Medical oncology is the “canary in the coal mine” for the difficulties of being able to assure the community that the care they are receiving is safe and high quality, influenced by extraordinary changes in clinical demands. A specialist qualification is no longer sufficient to reassure the community that this is the case. Revalidation is the regulatory response to this problem and absolutely depends upon peer review to make judgements about the appropriateness of treatment decisions. This raises a series of questions. How do we know that our peers are practicing appropriately? What do we do if we have concerns? What mechanisms are there to monitor each others practice and protect each other from deviating from community standards? The RACP is leading the response of physicians to these questions and developing tools such as multisource feedback and regular practice review. The medical oncology community will need to identify the opportunities for peer review that are relevant to medical oncology practice. Multidisciplinary team meetings are part of the solution but are not sufficient. After hours on call, cover for annual leave and second opinions are natural opportunities, but some opportunities may need to be created, such as review of recorded care or protocol compliance. Developing tools for peer review is part of the solution but taking a collegial response to ensuring quality and protecting the community, and each other will require a change in culture and input from the medical oncology community.