The programme in the Medical School at McMaster University inaugurated in 1969, represents radical innovations in medical education. However, misconceptions in regard to its educational philosophy and practice do exist. While new medical schools and those in planning stages have drawn in varying degrees on the experiences that McMaster has accumulated, nevertheless, educational divergences of significance have arisen.In order to improve perspectives on the important concepts in McMaster educational philosophy in medicine, a brief historical survey of medical education down to present times has been examined and some of its undesirable features identified. This is followed by a description and discussion of the programme at McMaster University, where problem based learning in small group tutorials predominates the programme. Advantages and disadvantages are recognised and the ability of the programme to respond to future developments in health education and care is identified among its major strengths.