- Organized medicine both in Europe and the United States has with a unified voice called for a renewed sense of professionalism among physicians and for an emphasis on this set of attributes in undergraduate and postgraduate medical education. In the last decade both the American Board of Internal Medicine  and the Association of American Medical Colleges  have launched major initiatives promoting professionalism, and the Accreditation Council on Graduate Medical Education in the Unites States lists professional development as one of the major goals of residency education . These efforts have culminated in the European Federation of Internal Medicine, the American College of Physicians±American Society of Internal Medicine and the American Board of Internal Medicine working together to develop a Charter on Medical Professionalism  that seeks to better define these attributes and mandate physician responsibilities. To date, the charter has been accepted and endorsed by over 90 professional societies worldwide (including the Israel Society of Internal Medicine) . The charter is based on the overriding principles of primacy of patient welfare, patient autonomy and social justice . From these principles a specific set of professional obligations are derived. As Harold Sox has pointed out in an introduction to the charter, the principle of the primacy of patient welfare dates from ancient times and is intuitive to most physicians. In contrast, the principle of patient autonomy is a product of the past century and is the basis for much of modern western medical ethics. The almost universally accepted Helsinki code on human experimentation relies heavily on this principle. The obligation to pursue social justice is in a sense the most revolutionary of the principles and for many physicians will represent an expansion of their responsibilities toward their patients and society, since medical organizations have in the past often acted more in their self-interest than for societal benefit. The impetus for these efforts in the words of the charter's authors is the fact that ` the medical profession is confronted by an explosion of technology, changing market forces, problems in health care delivery, bioterrorism and globalization. As a result, physicians find it increasingly difficult to meet their responsibilities to patients and society'' .