This review is a summary of a presentation at the 2005 Intersociety Conference on training for the future of radiology. Certification by all 24 boards of the American Board of Medical Specialties, including the American Board of Radiology (ABR), has changed significantly. All primary and subspecialty certificates issued by the ABR are currently limited to 10 years, and diplomates of the board must maintain their certification by completing the ABR's maintenance of certification (MOC) program. The program consists of 4 components (professional standing, lifelong learning and self-assessment, cognitive expertise, and practice performance) and 6 competencies (medical knowledge, patient care, interpersonal skill, professionalism, practice-based learning and self-improvement, and systems-based practice) that are the key elements to be incorporated within the concepts of continuous quality improvement. The result, over time, is intended to have a major impact in the quality of patient care in terms of outcomes and best practices. How adults learn in the environment of expanding knowledge and the electronic distribution of content is a substantive question requiring research, data, and change. We must seize the opportunity to explore adult learning and the process of MOC. Time-limited certification and MOC can become catalysts for future training requirements, for the design of training pathways, and for certification methodologies. Shaping the future is a noble task requiring leadership, vision, patience throughout change, and creativity.