A survey of program directors in continuing medical education (CME) was conducted to determine the priorities and practices of the persons who develop CME programs. Respondents from community hospitals, medical schools, specialty societies, state medical societies, and other organizations thought that the most important issues related to the measurement of educational needs and outcomes. A high degree of congruence between program directors' ideal priorities and those they thought were actually being attained in their organizations was noted. Differences between groups of CME providers were infrequent, but medical schools were significantly more concerned than other groups about funding and accountability; community hospitals, about needs assessment and training for program directors; and specialty societies, about methods for adult learning. The majority of directors thought that CME credits, recertification, and relicensure (but not reexamination) should be mandatory.