BACKGROUND In contrast to Britain, there has been very little debate about the constitution of medical boards in Australia. While the policy of the British Medical Association is that there should be an elected medical majority on the General Medical Council, state medical boards in Australia are mostly or entirely appointed. Appointments are often made by the Minister for Health of the relevant state or territory. OBJECTIVE This article questions why medical representatives on medical boards in Australia are not elected to ensure they are representative of the profession. None of the medical boards in Australia have an absolute majority of elected members. Other than in the Australian Capital Territory (ACT), there are no elections whatsoever. In four of the states or territories all the members are either public servants or nominees of the Minister for Health. DISCUSSION The lack of elections to medical boards, and the potential for ministerial influence on the appointment of board members, are causes for concern.