Small group teaching, and problem-based learning (PBL) in particular, demands greater time from faculty than a lecture format, but rewards active learning for development of clinical reasoning skills. How can faculty time be used judiciously, and still retain a small group format? We instituted an integrative PBL model at the end of the 2nd year curriculum that combined faculty, subject material, quiz and examination items, as well as contact hours across 3 existing courses. Each course previously had its own small group sessions. Time was saved with fewer faculty development sessions, substitution of wrap-up sessions for small group hours, and by having students work on their own for a two hour session without faculty facilitators. There was a 56% reduction in faculty time required with the integrative format. Student adherence to goals of the sessions were enforced through required attendance, quizzes that covered the content of the sessions, randomly calling on students during wrap-up sessions to discuss the findings, and having each small group compose a summary of their findings for each session. The students were engaged, as reported by faculty facilitators, the faculty were enthusiastic, students called on in wrap-up session gave excellent responses, and ratings from student evaluations were equivalent to those of other small groups for the whole year. This integrative format had advantages through placement at the end of the 2nd year: this wasn’t the first PBL session of the year and students were familiar with the format, the knowledge base of students was considerable, and there was a core of faculty already assigned to small group teaching. Through integration, the small group size went down (7 to 8 students per group, instead of 8 to 10 in existing courses), and in the student-run session the student roles were sometimes different from those with faculty present – some students became more active participants. The major disadvantages of this format included coordinating schedules of faculty from multiple departments, providing multiple faculty review sessions given by development person because of irregular faculty schedules, and course directors other than the lead author made little attempt to familiarize themselves with wrap-up format.