Embarking on and sustaining of new educational strategies is a challenge for all educational institution, Of the thirteen established medical schools in Malaysia (1962-2004), only Universiti Sains Malaysia, International Medical University and Universiti Malaysia Sarawak adopted problem-based learning (PBL) as their curricular philosophy, from the start. The other ten schools have either introduced or are contemplating introducing elements of PBL into their curricula. Universiti Kebangsaan Malaysia attempted changing from a traditional to a PBL curriculum in the early 90's. However with a broad lack of enthusiasm for the approach, high retention of didactic teaching and the departure of key staff members there was a gradual drift back to the old traditional approach. Universiti Malaya, which has introduced elements of PBL into its synchronised organ system-based curriculum in 1999, is still working towards a more PBL-oriented curriculum. Universiti Putra Malaysia and International Islamic University Malaysia are attempting to introduce elements of PBL into their medical curricula. Three schools with pre-clinical programmes outside Malaysia (Melaka-Manipal Medical College, Perak College of Medicine and Penang Medical College) and two new medical schools (Universiti Malaysia Sabah and the Asian Institute of Medicine, Science and Technology) have not yet introduced PBL. Universiti Teknologi MARA, established in 2003, has implemented elements of PBL in its curriculum. The variants of PBL curriculum that will eventually emerge in the various medical schools in Malaysia will largely depend on the readiness of faculty to shift from the role of ”instructor of knowledge” to ”facilitator of learning” and to accept ”central” rather than ”departmental” control of the curriculum.