Adverse exposure burden, NMR metabolomics, and risk of incident abdominal aortic aneurysm.

Lifelong learning (LLL) is widely recognised as a cornerstone of medical professionalism, enabling clinicians to adapt to rapidly evolving medical knowledge and practice. Beyond sustaining clinical competence, LLL is considered a marker of curriculum quality in postgraduate medical education (PGME) and a core value in speciality training. Its importance is underscored by the reality that in the fourth industrial revolution, powerful artificial intelligence (AI) systems still struggle with tasks that require adaptive reasoning and reflective growth, skills essential for safe and effective medical practice. Despite its prominence in policy and discourse, how LLL is intentionally taught during PGME is less well defined. While strategies such as problem-based learning, self-directed learning (SDL), and evidence-based medicine (EBM) are well documented to promote LLL in undergraduate literature, and continuing medical education (CME), continuing professional development (CPD), and maintenance of certification (MOC) programmes operationalise LLL in specialist practice, the specialist training period appears to receive less emphasis with regard to deliberate instruction in LLL. Possible reasons include the belief that undergraduate-acquired LLL skills endure, the perception that residency curricula leave little room beyond clinical and procedural requirements, and the assumption that LLL habits are developed naturally during training rather than through deliberate teaching. Existing research in PGME has focused mainly on defining and measuring LLL, rather than on developing educational strategies. Hojat et al. defined LLL as ‘self-initiated activities and information-seeking skills activated in individuals with sustained motivation to learn and the ability to recognise their own learning needs’. Conway reasons that definition is a critical step to ensure clarity in curriculum design, recognising the need for distinction between often conflated concepts such as self-regulated learning. Building on Hojat et al.’s definition, validated assessment tools such as the Jefferson Scale of Physician Lifelong Learning have been developed and compared for efficacy. These measures have been applied across the medical education continuum, revealing that registrars in training represent the most variable group in terms of LLL orientation. In fact, Ortwein et al. found that registrars place less value on LLL compared to specialists, which may contribute to registrars’ lack of readiness for independent practice. Robbrecht et al.’s qualitative exploration of medicine registrars and faculty found that registrars recognised the value of LLL, but they desired more ‘structure and guidance’.