Evidence and instinct indicate that identifying problems early should allow for effective pastoral help, and when necessary a remedial study plan Ideally,each student should see a trained pastoral tutor regularly, who would get to know individual students well and detect and resolve pastoral and academic problems. Resources, however, are always restricted, and the Royal Free and University College Medical School (RFUCMS) in London has 2,400 students in its care. We try to treat all our students as individuals, but with such large numbers each year, it is a constant battle to stop them feeling more like bar code numbers than people.