportunities, most students have selected projects in more traditional areas, such as laboratory-based research and patient-oriented research. The authors describe early successes in meeting program goals as well as some of the ongoing challenges of administering a required but individualized program of this nature.