Modernising medical careers proposes the introduction of Basic Medical Training (BMT) programmes to replace senior house officer (SHO) rotations. The current pre-registration house officer year and a broad-based first SHO year will become Foundation Years 1 and 2. This will be followed by a programme with eight options. To become a physician would entail doing the Medical Programme (as distinct from surgical, general practice, etc), and at the end of this a Certificate of Completion of Training in general internal medicine could be awarded. Specialty training will follow sequentially. Advantages, disadvantages and uncertainties of this proposal are discussed.