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Federazione delle Società
Medico -Scientifiche Italiane
CME Worldwide
BRAIDO F.
CANONICA G.W.
FISM
Task Force
FISM
Secretary General
Continuing Medical Education:
an international reality
Braido F., Popov T., Ansotegui IJ., Gayraud J.,
Nekam K.L., Delgado J.L., Malling H.J., Olson S,
Larchè M., Negri A., Canonica G.W.
EAACI CME Accreditation Committee
In press 2005
Applicants
Belgium
Denmark
Germany
Greece
Spain
France
Ireland
Italy
Luxemburg
Holland
Portugal
Austria
Finland
Sweden
Great Britain
EU Member Countries
Bulgaria
Ceska Rep.
Estonia
Cypros
Lettonia
Latvija
Magyarorszag
Malta
Polska
Romanja
Slovenja
Slovackia.
Turkiye
BELGIUM
Mandatory or Voluntary CME?
• Voluntary, but incentives exist for accredited doctors (they can ask
for higher fees, about 4.5%, + a yearly premium of 490 Euro.) There
are no sanctions besides exclusion of accreditation and no recertification.
Type of Credit: Points
Number of Credits:
• The number of credits required amounts to 200 per year (20 hours
of which 3 hours must be Ethics, and 4 hours in group peer review).
National Accreditor:
• CME in Belgium is regulated by an organization within the INAMIRIZIV (State Institution for Insurance against Disease and Invalidity)
and hence, is monitored by the profession, the universities and
scientific organizations and the (mostly politically linked) insurance
organizations.
BULGARIA
Mandatory
CME Agreement with UEMS
CROATIA
Mandatory or Voluntary CME?
Mandatory. Voluntary up to 1995, since then all physicians
have had to join the Croatian Medical Chamber. An Institute of
Licensure and Re-licensure was established. All physicians
with state examinations, already practicing medicine, were
granted a license for independent practice, renewed after six
years following the obtaining of 120 points of CME.
Type of Credit: 1 hour = 1 credit
National Accreditor: Specialists Societies and Hospitals (1996)
CZECH REPUBLIC
Mandatory or Voluntary CME?
• Mandatory, similar to Croatian system
Type of Credit: Credits system
Number of Credits: Credits obtained over 5 years
National Accreditor: Specialist Societies and Hospitals
Online CME? Yes
HUNGARY
Mandatory or Voluntary CME? Mandatory with sanctions
Type of Credit: Points
Number of Credits: 250 points over 5 years
National Accreditor:
• Four Medical Schools under control of a Supervisory Steering
Committee Other: Incentive to comply, Doctors pay to register and
are punished if they do not. Also important is the Hungarian
Physicians Chamber (HPC).
Other:
• Pharma companies (local and international), from both a financial
point of view as well as giving scientific information, are playing key
role in the continuous medical education. Every activity concerning
the credit point system should be in close cooperation with the HPC
and the entire Doctors Collegium (Neurology, Gynecology etc.)
POLAND
Mandatory or Voluntary CME?
• A law exists but doesn't work in practice.
Voluntary
National Accreditor:
• Polish Chamber of Physicians and Dentists
Other:
• The Head of Polish Gynecological Society Prof.
Wieslaw Szymanski can be interested in the
introduction of CME system and give assistance.
ROMANIA
Mandatory or Voluntary CME? Mandatory
Type of Credit: Credits per type of activity
Number of Credits:
• 50-200 credits every 5 years (depending upon specialty). A scale of
crediting has been established according to the difference between
courses with and without a final evaluation as well as taking part in
conferences and congresses.
National Accreditor: Romanian College of Physicians
Accreditation of providers:
• Providers are accredited with help of Scientific Societies and the
Professional Organizations – rules include experience and no
commercial links.
SLOVAKIA
CME is about to be established.
SLOVENIA
Mandatory or Voluntary CME? Mandatory.
