This article describes how three universities approach middle level teacher preparation through partnerships and clinical experiences. The authors share the structures of their programs and the role of their partnerships in the clinical preparation of their candidates. They also discuss the challenges and opportunities presented by school-university partnerships and discuss both the advantages and disadvantages of engaging in such work. Finally, they situate the implications of the National Council for the Accreditation of Teacher Education's (NCATE's) Blue Ribbon Panel Report in the historical and social context of middle level education and offer recommendations for others seeking to develop clinical experiences through school-university partnerships. (Contains 1 figure.)