Special Alliance Edition Look for us at the Jan. 21-24 meeting of the Alliance for Continuing Education in the Health Professions in Orlando. In particular, Dr. Dennis Wentz will be at the NCCME booth in the Exhibit Hall autographing copies of his landmark book, Continuing Medical Education: Looking Back, Planning Ahead. If you miss him there and want to order a copy at the conference discount of 30%, call 800 421-1561 and provide Code 124.-- Dennis, Lew and Barbara
That's the question facing academic medical centers now in the US -- and it will be a question for medical schools elsewhere in the world, if it isn't already.
Step One has been in place for many years: Educating medical students for roles in patient care in primary care and specialties.
Step Two has also been the responsibility of faculties: Educating residents in the specific knowledge and skills of a specialty.
Step Three has been practiced by some medical schools and not by others: Providing continuing medical education courses to practicing physicians.
Step Four will require new knowledge and skills by faculty: Ability to teach medical students, residents and practicing physicians in the use of technology and in the links between education and patient outcome improvement.
The editor of the journal Academic Medicine posed this question for 2011: What improvements in medical education will lead to better health for individuals and populations? We summarize two responses here.
Dr. Todd Dorman (pictured) of the Office for CME, Johns Hopkins, and Dr. Bonnie Miller of Vanderbilt proposed "a radically transformed CME system", focusing on precise areas of need and measured by "improved performance and meaningful patient outcomes". CME must sit at the "intersection of lifelong learning, knowledge integration, health information technology and performance improvement," they say, committed to "the creation of a health care system that produces continually improving outcomes for patients and populations."
Dr. Robert Morrow of Albert Einstein College of Medicine and Dr. John Haughton of Covisint, Raleigh NC, tackle the question: Is CME the task of the academic health center (AHC)? Their answer is Yes. "No other organization's collective expertise in education and in the dissemination of new ideas can compare," they say. The challenge is great, however. "AHCs have few faculty ready to train students, residents and other physicians in quality improvement, population based equitable care, cost sensitivity, team-based medicine and meaningful use of health information technology." Faculty need "training in the new and evolving realty of care delivery and networked learning systems."
Sounds easy to meet the expectations of these authors? Not at all. Medical schools will need to call on the expertise available in other departments of the university to pull together a curriculum and faculty to educate the educators. Outside North America, medical schools will begin to listen to the call from the World Federation for Medical Education to take the leadership in lifelong learning, collaborating with medical societies to reach out to their graduates in practice not only with content but also with methodology for improving care. That is our fervent hope.
Building on the success of the November 2010 "1st China International CME Conference", the organizers have announced a followup conference in Beijing March 23-25. Speakers are being invited from the Alliance for Continuing Education in the Health Professions (ACEHP), the World Federation for Medical Education (WFME) and representatives of medical education institutions and government offices of China's ministries of health, education and human resources.
Topics will include:
Domestic and global development of CME/CPD
Innovative models of CME/CPD
Strategy development in response to professional needs
Application of modern pedagogy technology in CME/CPD
Interested persons are invited to submit an article to the Journal of China Continuing Medical Education, which may also be presented as a speech, poster or abstract, based on evaluation by a Conference committee. Send to chinesecme@163.com, with name, title, employer, contact information of first or corresponding author.
Mr. Wei Hai ming, chairman of the conference, and Ms. Wang Xiao yan, of the secretary general of the organizing committee, will attend the ACEHP conference Jan. 21-24 in Orlando FL. Look for them and offer a greeting!
Pfizer's medical education grants department in the US has laid down tough new guidelines for supporting certified CME:
Track 1 will be driven by Requests for Proposals (RFPs) focused on a limited group of clinical areas.
Track 2 will fund unsolicited requests for live US national and regional meetings at which new data is being presented.
What does this mean for CME providers? First, to be eligible for a grant for Track 1, there must be evidence of real solutions to real needs -- and an external review board, not Pfizer grant managers, will decide on the RFPs. Second, for Track 2, Pfizer will no longer accept unsolicited requests to fund enduring or online activities.
While some CME providers believe there is a leveling off in funding from commercial support, others see the downward trend continuing. Estimates are that Pfizer will invest 50% or less in CME grants in 2012 than in 2011, perhaps in the range of $25-30 million -- and a far cry from levels in 2007-9. Other companies are already down in that range, and several have already switched to the RFP approach. The search for alternate funding is on in earnest.
A collaborative partnership of European CME providers, the Good CME Practice (gCMEp) Group, has issued a challenge to the European Union of Medical Specialists (UEMS) and the European Federation of the Pharmaceutical Industry (EFPIA): Come up with specific and compatible guidelines for funding CME activities without control over content by the pharma funder.
The group noted that the relevant codes of conduct and guidelines from the two organizations were sometimes in direct opposition to one another, "creating a significant conflict for those attempting to deliver CME that meets all relevant requirements". The open letter from the group to the two agencies continued:
"In the absence of explicit guidance from either the pharmaceutical regulatory bodies or the CME accreditation bodies, pharmaceutical companies often take the position that they are legally required to take formal steps to approve all content of CME meetings ... thus controlling content ... speakers, and stipulating how the finances are spent. [This] renders the event outside the ... UEMS requirements that CME events are free from any attempt by the supporter to influence the programme or content."
The group further encouraged clarifying the distinction between education and promotion, as has already been done in the US and Canada, and to ensure that CME is funded by a formal "hands-off" grant. In its appeal to UEMS and EFPIA, the group would like not only clear guidance but also "punitive measures" for cases of non-compliance.
1 The Alliance for Continuing Medical Education (ACME) has changed its name and mission to Alliance for Continuing Education for the Health Professions (ACEHP) to reflect the growing trend toward teamwork in patient care. "We are reaching out to pharmacy, nursing, physician assistants and other organizations to learn more about their learning needs", says outgoing president Dr. George Mejicano.
2 5 US surgeons brought an international surgical symposium on obstetrics and gynecology to counterparts in Vietnam with great success, and on the same visit watched as surgeons from other Southeast Asia nations learned techniques of minimally invasive thyroidectomy from an experienced Vietnamese surgeon. Truly an example of global CME.
3 CME providers in the international arena might be interested in the latest report that Japanese pharmaceutical companies are focusing on global expansion, particularly in the fields of oncology, central nervous system and immunology. Expansion into other Asian countries -- particularly China -- represent the largest area of growth, generally through partnering.
4 Following its drug scandals, the French government has issued three main decisions with an impact on CME/CPD to be implemented in 2012: a CME 0.6% tax on the turnover of the pharma industry to fund CME (about 150 million Euro per year), a sunshine act to disclose any payments to doctors, and a new CPD system, based on performance improvement, done with small groups of doctors. Look for an update in the next newsletter.
What a client says about WentzMiller
"WentzMiller's 2010 report on a Global Strategy for Support of Medical Education prepared for Pfizer has been a valuable resource in helping us frame our thinking relative to other commercial supporters, and the potential opportunities and challenges that exist around the globe." -- Maureen Doyle-Scharff, Senior Director, Pfizer Medical Education Group. We can help your organization too -- with strategic planning services, implementation and information about continuing health education around the world. Contact any of our 3 principals: Lew Miller, lew@wentzmiller.org; Dennis Wentz, dkwentz95@gmail.com; or Barbara Pritchard, BPritch887@aol.com.
