SUMMARYAs a result of the policy of apartheid, the University of Cape Town Medical School was prevented from admitting black African students by the South African Government until 1986. A further feature of this policy was to impose an inferior primary and secondary school education on African pupils, so that, in general, African school‐leavers are underprepared for tertiary education. Admission to medical school is highly competitive and African school‐leavers are unable to compete effectively with their counterparts from the other racial groups. Therefore, from 1986 to 1990 inclusive, an affirmative action admissions policy was followed that allowed the most successful African matriculants, whether competitive or not, to enter the Medical School and follow the regular course of study. This process failed in that an inadequate number of students gained admission to the MBChB programme and their academic progress was unsatisfactory. Since 1991, an affirmative action policy incorporating both academic support and mentor programmes has been followed by the Faculty of Medicine. This system has led to a substantial increase in the number of African students entering the first year of study and it is planned that up to 40% of all matriculants entering the MBChB programme in 1995 will be via this system. The academic load is reduced, and the results the students obtain at university have markedly improved, with 86% of students achieving the academic goals that they are set. The comparison between these two systems emphasizes the need to provide both academic and social support as well as flexibility in the curriculum if an affirmative action policy is to succ