The first major intake of medical students who studied the new GCSE occurred in Autumn 1990. These students have experienced a range of student-centred educational approaches to learning, but medical education in the UK remains committed to teacher-centred approaches. This mismatch of expectations is discussed. An innovative course in medical sociology at the University of Sheffield is reported, which illustrates student-centred learning approaches including transferable activity-skills development and self-assessment profiling. An innovative approach to course evaluation is discussed.