Recent upheavals within health care delivery, technological advances, and changing attitudes among consumers have challenged and changed health professions licensure. At the same time, traditional regulatory frameworks remain in place. Beginning with a comparison of California’s physician regulation with other states, we explore this tension between established regulatory systems and emerging reforms. Current trends in regulatory reform across the United States and in California include efforts to standardize practice requirements, expand scopes of practice for nonphysicians, and restructure boards. Because of these trends, medical educators will be expected to prepare physicians to practice under increased scrutiny and expectations of accountability; promote interdisciplinary education, training, and practice; and step up the efforts toward uniformity in medical education, training, and practice.