The author examines the role of the scientific elite as a distinctive and important factor in the development of domestic clinical medicine. The time frame in which this factor was influential is pinpointed – the first three-quarters of the 20th century (it follows that this time frame was the same as for clinical research schools). Three basic conditions for the emergence of the clinical elite are set out (a high standard of scientific and public life, the existence of large clinical schools, the realization by the state and society as a whole of the role of scientific elites).