Selection in medical education is a vastly under-researched topic, and there exist many uncharted territories for further exploration. Fiona Patterson and Eamonn Ferguson consider what is unique to selection in medicine emphasising the central role of job analysis studies and continual evaluation, to inform selection system design. A wide variety of key concepts that underpin robust selection systems are introduced alongside a description of the current state of selection processes - in both undergraduate and postgraduate medical education - around the world. Recommendations for best practice are made together with suggestions for a future research agenda.