How should continuous education be funded: UEMS point of view
Ensuring and promoting the highest standard of quality in the care we provide for our patients is one of the main goals for the UEMS, and to harmonise the postgraduate educational standards across Europe to ensure that all patients in Europe get the same high standard of care. Focusing on lifelong learning, continuing medical education (CME) and continuous professional development (CPD) is one way of achieving this, alongside with setting the standards for postgraduate medical education (specialisation) and quality assurance. The UEMS Section of Psychiatry is hence engaged in setting the standards for education and learning at all stages including the lifelong learning that we call CME and CPD.
CME is a significant part of the broader concept of continuing professional development (CPD), which includes managerial, ethical, social, and interpersonal skills. This is in accordance with the required competencies of a psychiatrist described in the section’s position paper Profile of a psychiatrist, based on the seven roles of a doctor as defined by the Canadian medical association. Both CME and CPD involve knowledge but the emphasis has developed into the application of this knowledge to change clinical practice and behavior resulting in improved outcomes for patients.
The first paper on CME outlining the section’s position and recommendations came in 1998 and was revised in 2003. In 2020 came a new updated version, this time including CPD.
A survey from 2020 conducted by the section showed that 18 of the responding 32 member states have mandatory CME/CPD. Currently there are no evidence that compulsory CPD results in better outcomes for patients, and the Section can therefore not recommend that CPD should be compulsory for all member states. This does not mean that the Section would recommend those states that have mandatory CPD to abandon it, as long as it ensures that there is a formal CPD program that the psychiatrists can take part in. Mandatory or not, a formal CME/CPD programme can facilitate structure, help identification of goals and learning outcomes, define standards and provide transparency. Sanctions and consequences for those non-compliant in CME/CPD activities are possible but it is more efficient to support and encourage our colleagues in striving for the highest professional excellence for the best of our patients.
To ensure best practice of CME/CPD the UEMS Section of psychiatry recommends individual preplanning of relevant, quality assured activities with appropriate governance. The Section further recommends that national associations should apply to EACCME for CME/CPD accreditation for quality assurance of the educational activities. The European Accreditation Council for Continuing Education (EACCME) is the UEMS body whose aim is to ensure access to recognised high quality CME/CPD activities by accrediting educational activities for CME/CPD.
The Section recommends that the role of the pharmaceutical industry, employers, government, national associations, and regulatory bodies should be recognised and defined by each member state, also when it comes to funding.
Funding is of great concern and contributes to variety between the member states. The medical profession cannot alone fund all the required CME/CPD activities required and therefore it is necessary to identify and agree upon appropriate sources of funding.
Of the 18 states with compulsory CME/CPD eight states allows the pharmaceutical industry to provide or financially support learning activities. The contribution from the pharmaceutical industry has undergone major changes the last 20 years, with many states now having strict regulations regarding the impact of the industry on doctors when it comes to educational events, sponsoring participation at conferences and advertisements.
Financial independence is vital to avoid commercial influence and bias, but UEMS and EACCME does not ban sponsorship from the industry but states that this can only be in the form of an unrestricted educational grant. Transparency is important to ensure this.
In my opinion the most important recommendations from the Section of Psychiatry on CME/CPD are that each member state should define the role and responsibility of the stakeholders, develop a national program with minimum recommended standards as well as encouraged and supported individual preplanning, and that transparent governance of the quality requires formal recognition from EACCME and sufficient independent funding. □
UEMS Charter on CME 1994
UEMS Psychiatry Section Report on CME 1998
UEMS Charter on CPD - the Basel Declaration 2001
UEMS Psychiatry Section Update Report on CME 2003
UEMS EACCME (European Accreditation Council for Continuous Medical Education) 2012
UEMS Psychiatry Section Report on The Continuing Medical Education and Continuous Professional Development