It has been recognized internationally that undergraduate medical education must adapt to changing needs, as illustrated by the Tomorrow's Doctors recommendations from the General Medical Council. This paper aims to relate contemporary educational theory to under-graduate medical educational requirements, specifically highlighting conditions (e.g. experiential learning) for: professional knowledge acquisition; critical thinking, problem-solving and clinical problem-solving; and lifelong professional learning. Furthermore, problem-based learning (PBL) is highlighted as potentially providing such conditions. There are lessons from contemporary educational theory for the reform of undergraduate medical education. These include valuing prior knowledge and experience; promoting learner responsibility through facilitating rather than directing learning; encouraging learners to test out and apply new knowledge, and using small-group work to foster explicitly the elusive skills of critical thinking and reflection. Contemporary educational theory contributes valuable insights, but cannot dictate the ultimate 'mix'; at best it provides some principles for reflective analysis of the learning experiences created for tomorrow's doctors.

Tensions are seen to lie in the varying interpretations of clinical decision making as art or science; the varying characterizations of the nature of skilled performance in the novice, the competent and the expert practitioner, and the varying reactions to the acceptability and usefulness of 'meta-' concepts in capturing the essence of professional practice. Habitual self-conscious monitoring of mental processes may be the key to the flexible transfer and application of knowledge and skills across the contexts, characterized by uncertainty and incomplete evidence, for which doctors must be prepared.

Background: While variations in medical practice are a norm and each patient poses a multitude of challenges, many clinicians are not comfortable in dealing with unexpected complex issues even though they may have enough knowledge as demonstrated by passing a number of tricky certifying (or exit)

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