In this edition of The NSW Doctor, we examine the mounting pressures facing NSW’s health system as the state heads towards the March 2027 election, from hospital capacity and workforce shortages to the need for stronger investment in prevention. We also explore the opportunities and risks of artificial intelligence in healthcare, hear from medical students about the challenges facing the next generation of doctors, and profile Dr Mackenzie Little as she balances a career in medicine with elite javelin. The edition also looks at cyber security, governance and the practical issues affecting doctors and medical practices across NSW.