Type of Credit: Credit Points.
Number of Credits:
75 points over 7 years for re-certification
National Accreditor: Slovenian Medical Chamber
Online CME? Coming up
TURKEY
Voluntary CME
with sanctions in certain areas
UNITED STATES
Mandatory or Voluntary CME? Mandatory in 40 states.
Type of Credit: Credit hours, move to credits
Number of Credits: 150 credit hours over three years
National Accreditor:
• The Accreditation Council for Continuing Medical Education (ACCME)
Online CME
• ACCME released policy 2002-A-11 stating eight points regarding online
CME program. In summary, they say that CME activities delivered via
the internet are expected to be in compliance with ACCME Essential
Areas, Elements and Policies.
Other
• Reciprocity agreement between AMA and the EACCME
1998
USD
302 millions
N.E.J.M. february 10,2005
2003
971 millions
N.E.J.M. february 10,2005
CANADA
Mandatory CME
As in the United States
Reciprocity agreement with USA
MEXICO
Mandatory since 2002
Bylateral agreement
with the USA
ARGENTINA
Mandatory or Voluntary CME?
• Voluntary but there are plans to make
it mandatory in the future.
National Accreditor:
• National Commission for Board
Certification and Re-certification
BRAZIL
• Not a formal system in place. Brazilian federal health
council has no rules for CME.
• Medical societies like: anesthesia, cardiology and
gynecology are playing a major role in establishing
standards for certifying and updating their members.
• There is a trend leaded by the major schools of
medicine to reduce the number of new physicians,
due to saturation of the market (9,000 new doctors
every year), the goal is to have better training and
CME for future board certification.
CHILE
Mandatory or Voluntary CME? Voluntary
National Accreditor:
• National Council for Medical Specialties Certification (CONACEM)
established in 1985. certification is provided through a diploma of
CME issued by this council.
Online CME? Yes
Other:
• Government health authorities, “CONACEM” and Chilean Academy
of Medicine are now considering implementation of CME and board
certification standards for all specialists.
• Pharmaceutical industry is playing a major role in education by
delivering CME enduring programs (print and online).
COSTA RICA
Mandatory or Voluntary CME?
• Voluntary for almost all medical specialties, but
mandatory for public health employees.
National Accreditor:
• Board certification and re-certification is ruled by the
committee for medical certification of the Costa Rica’s
national medical college. Re-certification required now
by 6 specialties every 3 years.
Other:
• Mexican influence in Costa Rica’s and Central America
due many opinion leaders from the region have
graduated or postgraduated in Mexico.
PERU
• In 1998 the National system for board
certification and re-certification under
the rule of the Peruvian college of
medicine) was established.
Implementation process is starting.
• There are many CME activities and
programs sponsored by pharmaceutical
companies.
KUWAIT
Mandatory or Voluntary CME? Looks voluntary.
Type of Credit: Points
Number of Credits:
 Health professionals who acquire a total of 250 credit points during a period of
five years receive a Certificate of Satisfactory Completion of CME from KIMS.
Category 1 Educational activities entitle the participants to claim 1 credit point
of CME for one contact hour of educational activity (Lectures, symposia, group
learning, seminars etc. that are structured and formal). Practical/clinical training
sessions yield 0.5 credit point per hour. Category 2 activities earn 0.5 credit
point of CME for every hour.
National Accreditor: Kuwait Institute for Medical Specialization (KIMS)
Online CME? Yes
Other

Category 1 comprises formal learning opportunities provided by recognized
educational institutions or professional bodies, and accredited by the CME
Council of KIMS. Educational activities that are less structured from a learning
viewpoint than those under Category 1 are included under Category 2.
SAUDI ARABIA
MANDATORY CME
80 different nationalities practising medicine CME
as standard practice 30 Hours
IRAN
Mandatory CME
25 Credits a year
Loss of licence
SOUTH AFRICA
Mandatory or Voluntary CME?
