The medical profession is ageing in parallel with the wider community, with more Australian doctors working into their 70s. This has implications for workforce planning and raises questions about competence. However, no Australian specialist college has policies relating to the special circumstances of ageing practitioners. Ageing practitioners are affected by a number of age-related sensory and neurocognitive changes, including a decline in processing speed, reduced problem-solving ability and fluid intelligence, impaired hearing and sight, and reduced manual dexterity. A policy of mandatory retirement is not consistent with the wide individual variations in cognitive ageing. However, there may be an age ceiling, which varies by medical specialty and individual. Studies show the older doctors in several specialties perform worse than their younger colleagues. Older doctors, many of whom are found to be cognitively impaired, are more likely to be reported to the authorities for poor performance. The wisdom and experience of older doctors is of great value. However, work adaptations may need to be considered. For intensivists, these could include part-time work towards retirement, reduced after-hours call and shift work, and reduced exposure to acute crisis intervention, with an increased focus on mentoring, teaching, administration and research.