High-profile attention has recently been given to the problem of surgical competence of a few cardiothoracic surgeons and to abuse of limited private practice by some full-time state-employed doctors. These issues raise questions about the adequacy of postgraduate training facilities, the rigor with which new specialists are evaluated before being allowed to enter practice, and the need for accountability on the part of those who take time off from full-time public service to work privately. In this editorial attention is drawn to the need for greater diligence and vigilance in overseeing and rectifying these aspects of professionalism.