Most learning in accident and emergency (A&E) occurs during normal work. It is a rare week that I do not see a condition I have never seen before and every follow up, whether it be a patient returning to the clinic or visiting a patient in the intensive care unit or postmortem room, is a learning opportunity. Referrals to colleagues and chance discussions about patients over lunch are often educational, as are regular meetings with radiologists and intensivists. For those who do them, even medicolegal reports may help to clarify ideas on prognosis (and psychology). However, doctors and other professional people should not just learn by osmosis, but have a responsibility to devote time specifically to education and development. The responsibility for a junior doctor's postgraduate medical education is shared with their educational supervisor and programme director but for doctors in career posts, including consultants, associate specialists, staff grade doctors and permanent locums, the responsibility for continuing medical education (CME) is a personal one.

This concept of CME is not new as most doctors have always sought to improve their knowledge and skills throughout their career. Their reasons may have been a recognition of their own shortcomings; as preparation for a new job or just as an intellectual challenge but in the past the decision on whether to do CME, how much to do and what to learn has been left largely to the individual practitioner. However, the importance of CME has been emphasised in recent years and other groups including the government, employers, purchasers, insurers, and patients all want confirmation that a doctor is up to date. Keeping up to date is now accepted as a personal and lifelong professional obligation of all doctors.^1,2

All doctors, including those in non-consultant posts, have responsibilities over and above the …