The information explosion, the plethora of continuing medical education activities, the complexities and fragmentation of graduate and postgraduate training and the need for cost containment and faculty development all contributed to the decision to create an office of paediatric medical education (OPME) at the Children's Hospital National Medical Center. To plan and prepare strategies for this office, we surveyed all 150 moderate—to—large US paediatric programmes to elicit information about the educational organization of paediatric departments, including administration, staffing, funding, responsibilities, and level of involvement; and the current needs in paediatric medical education. The results suggest that there is a trend towards formalizing education in paediatrics. Thirty—eight per cent (33) of those responding reported OPMEs, with most (86 per cent) of the OPMEs evolving within the last decade and 50 per cent within the last five years. Respondents cited as a priority the need for better organization of medical education to improve the quality of teaching and learning and thus achieve higher quality and more cost—effective health care.