The article reviews the educational foundations of the 20-year-old air medical transport industry, which are' based primarily upon models from ground-based emergency medical services, in-hospital practice standards, and military training manuals rather than research specific to civilian air medical transport. To draft a training and continuing education plan, program directors must consider cost, the available labor pool, the intended mission profile, the level of support offered by those with budgetary oversight, and the availability of local training resources. Although mandating a single, industrywide level of practice does not appear to be appropriate, air medical operations should provide their transport teams with a standardized curriculum in air physiology and a workload sufficient to maintain vital skills. The organization should also provide regular communication of its mission statement, clear demarcation of lines of authority to ensure team confidence in decision making, and regular training in air medical safety practices. The air medical transport industry must face questions regarding the validity of practice standards and questions about cost effectiveness by embracing accepted methods of research and data gathering. Such methods will greatly influence the nature of the industry in an environment of change.