Background The University of Sydney Medical School first enrolled students in 1883. Until recently, it admitted the majority of each class directly from secondary school into a five-or six-year curriculum. The traditional discipline-based programme progressed from basic science through the medical sciences with the students full-time in clinical studies only in the fourth year, after some very limited exposure to patients in the third year. Class sizes are over 200. The Faculty of Medicine is distributed widely geographically not only on the University'S main campus, but also in four clinical schools that incorporate six major and many minor and specialist teaching hospitals, up to 300 kilometres away.