In the past three decades, there has been a significant increase in the formal involvement of practicing clinicians at the most senior levels of government health policy making, and current proposals present an opportune juncture to reflect upon these experiences, to distil learning which may contribute to future opportunities being utilised effectively.

In light of this, we set out to analyse the institutional roles that clinicians have filled in national policy making over the last dozen years or so; to summarise what has been learned about the efficacy of these different roles. Taking the lessons from these experiences, we outline a number of ‘conditions of success’ which we suggest should be considered when further appointments are being made.