There are training dilemmas which are characteristic of medical settings. Clinical psychology students interning in a hospital setting are unfamiliar with the hospital culture, and the demands of patient care require a practical active approach. Experiences with training clinical psychologists to consult with pediatricians are reviewed. Disparate training backgrounds and problematic models of collaboration are seen as barriers to learning effective consultation. To meet these potential obstacles, training approaches should stress observation of staff interaction, participation in viable consultation structures and intensive clinical training. With optimal supervision, psychologists at a variety of levels can be trained to consult successfully with pediatricians. (Author/BN)