To the Editor.
—The excellent article by Drs Manning and Petit1 about continuing medical education fails to address two important and salient problems that postgraduate education needs to attend to.First, for those who attended undergraduate and medical school in the precomputer age, achieving computer literacy is an expensive and time-consuming problem. Second is the challenge of achieving proficiency and technical finesse in newly developed procedures. Some examples that come to mind are intraocular lens implantation in ophthalmology, coronary angiography and angioplasty in cardiology, and the use of lasers in a variety of medical disciplines.Didactic courses provide only the base on which to build, analogous to the preclinical years at medical school. Methods must be devised whereby practitioners, in a structured manner and preferably at established teaching hospitals, can obtain hands-on experience in new procedures under the guidance of practiced physicians. Not only is this important for licensing,