This article was migrated. The article was marked as recommended. The number of medical school places appears to be increasing faster than population growth in many parts of the world, with perhaps two main drivers. The first is the increasing population, in particular those with who are older and with chronic, complex health conditions. The second is globalisation and commercialisation of medical education, with growing numbers of fee-paying programs for applicants seeking careers in countries that offer the best career opportunities. Using Australia as an example, this paper suggests that while access to primary medical qualification programs is increasing, barriers to progress may have simply been moved to postgraduate employment and training opportunities, such that producing the workforce needed for a healthier population remains challenging.