During the past decade a number of detailed research and discussion papers have been released dealing with the Australian medical workforce. Reports on workforce participation and training have been prepared by bodies such as the Australian Medical Workforce Advisory Committee (AMWAC), the Australian Institute of Health and Welfare (AIHW) and the Medical Training Review Panel (MTRP). These studies have identified emerging trends in the composition of the workforce and highlighted the apparent growing divergence between the aspirations and expectations of young doctors entering the workforce and present training and workplace practices. The purpose of this discussion paper is to canvass the more significant issues affecting the medical workforce, their impact on training and workplace flexibility and the scope for driving positive changes that reflect the needs of the new medical workforce.