“…Pioneering steps have already been taken by King's medical firm in the community,3 the Cambridge community based clinical course,4 and the preregistration house officer rotation in general practice organised by Lisson Grove Health Centre and St Mary's Hospital in London 5. This week's journal contains accounts of how the Cambridge approach provided Mandy Wharton with “a rich environment in which to anchor … teaching of disease, health, and clinical skills” (p 407)4 and how house officers in general practice gain insight into primary care services and receive substantially more teaching and clinical time than hospital colleagues (p 369) 6. If these initiatives are so satisfactory why is the move to community based learning of medicine so slow?…”