A brief outline of the aims and structure of a medical psychology course, and subsequent responses to the course is described. The firm rooting of medical psychology as a relatively new discipline into a conservative and deeply entrenched medical system poses numerous obstacles. Several unresolved issues are highlighted. Differences in conceptions of human nature, health care delivery, professional responsibilities and rivalries are major problem areas. Fundamental changes in the approaches and goals of the psychologist in "marketing" their expertise is advocated. Positive moves involve a greater involvement in patient care, and vigorous collaborative research with the more enlightened medical practitioners.