Medical schools and postgraduate training providers need to answer to governments, regulators, funders and the public in terms of whether what they are delivering is fit for purpose. “Fit for purpose” can be considered from a number of angles. Are we selecting the best applicants to successfully complete medical education and training? Are we producing the right doctors in terms of skills, knowledge and behaviours to meet the health needs of the communities they serve? And, are we delivering these outcomes not just to a high standard but in a fiscally responsible way given current financial challenges to the academic and healthcare institutions which deliver this education and training?