There are various influences and obstacles when planning an educational curriculum. The imprint of globalisation on the landscape of Irish medicine highlights the importance of delivering a diverse curriculum with international dimensions so that knowledge and skills can transfer across borders. It is also clear that medical emigration has a negative impact on the delivery of services in Ireland and in maintaining a sustainable workforce. In addition, financial constraints will always play a role in the logistics of medical education and it is important that more cost effective virtual learning modules are incorporated into to the traditional classroom based approach. Further research is needed into career satisfaction within medicine. One needs to try to understand what motivates doctors to stay within the Irish medical system, so that a curriculum with retention of graduates in mind can be designed. If a culture of education, guidance and support is fostered in our universities and hospitals, there is hope that a strong, competent and resilient breed of doctors will emerge to serve future generations.