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Teachers today are called on to have an ever expanding knowledge base and skills that support working within a multi-tiered system of supports, including Response to Intervention (MTSS/RtI). Yet, most teachers do not possess these skills. Current field-based professional development initiatives focus on the existing teacher corps. However, Pk-12 schools require an entering teacher corps that has acquired this knowledge and skills during their teacher preparation program. This article addresses the need for initial teacher preparation programs to prepare teacher candidates who graduate with this knowledge base and clinical skills, presents an overview of RtI domains of knowledge and practice that should guide pre-service preparation programs, and describes a teacher preparation program's efforts to accomplish this goal.