BACKGROUND:The NHS plan proposes up to 1000 general practitioners with a special interest (GPwSIs) by 2004.1,2 Following a meeting organised by the General Practice Airways Group (GPIAG) Williams et al, in their discussion document3 outlined the possible roles of a GPwSI, using respiratory medicine as a model. A GPIAG working party then met up with the representatives of the Royal College of General Practitioners (RCGP) and produced a draft working document which could give guidance to primary care organisations (PCO's) about the the possible role of a GPwSI in respiratory medicine together with the core competencies needed to fulfil such a role. This stated that the role of a GpwSI in respiratory medicine is primarily one of leadership and service development (i.e as a GP lead in respiratory medicine within a PCO). This is contrast to other specialities such as ENT or dermatology where the GPwSI has a predominantly clinical role. In addition the draft document envisaged that the "gold standard" qualification for a GPwSI would be a Diploma in Respiratory Medicine. The GPIAG draft document was modified after consultation with the British Thoracic Society, Royal College of Physicians, Royal College of Nursing, National Asthma Campaign, National Respiratory Training Centre and the Respiratory Education Training Centre and submitted to the RCGP. The resultant framework, published in this issue (pp38-41), is a chimera of a generic RCGP framework (for example, certain competencies such as negotiating skills will be common to all specialities) with the respiratory disease specific framework of the GPIAG draft document.