The basic premises in development of continuing medical education (CME) program demand to provide an equal opportunity for a11 practitioners and to plan a valid instructional design to meet the characteristics of adult education. Of a variety of identified problems with regard to implementation of CME programs for practicing physicians in this country, the most serious one is that majority of the current programs have aimed only for large city-based physicians and no effort has been made for those who are geographically away from the educational resources or those who could not participate because of their personal inconvenience. Furthermore, an additional critic raised among the learners is that most of CME programs have been instructed in a form of teacher-based or lecture-oriented didactic teaching. This paper describes a problem-based, self-assessment format as a possible tool for CME program primarily for those who practice in the rural areas. The program is characterized by combination of (1) self-instructional system using mailed educational materials, and (2) self-assessment system under a strictly guided instruction. Appropriate need analysis is the prerequisite of the format and is followed by mailing of educationally well-designed resource materials (reading assignment, workbook, video-tape, audio-tape, etc) and quiz items to facilitate the participating physicians to study the related areas upon their interest, and by close follow-up with comprehensive feedback on the returned answer sheets. Emphasis is given to the computer-based personal filing that is an essential administrative procedure for analysis of performance progress. It should be also equipped with advantages of adult educational principles in learning and evaluation process. The detailed operational procedures are described and educational significance is discussed in each step.