Background . The burden of HIV and tuberculosis epidemics in South Africa (SA), Africa and developing countries in other parts of the world has an influence on the change in case mix. Shortages of beds in training hospitals and the need to train more healthcare professionals contribute to the saturation of the teaching platform. Clinical simulation as a tool to enhance the education and training of medical students in SA and recommendations in this regard were investigated. Objective . To obtain recommendations regarding the development of simulation training, assessment facilities and programmes, and determine whether simulation training could enhance medical education and training in the developing world. Methods . Qualitative research methods, including semi-structured interviews with international simulation experts and focus group interviews with heads of department and lecturers of the local medical school, were used to generate data. Results . A set of recommendations regarding the introduction of simulation training at an SA medical school was developed to improve patient safety, create a better training environment, and address the healthcare education challenges in SA hospitals. Conclusion . The incorporation of simulation into medical curricula and the development of clinical simulation training facilities for healthcare professionals in SA could bridge the gap currently experienced in health sciences education in the country. The recommendations outlined in our study may assist other medical training institutions in the developing world in setting up simulation training facilities.