Twenty-five years ago, when I finished my surgical training and obtained certification by the American Board of Surgery and the American Board of Colon and Rectal Surgery, I felt relief and told myself that my education was finally finished. How wrong I was! I do know surgeons who, although my contemporaries, quite literally "finished" their education after residency, and I can see how dramatically their practice of colon and rectal surgery differs from mine. Thus, I feel it is truly necessary that we continue to broaden our horizons through a lifetime of learning.

The American Board of Medical Specialties has only recently approved significant changes in the way its member boards provide certification and re-certification for physicians. One of the new concepts involves moving from re-certification to maintenance of certification. One of the four basic components of maintenance of certification or continuing competence is "evidence of commitment to lifelong learning and involvement in a periodic self-assessment process." It is ironic that so many years earlier, in 1982, Bert Portin I entitled his presidential address to this society" "self-assessment and self-education." It is also no accident that most institutions of higher learning refer to their graduation exercises not as completions but as "commencements," thus reflecting the beginning of a lifetime of learning.

The need for lifelong learning is particularly evident in medicine. During the past 25 years the changes in colon and rectal surgery have been quite dramatic. I will mention but a few of the innovations that I have had to adopt to stay current in the practice of our specialty.