In response to the latest recommendations on undergraduate medical education from the General Medical Council and other pressures and opportunities for change, innovation in United Kingdom medical schools is flourishing. This report arises out of a conference held at the King's Fund Centre in November 1993 to highlight key issues in innovation in learning and assessment through the presentation and discussion of case studies and the sharing of ideas and experiences. The emphasis is on new developments in relation to self-directed learning and skills development, alternatives to traditional clinical teaching, computer assisted learning and the assessment of competence.