A choice between self directed learning and sitting in lectures struggling to stay awake

The postgraduate education allowance for general practitioners in the UK was introduced in 1990, amidst the turmoil of the “contract row” between the secretary of state for health and general practitioners. It makes up just under 5% of general practitioner' intended net remuneration, replacing direct reimbursement of educational expenses under “section 63” with a payment to which conditions are attached. To qualify for the allowance, general practitioners must satisfy regulations of byzantine complexity, the essence of which is the requirement to attend 30 hours of approved continuing education in each of the previous five years.

Educational theory, supported by research and most people's experience, suggests that active learning—in small groups, using interactive computer packages, or even reading—is more likely to change clinical behaviour than sitting in large lecture theatres struggling to stay awake. But for many general practitioners, the allowance poses bureaucratic hoops …