A survey was undertaken of the medical directors of National Health Service trusts in the South Thames Regional Health Authority of the United Kingdom. The purpose of the survey was to ascertain medical directors' views regarding the importance of various areas of administrative practice, their preparedness in these areas of administrative knowledge prior to taking up their roles as medical directors, and their views as to the body of knowledge required for future medical directors. The study was compared with a similar study undertaken in the United States. While there were many areas of agreement between the English and the American medical administrators, there were also areas of significant differences of opinion. The need to develop a recognized training program in medical administration is acknowledged.