There are two distinct types of school medicine practice. The more common is practiced in nonresidential elementary and secondary schools. This practice is a combination of pediatrics, emergency medicine, and public health. Large school districts usually employ a physician to direct the school health programs and oversee the nursing staff. Smaller districts rely on physicians in the community to provide these services as paid consultants or as unpaid volunteers. The second practice type is school medicine programs in residential schools—usually in colleges but in some elementary and secondary boarding schools. The basic problems are the same in both settings, but the physician’s responsibilities are greater in the residential settings.