There has been a tremendous explosion of new scientific and technological knowledge. More than 1,500 new journal articles and 55 new clinical trials are entered in the National Library of Medicine database every day.4 Less than 1% of published clinical information is likely to be relevant to a particular patient’s care, but that 1% of new knowledge may be lifesaving. Identifying, accessing the required knowledge, and acquiring the necessary skills and care processes defined in that less than 1% of relevant development takes a focused, almost Herculean effort. There is a burgeoning technology, particularly in the field of cardiovascular medicine with its new diagnostic techniques and interventional

Inhibitors,research,lifescience,medical procedures, that requires new knowledge and technical skills. It has grown increasingly difficult, Inhibitors,research,lifescience,medical if not impossible, for any individual to keep abreast of all advances pertinent to his/her specialty. It has also recently been documented that a physician’s clinical skills decline over one’s career.5 This decline may be the result of a number of factors, including age-related cognition, the ability or even desire to learn new science and knowledge, dated care processes and transitions of care, and

even physician burnout. There are other occupations in which it is essential to maintain and continuously update professional competence Inhibitors,research,lifescience,medical as measured by knowledge, technical skills, and performance. In the airline industry, pilots are continually tested on their knowledge and technical skills using written examinations and flight simulators. Certainly, Inhibitors,research,lifescience,medical the public would not tolerate flying in a plane with a pilot who has not demonstrated continuous achievement of knowledge, technical skills, communication skills, and performance benchmarks to react competently to emergency check details situations. A similar or even higher standard should be set for physicians. The role of the physician is to manage a patient’s illness through the application of science and technology, without pretext Inhibitors,research,lifescience,medical of personal gain and in a compassionate manner that accounts

for the specific gender, social, ethnic, and emotional aspects of the patient. Clinical reasoning is required for proper application of science to individualized treatment decisions, based upon the compilation of historical clues, physical examination abnormalities, and laboratory results. Care of the patient also requires an understanding of the cognitive and Apitolisib psychological impact of illness, including individual needs, preferences, and values. Additionally, there is the expectation that the physician consider the impact of treatment decisions on society, taking into account the cost and appropriate utilization of resources.6 Communication with peers, other members of the health care team, patients, and families remains an essential part of being a competent physician.