Sir,Bhattacharya has created an excellent guide on how to get the best value for money out of conference attendance.[1] The article is particularly timely as individuals and funders seek to ensure that money on medical education is money well spent. The article is also reflective of a growing interest in cost and value in medical education more broadly. Any cost-value analysis is fundamentally dependent on two components — first a comprehensive account of the costs and second a comprehensive account of benefits or utility accrued.[2] Bhattacharya's account of the cost of conference attendance is comprehensive — apart from one component that is missing — that is the payment of locum fees that are often necessary.To change tack and to look at things from a completely different perspective, perhaps the fee could be picked up by someone else - thus rendering the attendance free of charge. A delegate's employer may pick up the fee as may a commercial sponsor. However, the commercial sponsor may want something in return and thus a free ticket may in the long run cause more problems than it solves. If an employer pays then, the employer will expect the attendance at the conference to result in an improvement in clinical care at the home institution - which is a perfectly reasonable expectation.In terms of benefits from attendance at conferences, some benefits as the author suggests are non-tangible and difficult to quantify. However, some benefits are more explicit. Conference attendance might enable a delegate to learn how to shorten patients’ length of stay for certain procedures. This will result in real cost savings for the home institution. Conference attendance may enable a delegate to learn how prevent adverse events, and preventing such adverse events may once again result in a tangible monetary saving to the institution. When these things do occur, it is certainly worth reporting them back to the institution. The institution in question will them realise the benefits of sending its doctors to conferences.Finally and importantly conference delegates should think not only about the monetary cost of attendance, but also the cost in terms of climate change. Reducing carbon footprint is vital, and healthcare professionals undoubtedly have role to play in this regard also.