In the education of today’s healthcare professionals, we are faced with the need for change in response to different patient demands, requirement for greater accountability, developments in healthcare delivery systems, and advances in medicine. Action is especially important for new developments in curriculum development, teaching, learning and assessment of students’ competence. It has been strongly argued that there is a need for transformative change in how we educate our doctors. These increasing demands on teachers come at a time of financial constraints and uncertainty as to future directions. I have previously argued that sclerotic bureaucracy, territorial warfare, incompetence and ignorance about the process have been enemies of change in education, and advocated that ‘we need to build windmills not walls.’ Effective leadership is essential if the obstacles to change are to be overcome, otherwise good ideas for change in medical education may stagnate in a curriculum bureaucracy. What is seen as a disruptive innovation may at best be given only passing attention and at worst ignored. As teachers, we should be the change makers and not simply the recipients of change. We should not be isolated from change but should be part of it and, indeed, the leaders.