For every physician that interprets ECGs, there is great need to understand a vast amount of information regarding the technique. That the basics of the technique have changed little over the last 100 years means that there is a huge amount of subtle detail that must be learnt to enable its effective use as a diagnostic test. The ECG technique is critical for deciding upon further diagnostic procedures and therapeutic interventions (notably coronary angiography, PTCA, stenting, coronary artery bypass grafting, pacemaker insertion, ablation, electroconversion etc). Without attaining the skills to practice the ECG procedure and knowledge of its diagnostic value - skills often overlooked during medical training - physicians will be unlikely to use it to the benefit of their patients.