Ronald Harden, in a conversation with Lawrence Sherman, challenges current practices in medical education. He argues that decisions are too often taken in the absence of evidence, such as the use of National Licensing Exams and graduate entry to medical school. In other situations where evidence is available it is not acted upon, such as the continuing use of MCQs despite the fact that VSAQs have been shown to be more reliable and valid. He also questions the length of medical training, and recommends how it could be dramatically shortened.