“If a clod bee washed away by the Sea, Europe is the lesse” [^[1]]

One never stops learning! Reflecting on these uncertain political times, I thought John Donne’s poem “No man is an island” might appropriately head this editorial; only to discover it was originally a a meditation not a poem![1] ‘No man is an iland, intire of it selfe; every man is a peece of the Continent, a part of the maine; if a clod bee washed away by the Sea, Europe is the lesse,..’[1]

As 2019 opens, my personal meditation (although in less fine language) would be that, more than ever, this journal must work with the World Organisation of Family Medicine Doctors (WONCA) to ensure we unite as clinical educators globally. Only together can we champion the crucial medical education changes needed to produce an appropriate workforce for 21^st century health care. The resistance to change at times seems formidable. Was a colleague from Pakistan exaggerating when she talked of the challenge of overcoming the ‘tyranny of secondary care’? One thing is certain, despite current politics, we must strengthen our links with Europe if we are to succeed in raising the status of primary care education.

And there is so much to learn from each other. I was delighted that Jo Buchanan, President of the European Academy of Teachers in General Practice/Family Medicine (EURACT), and Jan Degryse, Chair of the 2018 EURACT conference in Leuven [2], agreed to write a guest editorial to open our 30^th issue. As a collaboration of 38 European organisations they argue the need to breakdown the secondary/primary care traditions of medical education. Why not empower family medicine trainees on secondary care attachments to teach their hospital colleagues about community care? It’s not a one-way learning street. Why are the Dutch recruiting well to general practice: do their strong University academic links attract graduates? As UK academic general practitioner trainees recently wrote to us, raising the visibility of academic general practice is a key priority to harness interest and curiosity and grow recruitment [2]. The Dutch understand this.

This issue offers much to stimulate educational interest and curiosity. Hilary Neve explains the application of threshold concepts, fundamental ideas which are ‘transformative, integrative, irreversible and usually troublesome’ but extraordinarily helpful in enabling trainees to resolve the uncertainties of primary care. Chris Harrison challenges the UK Royal College of General Practitioners to move their membership processes to more formative assessment; this seems to work in Denmark! Explore for yourself the range of articles including entrustable professional activities (Netherlands), appraisal (Scotland), faculty development in low and middle-income countries (Canada) and legitimate peripheral participation theory applied to community placements (New Zealand). So much to learn from each other! I rest my case.

As we look forward to our 30^th year we thank all our reviewers and authors for their contributions last year and look forward to working and hearing from you in 2019. John Donne’s meditation of 1624 remains as poignant as ever: ‘Every man is a peece of the Continent, a part of the maine.’ Without you the evidence base for Primary Care Education cannot move forward. We must not let political erosion lessen our collaboration with Europe and the world even ‘if a clod bee washed away by the Sea!’