In the 1990s, academic leaders in internal medicine from the United States and Europe started a project to define medical professionalism. Their charter was published in the Annals of Internal Medicine and Lancet simultaneously in February 2002 . The first professional commitment the charter cites is a commitment to maintain lifelong professional competence, and not just for the individual physician; "...the profession as a whole must strive to see that all of its members are competent." This requirement for lifelong learning by physicians was stressed by William Osler in the early 1900s . Most state licensing bodies in the US arbitrarily mandate 40-60 hours of continuing medical education (CME) every year for renewing medical licenses. Doctors are not the only professionals required to demonstrate continuing competence. Lawyers, nurses, and most other professionals also have similar continuing education requirements.