Abstract
As Otago Medical School marks its 150th anniversary, this paper reflects on what it means to train doctors for both today and the decades ahead. It traces the school's evolution from its nineteenth-century foundations through key innovations in curriculum, clinical training and rural health, highlighting the ongoing balance between tradition and change. While early efforts mirrored global trends, Otago has grown into a leader in areas such as assessment, interprofessional education and Indigenous health. This paper explores future challenges including competency-based education, personalised learning and the integration of artificial intelligence, arguing that these developments must be grounded in enduring values: professionalism, teamwork and community engagement. The central task remains unchanged: to train doctors who are not only knowledgeable and skilled, but also compassionate and committed to those they serve.