Medical research is being harmed by changes in science and in society. These changes are leading researchers away from the essential values of science. Essential, because without them, medical research becomes unreliable and future benefits are put at risk. Warwick Anderson uses his decades-long national and international experience in research funding leadership to propose far-reaching but concrete reforms to re-embed the values of science in medical research; how to value quality over quantity in research careers, professionalise research leadership, reward good scientific stewardship, and reduce the damage of hypercompetition on early careers. And why researchers must lead the changes.