Last week, Dr. Murray Kopelow, president and CEO of the Accreditation Council for Continuing Medical Education (ACCME), offered his insight into two important areas of continuing education: international CME and the challenges CME faces for the next generation of physician learners.
European Accreditation for Continuing Medical Education
Continuing medical education accreditation systems in Europe and the United States are very different from each other. "The majority of accredited CME in Europe comes from individually accredited activities either by the national accreditation authority or by the UEMS, while in the United States, the majority of accredited CME is delivered by CME providers, accredited within the ACCME system," writes Dr. Kopelow.
He believes the U.S. model has developed at least in part because of the link between accredited CME and physicians’ maintenance of licensure and specialty certification. "Virtually every doctor in the United States is involved in a professional regulation system that requires, or expects, participation in accredited CME," Kopelow notes. This has contributed to a more unified licensure requirement than abroad. "These uniform regulations affect more than 90% of the licensed physicians in the United States," he states.
"The ACCME system has always been a provider-based system and remains so because of the economies of scale and scope it offers in addressing the task of the quality assurance of so many activities every year," Kopelow writes. "This provider-based system has been an efficient distribution channel for a single CME standard applied to the 130,000+ ACCME-accredited CME activities offered by 2,000+ providers for 24 million physician and non-physician registrants per year."
Dr. Kopelow recommends that "perhaps, a step forward in Europe would be a single set of CME/CPD accreditation standards, promulgated by a committee whose members represent the various types of CME provider organisations that could exist in Europe." As with the ACCME, the European model would "need not accredit activities or providers but rather it could simply oversee the accurate application of its requirements by other organisations which it has deemed acceptable accreditors."
View Dr. Kopelow full article: Journal of European CME 2015, 4: 27103, available at http://dx.doi.org/10.3402/jecme.v4.27103
Dr. Kopelow also took up another challenging question last week when he addressed, what is the future of continuing medical education?
"As you might imagine, the ACCME...is thinking about and asking whether our system is ready for the future of continuing medical education," states Kopelow in a video commentary, available here.
"Of the 856,000 physicians that are operating now in the United States, many of them were born after 1980," he notes. This group of millennials are the group of physicians that accreditation systems like the ACCME need to plan for going forward.
Currently, less than 10 percent of the physicians are under 30 years of age. Over the next 20 years--"over the period of time during which I was the CEO of the ACCME," notes Kopelow--50 percent of the physicians in the United States are going to have been born after 1980.
Kopelow believes that this group, having essentially grown up using Google, YouTube, and Skype has integrated technology into their lives in an entirely different way than previous generations. Quick access to information, of various levels of quality, is now a way of life.
Furthermore, blogs, Twitter, LinkedIn discussions etc. allow for interactive discussion with others. Kopelow states:
This is a group, synchronously, asynchronously, getting together, learning about some issue, and discussing some issue. And it would seem that the skill involved here is different than the one that's present in the current system. Here, people are going to have to be challenged and have the ability to validate the content. To determine whether what they're hearing and seeing is something that should be integrated into their practice. It isn't going to be, have any value to accredit Twitter because Twitter is not going to really have any control over what happens here.
[Today's] models were built from a framework of people saying: I know what my professional practice gap is. And I know what the framework is for me to address those. I have to do it in the context of a competency. There's a certain subject that I have to go get information about and I have to modify my knowledge, competence, or performance and that will satisfy the educational needs. But is that going to be [how] millennials, are going to operate? And is that enough of a construct for the accreditation system, for the standard setters, being explicit about obligations and expectations? When in fact, in 20 years from now, people are going to recognize what their professional practice gap is, but they're going to find that learning in certain communities and locations via certain unpredictable, unknown media. And it is that context in which they're going to be doing their learning and changing. Don't we owe it to these people to establish a context and a set of rules and requirements and expectations for behavior in those opportunities?
While his commentary doesn't offer a concrete solution, Kopelow has provided a lot to dwell on as the ACCME changes leadership in the next few months.