Psychiatry today mirrors, and in many instances highlights, the dilemmas of medicine. Scientific and technical advances, often not shared by psychiatry, may have diverted attention from these difficulties, but they are there nonetheless. The various roles of the doctor, as clinical scientist, social agent and pastoral counsellor, are intermingled without clear demarcation being attempted or even thought necessary. Priorities appear to be determined by mysterious forces which it would take a Tolstoy to describe, but somehow the chronic sick usually end up last in the line. General practice has only relatively recently come to be recognized as a specialty in its own right, and medical students sometimes still complain of some degree of irrelevancy in what they are taught to what they will have to be doing. It has been said that one of the most important things for them to learn is to have the right attitudes, but apart from agreement that they should have a respect for scientific method there is no clear consensus as to what these attitudes should be.