Council for Education in Pharmaceutical Medicine
16 February 2006

CONTINUING MEDICAL EDUCATION AND PROFESSIONAL DEVELOPMENT

Preamble

Continuing Medical Education (CME) programmes for physicians are progressively introduced in various countries over the world. Structured supervision of the CME activities of the practising physicians is following soon or is already operational.  As CME is essentially a national issue, CME programmes and supervision structures for pharmaceutical physicians should follow as closely as possible the local requirements set for other medical specialties. However, in order to keep some harmonisation into the system, the CEPM thought it to be useful to issue some recommendations to be followed as far as these are not in contradiction with local regulations and requirements. Local (legal) norms should always take precedence.

Introduction

Pharmaceutical physicians have a duty to keep their knowledge and skills up to date throughout their professional career in order to remain competent in the fulfilling of their multidisciplinary tasks.

Continuing Medical Education (CME) and Continuing Professional Development (CPD) in Pharmaceutical Medicine are continuing learning processes that help physicians practicing pharmaceutical medicine to keep up to date with the scientific advances in medicine in general and in their specialty (CME) in particular, and develop new skills (CPD), enabling them to maintain and improve their professional practice to the highest possible standard.

A few European countries have structured CME/CPD programmes in operation for pharmaceutical medicine, but most countries in Europe and on the other Continents are still in the organisational or planning phases. In order to assist our National Member Associations  in the latter countries in setting up locally their own system and to ensure that these upcoming local CME/CPD programmes will be harmonised between each other, the Working Party on CME/CPD of the Council for Education in Pharmaceutical Medicine has established the present Guidance Notes.

General Principles

CME/CPD programmes are based on the following principles:

1) Certification as a physician specialist should be limited in time.

2) To renew certification in the specialty, physicians should provide proof that they have participated in and completed CME/CPD activities of appropriate quantity and quality to justify re-certification.

3) A national Committee of CME/CPD should set the standards and have a team of reviewers in charge of verifying at appropriate intervals the quantity and quality of the CME/CPD programmes followed by the physician specialists.

Recommendations

1) Frequency of renewal of certification

The duration of validity of a certificate of specialist in pharmaceutical medicine should preferably be of 5 years.

2) Time of initiation of the CME/CPD programme

Physician specialists in pharmaceutical medicine should start a CME/CPD programme after completion of their training and/or after being awarded the title of specialist in this specialty.

3) Allocation of credits

Generally speaking, the allocation of credits should be based on one hour training equals one credit (what is understood by “one hour” should follow national regulations). While this is a good basis for evaluation for most CME/CPD activities, it may be more difficult to apply to some other activities (see below item 6)

4) Number of  credits needed

The number of credits needed to obtain re-certification as physician specialist in pharmaceutical medicine is 250 over a period of 5 years i.e. an average of 50 credits per year.

5) Distribution of credits earned

The credits earned should cover a spectrum of activities in various fields of medicine, pharmaceutical medicine and professional development and avoid collection of too many credits in a subspecialty. The suggested distribution is as follows:
a) 15 credits/year in general and specialised medicine;
b) 30 credits/year in pharmaceutical medicine;
c) 5 credits/year in the development of personal skills (e.g. managerial skills, medical writing, negotiation skills, etc.).

6) CME/CPD activities awarding credits

Credits can be gained by participating in the following training activities:

a) Attendance at medical professional meetings, congresses, seminars, conferences, round-table discussions, workshops, in-house training courses or educational activities, structured self-learning programmes provides 1 credit per hour (unless indicated otherwise by the organisers or the CME/CPD committee: see below).
b) Presentation(s) at one of the above: 3 credits.
c) Abstracts or Posters at one of the above: 2 credits (unless they are leading to a publication).
d) Publication in a scientific Journal: 5 credits.
e) Books: editorial task = 15 credits; writing of a chapter = 10 credits.
f) Teaching: 2 credits/hour.
g) Reading: 1 credit/hour (maximum 10 credits per year).
h) Long-distance learning (e-learning): number of credits allocated by supervising organisation.
i) Sitting on Committees of Experts and/or Advisory Boards: 1 credit/hour with a maximum of 5 credits per year.

