Various selection methods for medical students include assessments from different examining boards or non-traditional qualifications. Attributes such as general mental ability, critical thinking, problem-solving, communication skills, empathy, psychological robustness, and integrity are commonly cited as required qualities for medical students. Aptitude tests like the BMAT, MSAT, and GAMSAT assess critical reasoning, problem-solving, and understanding of interpersonal issues and written communication. The Personal Qualities Assessment (PQA) tests verbal, numerical, and spatial reasoning, includes a personality inventory, and has an ethical reasoning paper. These tests aim to assess more than intellectual ability and evaluate non-cognitive characteristics in potential medical students. A defensible selection method must be reliable across successive applicant cohorts, test what it claims to test (construct validity), and predict the eventual performance of selected candidates. The PQA has been shown to distinguish candidates based on cognitive function and personality, independent of social class and schooling. While the test's reliability and validity are documented, its long-term predictive value as a doctor is still under investigation. The BMAT and MSAT have high face validity and allow differentiation between candidates without inflating A-level grades. Although experience in the UK, Australia, and New Zealand is positive, further validated data are needed to confirm these tests' long-term predictive value. No one is advocating the abandonment of A-levels in medical student selection. It is timely to develop and evaluate selection methods that may be useful adjuncts in a fair, transparent, and accountable selection process. Funding: None. Competing interests: SN is a member of the national working party of medical schools examining the role of aptitude testing in undergraduate medical student selection. Transformational leadership in clinical practice involves motivating staff to think and empower them to enhance patient care. A story illustrates how a nurse, acting as a leader, broke traditional hierarchies to prioritize patient wellbeing, leading to improved care. Transformational leadership, widely applied in business, needs to be encouraged in hospital practice.Various selection methods for medical students include assessments from different examining boards or non-traditional qualifications. Attributes such as general mental ability, critical thinking, problem-solving, communication skills, empathy, psychological robustness, and integrity are commonly cited as required qualities for medical students. Aptitude tests like the BMAT, MSAT, and GAMSAT assess critical reasoning, problem-solving, and understanding of interpersonal issues and written communication. The Personal Qualities Assessment (PQA) tests verbal, numerical, and spatial reasoning, includes a personality inventory, and has an ethical reasoning paper. These tests aim to assess more than intellectual ability and evaluate non-cognitive characteristics in potential medical students. A defensible selection method must be reliable across successive applicant cohorts, test what it claims to test (construct validity), and predict the eventual performance of selected candidates. The PQA has been shown to distinguish candidates based on cognitive function and personality, independent of social class and schooling. While the test's reliability and validity are documented, its long-term predictive value as a doctor is still under investigation. The BMAT and MSAT have high face validity and allow differentiation between candidates without inflating A-level grades. Although experience in the UK, Australia, and New Zealand is positive, further validated data are needed to confirm these tests' long-term predictive value. No one is advocating the abandonment of A-levels in medical student selection. It is timely to develop and evaluate selection methods that may be useful adjuncts in a fair, transparent, and accountable selection process. Funding: None. Competing interests: SN is a member of the national working party of medical schools examining the role of aptitude testing in undergraduate medical student selection. Transformational leadership in clinical practice involves motivating staff to think and empower them to enhance patient care. A story illustrates how a nurse, acting as a leader, broke traditional hierarchies to prioritize patient wellbeing, leading to improved care. Transformational leadership, widely applied in business, needs to be encouraged in hospital practice.