This testimony focuses on the reauthorization of the health professions education programs authorized under titles VII and VIII of the Public Health Service Act. It argues that the effectiveness of these programs--which are designed to increase the number of health professionals, improve their distribution in locations that have a shortage of health professionals, and add minorities to their ranks--will remain difficult to measure as long as they are authorized to support a broad range of health care objectives without common goals, outcome measures, and reporting requirements. The testimony maintains that the implementation of the Government Performance and Results Act of 1993 and the "clustering" concept offer an opportunity to address these problems by providing the framework and flexibility to clarify the role of Title VII and VIII programs and direct federal efforts to achieve desired outcomes. It is concluded that unless these steps are taken with a clear eye to addressing the problems, these developments could meet with little success. (MDM)