This list is not exhaustive. Many other activities may qualify for CME/CPD credits. In case of doubt, specialists should ask for advice and/or allocation of credits by addressing their request to the CME/CPD Director (see item 7).

7) Allocation of credits to CME/CPD activities

The number of credits awarded for the activities listed under 6a are usually negotiated by the organisers with the supervising scientific body. If not, the CME/CPD Director should be asked in advance to allocate a number of credits to the event.

As a general rule, requests for credit allocation by the CME/CPD Director should as much as possible be done prospectively.

8) Recording of credits

The CME/CPD committee will prepare a model diary that should be available from its web site and used by each participant in the CME/CPD programme to record his/her qualifying activities.
The Diary spreadsheet should show:
a) the date(s) of the event;
b) the name of the event;
c) the kind of documentation provided as evidence of participation in the event,
d) the number of credits earned for each of the three categories (general/internal medicine, pharmaceutical medicine, skills).

The physician specialists will update their diary at regular intervals and use one computerised spreadsheet per calendar year.

9) Documentation of credits

Each activity mentioned on the Diary should be properly documented.

a) For events mentioned under 6a one should obtain a certificate of attendance and/or a programme with annotation of the presentations attended or a list of participants or other types of evidence of attendance.
b) For events mentioned under 6 b, c, d, e one should provide copies of the material presented or published.
c) For events mentioned under 6 f and following specific evidence will be provided such as written reflection on each event, learning outcomes, value to individual, benefit achieved, etc.

10) The local CME/CPD Committee

It is recommended that each country wanting to organise a structured CME/CPD programme in pharmaceutical medicine would establish a national CME/CPD Committee reporting either to the national Association of Pharmaceutical Physicians or, preferably, to a joint organisation made of members of the national association and another national academic, regulatory or medical organisation (unless the local regulations require another type of supervision).

11) Structure and functioning of the local CME/CPD Committee

The local CME/CPD Committee would ideally be composed of the following structures, but its establishment should take into account available local manpower resources:

1) A CME/CPD Director: who explains and promotes CME/CPD among the physician specialists, supervises the activities of the Committee, decides on accreditation requests of training events, approves re-certifications. He reports to the head of the organisation mentioned under item 10 above.

2) A secretariat: responsible for the collection, pre-screening and distribution for evaluation to reviewers of the diaries and documentation provided by the specialists. The secretary reports to the CME/CPD Director.

3) A Team of Reviewers: composed of senior pharmaceutical physicians in charge of the evaluation of the quality and quantity of CME/CPD attended by the specialists. Each 5 yearly CME/CPD dossier submitted by the specialists should be evaluated by two reviewers.  The number of reviewers in the Team should be calculated on the basis of the number of specialists participating in the CME/CPD programmes. The Team of Reviewers reports to the CME/CPD Director.

If a specialist disagrees with the decision of the Team of Reviewers on the adequacy of his 5 year CME/CPD dossier he/she can appeal to the organisation mentioned under item 10 above.

12) Auditing of CME/CPD data submitted by specialists

Upon request of the CME/CPD Director, the CME/CPD Secretariat will request the submission of the following documents.

a) Of the Diary only: at least once from each specialist within his 5 years certification period; this means that the number of diaries to be reviewed on a yearly basis represents 20% of the participants. If, due to a lack of human resources, it proves impossible to review yearly the diaries of 20% of the specialists, this may be replaced by an at random verification of the diaries of a lower percentage of specialists (% to be determined by the CME/CPD Director according to local resources available).

b) Of the diary + the full documentation (i.e. the CME/CPD dossier covering 5 years of activity): every 5 years at the end of the certification period.