TWO DECADES HAVE PASSED SINCE THE 1992 PUBLICAtion of the JAMA article that posited evidencebased medicine (EBM) as a new method of teaching the practice of medicine. During this period, EBM has been accepted by many national and international bodies as a standard for accreditation of undergraduate and postgraduate medical education. However, incorporation of EBM into the teaching and practice of medicine has not achieved universal success. Residency programs in most resource-rich countries have attempted to incorporate EBM in their teaching. In the United States, the Accreditation Council for Graduate Medical Education mandates the teaching of EBM, through the core competency of “practice-based learning and improvement.” Despite the mandate and availability of adequate resources, the teaching of EBM faces many challenges. These include inadequate and unprotected instructional time, lack of awareness of EBM resources, lack of trained and motivated faculty, and insufficient funding. Having a faculty EBM champion in a department is an asset for effective implementation of EBM teaching in residency, but such trained, motivated, and confident faculty are not available in all places. Thus, there is lack of uniformity in the extent and depth of EBM training across various residency programs. To overcome this problem, the European Union–EBM Unity Project has developed a clinically integrated course for teaching the trainers of EBM who supervise postgraduate medical training. The course seems to meet the criteria for a successful continuing professional development course, but its effectiveness is uncertain. Despite limitations, teaching EBM in developed countries is characterized by established national and institutional recognition, continuous improvement, and steady progress. In contrast, the feasibility of teaching EBM in resource-limited settings is unclear. However, EBM is at least equally and arguably more relevant for low-middle– income countries, because this knowledge empowers health care practitioners to recognize valid and clinically important evidence relevant to their practice. Practitioners in resource-limited countries may accept without question the research results emerging from resource-rich countries. This puts clinicians in these countries at risk of prescribing drugs that may not be effective for the patients under their care, most of whom may be poor and uninsured. At the same time, under the burdens of large patient loads and lack of resources, the practitioners are at substantial risk of being out of date and providing poor quality of care. Evidence-based medicine has an important educational role to play in ameliorating this situation. The EBM process is a method of lifelong learning and problem solving. Training current and future practitioners in EBM can help them to remain up to date and provide effective protection against misleading medical literature and misconceived marketing pressures. Ability to analyze the quality of evidence and to correctly conceptualize the benefit-risk and benefitcost ratio of a health care intervention can empower clinicians to optimize value for money for their patients. Practitioners, residents, and students, equipped with the knowledge and skills of critical appraisal, can form independent views based on validity and on generalizability of research results from other countries. Feasibility of EBM teaching in resource-limited countries poses major challenges. These include lack of educational resources, language barriers, unreliable Internet connections, inequity in accessing evidence, lack of a supportive environment, and inadequately trained faculty. Although 240 members from resource-limited countries were trained in EBM knowledge and skills under the International Clinical Epidemiology Network program funded by the Rockefeller foundation, this relatively limited number of faculty cannot meet the needs of more than 1200 medical schools in these countries. Innovation is required to deal with the shortage of EBMtrained faculty. One innovation is e-learning, in which learning modules are presented as videos and exercises are computer based. Combining this approach with appropriate e-resources makes it suitable for integration with clinical practice. E-learning appears promising, but consistent with the principles that EBM espouses, any innovation in EBM teaching and learning should be adopted only if its testing