Purpose: Medical education is an evidence-driven professional field that operates in an increasingly regulated environment as compared to other fields within universities. The purpose of this paper is to establish the extent to which Porter's five competitive forces framework (Porter, 2008) can drive the management of medical schools in Australia. Design/methodology/approach: Drawing on data from semi-structured interviews with over 20 staff from 6 case study Australian medical schools, this paper explores Australian medical education, by looking at the current policy context, structure and interactions between organizations within the system. Findings: The findings provide evidence that environmental forces affect the nature of competition in medical education, and that competitive advantage can be gained by medical schools from a sustained analysis of the industry in which they operate in. Consequently, it is possible to apply a pre-dominantly profit-oriented framework to higher education. Research limitations/implications: As an industry facing increasing pressure toward marketization and competition, the findings provide sufficient evidence that an analysis of higher education as an industry is possible. Practical implications: The findings provide evidence that strategic leadership and management in higher education should encompass greater levels of delegation and decision making at all levels. Effective leadership should focus on creating an inspiring vision of the future through a sustained analysis of the industry in which they operate. Originality/value: The study has made a key contribution through an industry analysis of Australian medical education, which provide important implications for leadership and management in higher education. The study is of significant value to researchers as well as senior management in higher education.