The Fiftieth Annual Medical Symposium of the Medical Society of Papua New Guinea held in Goroka from 31 August to 3 September 2014 celebrated the success of the Medical Society and the Papua New Guinea Medical Journal. This paper was presented as an address at the meeting and praised the work of medical doctors, allied health staff, medical scientists and research staff engaged in the field and laboratory for their many achievements over these 50 years. It describes the major Papua New Guinean medical icons of kuru, pigbel and swollen belly syndrome and draws out lessons learned from them and the research that elucidated them. Other medical icons that are briefly described include neonatal tetanus, Burkitt lymphoma, standard treatment books, respiratory bacteriology, insecticide-treated bednets, pneumococcal polysaccharide vaccine, a blood-stage malaria vaccine, snakebite, conservative management of ruptured spleen, radial paralysis in leprosy, the response to BCG and the BCG leprosy trial, bottle-feeding legislation, betelnut chewing and oral cancer, hyperreactive malarious splenomegaly, genetic polymorphisms associated with malaria, subacute sclerosing panencephalitis, donovanosis, endemic goitre and endemic cretinism, lymphatic filariasis, adult asthma and sago haemolytic disease. Attention is also drawn to likely future challenges – from infectious diseases and their unpredictability, outbreaks of disease on a global scale, climate change, the difficulty of establishing effective community engagement in the pursuit of greater equity in health and well-being, and the need to ensure that the mineral wealth of the nation is used for everybody’s benefit. A Health Think-Tank is proposed as a means of developing innovative and efficient ways of improving the health of all Papua New Guineans.