  At the present time there is a lively debate within the nuclear community
concerning the relevance of quark degrees of freedom in understanding nuclear
structure. We outline the key issues and review the impressive progress made
recently within the framework of the quark-meson coupling model. In particular,
we explain in quite general terms how the modification of the internal
structure of hadrons in-medium leads naturally to three- and four-body forces,
or equivalently, to density dependent effective interactions.
