As the continuing medical education (CME) enterprise evolved over the last half century, a variety of rules, national and state regulations, and reporting requirements developed, with a resultant substantial variation in what is required of a physician. That CME needs fundamental reform is not news to those who read the literature. Yet many of the physicians who are served by the current CME system are comfortable with it. Following an initial report of the Council of Medical Specialty Societies, representatives of major stakeholders in CME met voluntarily over 3 years to explore, agree on, and finally propose changes to the present CME system. Their belief in the need for change and their recommendations achieved a collegial outcome; fundamental systemwide changes must occur in CME. This involves educational methods and physician performance, particularly in self-assessment. It also involves the leadership of organized medicine in accreditation, certification, credentialing, licensure, and credit recording, reporting, and funding. The multiple parties involved who control various aspects of CME agreed to focus on the physician end user and to create a revised CME system that would allow simplified and identical reporting of the CME experience and credits for individual physicians. The system also would offer a simplified and more rational approach to credit. Recommendations and action plans to accomplish the objectives were agreed on and have been assigned to organizations according to commitment and relevant historical interest.