1 CHAPTER 1 The history of change in the UK Sam J Leinster Medical education is widely regarded as a very conservative part of a conserv- ative profession but in the early 1990s change swept through UK medical schools. Medical school curricula, which had been relatively homogenous, became diverse in terms of teaching methods and content, although all are required to meet the learning outcomes set by the General Medical Council in Tomorrow’s Doctors. At the same time medical education began to develop as a distinct specialty with its own units and departments. Universities began to appoint professors of medical education, some of whom were clinicians while others were educationalists or psychologists. In parallel with these changes Government policy led to an increase of medical student numbers by 40%. Some of this increase was met by enlarging class sizes in existing medical courses; some was met by the creation of shortened graduate entry courses alongside the traditional courses in established medical schools; some was met by the creation of new medical schools. 1 For those involved there has been a perception of unprecedented rate and extent of change almost amounting to a revolution. Formal regulation of medical education in the UK began with the Medical Act of 1858 which established the General Council for Medical Education and Registration and gave it authority to determine what con- stituted adequate education for a registered medical practitioner. Prior to