Until recently the undergraduate medical course had remained largely unaltered for decades, having slowly and steadily evolved over centuries of medical learning. All that has had to change in the past decade as the structure of the traditional course came face to face with the strains of modern medicine. The explosion of scientific knowledge, the unstoppable advances in technology, the ever-developing complexity of clinical practice, and changing health-care provision have all added to the tremendous demands on tomorrow's doctors.

At the same time there has been a reaction against the soaring dominance of modern science over old-fashioned art in medicine, technical capability over wise restraint, and process over humanity. A growing concern (not necessarily justified) that preoccupation with the diagnostic and therapeutic potential of molecular biology will obscure the patient as a whole person, a person who so often simply does not feel well for relatively trivial and unscientific reasons, and probably only needs to be listened to and encouraged to take responsibility for his or her own health.