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Arch Intern Med. 1999;159:648.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

IT HAS long been clear that most physicians receive the majority of continuing medical education (CME) from peer-reviewed medical journals, which is in contrast to how they receive the bulk of their accredited and documented CME necessary for relicensing. Like almost all aspects of medicine at the end of the 20th century, CME is undergoing major changes, much in response to changes in other aspects of the practice of medicine.

Managed care organizations and changes in Medicare documentation requirements and reimbursement, imposed by the Health Care Financing Administration, have reduced the discretionary time of physicians to levels even lower than 5 years ago. At the same time, the continued rapid pace of medical innovation has made life-long learning even more essential for physicians.

If one were to believe the implicit message of for-profit purveyors of CME, the two primary criteria in choosing CME activities are location and leisure time activities. . . . [Full Text of this Article]

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