This plenary presentation from the EACH International Conference on Communication in Healthcare in Oslo 2008, takes an honest look at the present state of communication teaching and considers how to take the next steps to move communication into the very centre of medical education. Although clinical communication teaching has become increasingly accepted as a formal component of the medical curriculum, there is still a problem to be faced. Communication still often appears in medical education to be a peripheral element rather than a mainstream activity truly perceived by schools and learners as central to all clinical interactions. This presentation explores why clinical communication often appears to be a minority sport in medical education, considers how to overcome this via integration throughout the curriculum, looks at five specific examples of integration in action, presents a new UK consensus statement which helps integrate communication into the mainstream, and finally explores the progression to maturity in communication curricula.