No to mandatory continuing medical education, yes to mandatory practice auditing and professional educational development.

The issue of mandatory continuing medical education (CME) is controversial. Traditional measures mandate only attendance, not learning, and have no measurable performance end points. There is no evidence that current approaches to CME, mandatory or voluntary, produce sustainable changes in physician practices or application of current knowledge. Ongoing educational development is an important value in a professional, and there is an ethical obligation to keep up to date. Mandating self-audit of the effect of individual learning on physician's practices and evaluation by the licensing authority are effective ways of ensuring the public are protected. The author recommends the use of a personal portfolio to document sources of learning, the effect of learning and the auditing of their applications on practice patterns and patient outcomes. A series of principles are proposed to govern its application.