Continuing medical education in the United States. An enterprise in transition

The nation's continuing medical education (CME) enterprise is undergoing profound change. Once a simple teacher-to-learner activity, CME has now grown into an immense undertaking that is increasingly complex and costly. Simultaneously, it has evoked reactions from certain critics who find fault with its premises, its methods, and its outcomes. But CME's age-old mission--to help practicing physicians maintain their competence in patient care--has not changed, and even today's unwieldy, perhaps flawed, enterprise has not strayed from that basic commitment. Moreover, CME is showing encouraging indications of a willingness to incorporate into its process sound principles of adult education. Even more encouraging are the signs that CME is beginning to make use of computer and other electronic technologies in ways that promise to mend some of its flaws and restore its historical learner-oriented focus.