Abstract
Specialist education and continuing professional development are likely to change considerably over the next 20 years. This will reflect the context within which medicine is practised. This will include changes in disease patterns, population structure, medical advances, information technology and, perhaps most powerfully, public involvement. In speciality education there will be a need to define more clearly both the role of the specialist, and the competences to be achieved. CPD is the longest period of education and, as such, it is the phase during which there is likely to be greatest change in clinical practice. There is a need to develop mechanisms to assure the public that doctors continue to practice up-to-date medicine, and that there is confidence and trust in the process.