In recent years, it has been widely recognised that modern doctors are not receiving the training they need to provide appropriate and effective palliative care. Deficiencies in care have been reported in several formal studies and, anecdotally, in many professional and popular lay publications. Doctors themselves have attested to their lack of confidence and competence in many aspects of palliative care. These problems cross national, cultural and religious boundaries, as evidenced by initiatives in many countries to correct the situation, which will be reviewed in this paper.