[Rational continuing medical education]

The goal of continuing medical education is to enhance quality and effectiveness of patient care and the health of the public. Everything helping to reach this goal is continuing education. Knowledge and principles needed to improve practice can only be acquired to a small extent by attending conventional lectures. Results of a survey, which are in good agreement with American studies show that literature and personal advice from colleagues are the most important sources for improving practice (35 resp 30%). With the introduction of electronic publishing and full text databases becoming available publications can be retrieved and downloaded anywhere and any time. Study groups for practice-based learning can prepare themselves for discussions of their problems or of simulated cases systematically provided by central organizations with experts using information technology. A pilot study showed great interest in the application of information technology: 80% of the responding colleagues showed interest in occasional or regular use of medical or non-medical full text database, preferably using their own computers. Competence depends on the kind and number of patients cared for. Physicians working for a long time in their specialty often concentrate on a restricted number of diseases. In order to keep up competence in the whole certified specialty, organizations issuing the certificates have to provide simulated cases exemplifying all aspects of their specialty. German medicine was the last to transfer clinical teaching from the ward to the lecture theatre compared to predecessors at Leiden, Edinburgh, Philadelphia and Paris. It is also the last still believing in its efficacy.(ABSTRACT TRUNCATED AT 250 WORDS)