Following the move of midwifery education into institutions of higher education (IHE), professional sources have voiced some concern over the apparent 'cultural conflict' between IHE and the midwives. In order to investigate this, a 1-day conference was convened for midwife teachers and external examiners in the south of England, during which data were collected from recorded discussions and interviews. The findings confirm the existence of conflict which polarized around two issues: first, the centrality of practice for midwives and the perceived undermining of that practice by the academically orientated IHE; and second, the somewhat ambiguous role of the external examiner. These findings are explained in terms of recent work on professionalization which suggests that professional knowledge can be legitimized where the emphasis is placed on the indeterminate elements of the work and where knowledge originates from abstractions and conceptualizations derived from working practice. Such a knowledge base would be rather more resistant to undermining by the deductive, rationalist approach employed by IHE academics. It is suggested that external examiners are best placed to represent practice based knowledge to IHE examiners.