This chapter alludes to the recent, and dramatic, changes in medical education that appear to go against the values and characteristics of a university education. Recent turn of events require critical debate, as education and training for medicine at university are being questioned and potentially undermined by the development of medical apprenticeships, which are thus far limited to the UK, and by the advent of artificial intelligence. Following introductory comments concerning how changes to the medical curriculum and assessments and examinations have departed from past practice, the authors outline what the features of a university education should be and conclude that medical education has critically departed from this model. Questions are raised about who is responsible for this situation and how medical training might be arranged to be once more worthy of being labelled a ‘university education’. The points raised are wide-ranging and are deliberately provocative as debate has for too long been one-sided. Indeed, a practical synthesis can only emerge when thesis meets antithesis. In our view, change is inevitable, but change should occur in the context of what is appropriate for a university education and what best benefits patients. The issues raised have important implications for the esteem of the medical profession. Indeed, this has a considerable impact upon medical practitioners who play an important role in society and who are presently much appreciated by the public as being amongst its most learned members.