INTRODUCTION Something is lost, as medical students move through their training. I have worked in medical education for the past seven years and have had the privilege of sitting on interview panels to assess entrants to medical school. The process is highly competitive with approximately 800 students interviewed for a possible 260 places each year. All have exemplary academic records. Most have impressive work experience, for example working in healthcare in a developing country, volunteering in a local hospice or working as a care assistant in a nursing home. They also show evidence of a range of artistic, literary, musical and dramatic skills. I was recently presented with a children’s book that a potential medical student had written and published. Overall, the students are bright, earnest, passionate and committed to a medical career. Many express an eloquent and clear understanding of empathy even though they are in their late teens. For those who are successful in gaining entry, the commitment and determination remain, yet I witness an erosion in the passion and enthusiasm that brought them to the study and practice of medicine, to the desire to care for and work with others. It may be described as a dulling that sets in almost imperceptibly. Is this a function of the way in which we train our students, the content and volume of the work that they have to digest, a coping mechanism, or something else?