The standard programme in the United Kingdom (UK) leading to the award of a medical degree (MB ChB) lasts for five years with shorter, four year “fast-track”, programmes available for graduate entry. Students may also elect to pursue a further year of study to gain an Intercalated Bachelor of Science (B.Sc) degree in Physiology or a related subject. In the UK medical curricula have been modified to meet the recommendations set out within the General Medical Council’s document Tomorrow’s Doctors (GMC 1993). The document called for medical schools to reduce the factual overload of their curricula and suggested that the traditional divide between the pre-clinical and clinical components was a significant factor in perpetuating the overload. The document did not define a national core curriculum but allowed each institution to develop its own syllabus and encouraged the incorporation of special study modules to allow students to explore their individual academic interests. The majority of medical schools developed a systems-based approach with teaching delivered by both biomedical scientists and clinicians throughout the programme whilst a small number have adopted problem based learning (PBL). Since 1997 there has been a 60% increase in the number of students entering UK medical schools without a corresponding increase in academic staff. This expansion has required the development of computer-marked assessment and greater utilisation of computer-aided learning (CAL). The assessment techniques include multiple-choice questions (MCQs), data interpretation questions (DIQs), short answers and extended matching questions (EMQs) with the examinations constructed using the blueprinting technique. In order to share good assessment practices, and develop a database of examination questions, several medical schools have collaborated to form the Universities Medical Assessments Partnership (UMAP). The majority of Physiology departments in the UK are based within the Universities and are primarily involved in research and teaching rather than provision of clinical services. The vast majority of physiology teaching staff are therefore basic scientists who are not medically qualified, although our “integrated” curriculum provides opportunities for collaborative teaching sessions that also involve clinical colleagues. The Bristol department is involved in teaching an annual intake of over 250 medical students (as well as dental, veterinary and physiological science students) and is quality assured by visitations of the Quality Assurance Agency for Higher Education and the General Medical Council. The increasing emphasis in the UK for achieving research targets and a demise in systems research has resulted in a decrease in the number of staff with the appropriate background for teaching systems Physiology. In response to these changes the department employs medical demonstrators, these are medical graduates with several years of clinical experience who join the department for six months to participate in systems teaching in practicals and tutorials.