There have been persistent concerns over teacher pre-service education for decades. The basic model of university or college coursework plus practice teaching has been found wanting. Despite attempts to rectify this, beginning teachers in Australia rate themselves as not being well prepared when they begin full-time teaching. This article examines these concerns before offering an alternative. There are two aspects to this new model: a clinical approach to teacher pre-service education, coupled with new roles, practices and structures designed to overcome the so-called theory-practice gap and to enable implementation of clinical, interventionist practice. However, the adoption of a clinical approach to teacher education and teaching practice requires understanding, knowledge, commitment and support from education leaders if the cycle of teachers teaching as they were taught is to be broken. Educational leaders require a thorough grounding in instructional leadership for clinical teaching if real change towards evidence-based teaching practice is to occur.