We believe that the debate on the impact of technology on modern medicine, recently enlivened by the rapid increase in both the demand for and the cost of‘high technology’medicine, will be enhanced by the publication of a series of authoritative papers on this topic. We invited the Presidents of the United Kingdom Royal Colleges of Medicine (or their nominees) each to contribute an article on the impact of technology in their own specialist fields. The first in the series is published in this issue. Two further articles will be published in the next issue of the Journal and others in subsequent issues.