AIM: To discover the attitudes to continuing medical education (CME) of the Wessex pathologists who participated in the Wessex CME pilot scheme and to identify their preferences and difficulties in pursuing CME activities. METHOD: The views of pathologists in the scheme were collected during a period of one year using workshops and discussions. A confidential, anonymous postal questionnaire based on these issues was sent to the 103 pathologists in Wessex who participated in the pilot scheme. RESULTS: A 64% response rate was obtained. The respondents identified lack of time and funded study leave as major barriers to CME and highlighted the gap between CME activity and its recognition and funding by employers. They wanted a wide variety of locally based CME activities to be recognised, and they valued local activities that linked theory with practice. They believed that the college scheme tended to favour academic activities over more practical and locally based ones. They found the paired peer review process time consuming but valuable for identifying their learning needs in some cases, but demonstrated that they have mixed preferences about the way they do their CME. CONCLUSIONS: The Wessex pathologists believe that CME is important and have positive attitudes to it. Their attitudes to CME echo the current literature about what makes CME effective. Unless individuals' preferences and difficulties are taken into account, CME programmes in which they participate are not likely to succeed.