It is now 30 years since the first consultants in accident and emergency medicine were appointed. The Faculty of Accident and Emergency Medicine celebrated its first decade in November 2003. We live in turbulent times with service pressures increasing while others outside our specialty (not fully understanding what we do) seek solutions for the provision of emergency care by looking outside the emergency department.

Perhaps now more than ever we need to take stock of our specialty. We need to define what knowledge, skills, and attributes we expect of all future consultants, so that a consistently high quality service can be assured within the boundaries we choose. By specifying what we do and don’t do, it becomes clear to both ourselves and others what should happen in emergency departments and therefore the resources that are needed and the training that is required.

By saying what we do, we define our specialty, our service, and our syllabus. This does not mean that we cannot develop our own interests and expertise but this would be in addition to the defined “core” activity that we think should be common to all UK A&E consultants. To get things right for the consultants of the future, we need to define what our core function will be in five to eight …