The past, present, and future of continuing medical education. Achievements and opportunities, computers and recertification.

Changes in continuing medical education (CME) during the past three decades have been controversial and complex. A 1950s-style, small-scale, voluntary activity has evolved, in 1987, into broad-scale programs with accredited sponsors and with ties to relicensure. Within the next three decades, CME will be directed by methods chosen by specialty boards for recertification and by exploitation of computer and telecommunication technology. Written recertification examinations can waste physicians' time studying material that will not improve care of their patients. We hope improved methods of analysis of individual practices, on-the-spot access to pertinent medical information, and better communication among physicians can be incorporated into recertification procedures. Policies established now will shape CME for decades to come. We encourage a coordinated effort by medical specialty boards, medical societies, hospitals, medical schools, computer corporations, telecommunication firms, granting agencies, and the National Library of Medicine to ensure the most effective and efficient recertification and CME policies.