Mandatory.
Type of Credit:
Credit Points (1 point = 1 hour of CME activity)
Number of Credits: 50 points
National Accreditor:
• Medical and Dental Professional Board under the
jurisdiction of the Health Professions Council of South
Africa (HPCSA).
SINGAPORE
Mandatory system for Specialists
AUSTRALIA
Voluntary for Specialists
NEW ZEALAND
Voluntary for Specialists
COUNTRIES with MANDATORY CME
North America: Canada, USA (40 States)
Central America : Mexico
Europe: Austria, Ireland, Italy, Netherlands,
Norway (only GPs.), Switzerland, U.K. (CPD)
Eastern Europe: Bulgaria,Croatia, Check Republic,
Romania, Slovenia
Africa: South Africa
Asia: Iran, South Korea, Singapore,
Saudi Arabia, Arabian Emirates
CME ITALY
CME EUROPE
usa
CME USA
CME WORLD
RECIPROCITY
EACCME --ACCME
CME Credits
till 2006
UNMET NEED
&
ABSOLUTE REQUIREMENT
Harmonization of CME Systems
throughout Europe
Currency
Euro
CME
Italian CME Credit System
German CME Credit System
European
CME
Credit System
EACCME
French CME Credit System
A harmonized system of CME
throughout Europe
is
inevitable
in the next few years
“USA-EU:
Sharing the educational effort”
Milan
Rome
Rome
- March
- October
- April
2003
2003
2004
G. Walter Canonica, Chairman, European Academy of Allergology & Clinical
Immunology Accreditation Council, Secretary General, World Allergy Organization,
Secretary, Italian Federation of Scientific Medical Societies, Genoa Italy
Murray Kopelow, Chief Executive, Accr Council for Continuing Medical Education,
Chicago, IL,
Bernard Maillet, Secretary General, European Union of Medical Specialists, Brussels,
Belgium
Herve Maisonneuve, Task force on Health Care Professionals' Competencies, Paris,
France
Alfonso Negri, Secretary General, Italian Council for Accreditation in Pneumology,
Milan, Italy
Helios Pardell, Director, Spanish Accr Council for Continuing Medical Education
Madrid, Spain
Teodor Popov, European Academy of Allergology and Clinical Immunology, Sofia
Bulgaria
Barbara Schneidman, Vice President for Education, American Medical Association,
Chicago, IL
Pasquale Spinelli, Vice President, Italian Federation of Scientific Medical Societies
Milan, Italy
Riccardo Vigneri, Chairman, Long Distance Learning Sub-Committee, Italian
Continuing Medical Education Commission of the Ministry, Catania, Italy
Kate Lancey, Royal College CPD London UK
Next Meeting : Rome May 16, 2005
ROME, April 25 - 26 , 2004
B.M.J. May 2004
Consensus on Basic Values and Responsibilities Underlying
the Substantial Equivalency of CME and CPD Systems
Values
CME/ CPD systems should be based on the following enduring values
Continuing medical education and life-long learning:
1.
2.
That enhances physician performance and thereby improves
the health of people.
That is based on information concerning the educational needs
of physicians with the ultimate aim of helping them improve health.
A process for the accreditation of providers/organizers
of CME/CPD activities that includes:
1.
2.
3.
4.
5.
Fairness, validity, innovation, honesty and consistency
in accreditation practices.
Reasonable standards and criteria for CME providers/organizers.
Accountability, responsiveness, and leadership of accreditation bodies.
The promotion of continuous quality improvement of the accreditation
process as well as the education systems it supports.
Collaboration and partnership between and among accreditation bodies,
and between accreditation bodies and providers/organizers
Allergy 2005 in press
Responsibilities of the provider/organizer of CME/CPD
activities to be fulfilled in order to grant credit
1.
Any commercial sponsorship or interests of the programme planner,
presenters, or facilitators must be disclosed to the provider / organizer
and the learners.
2.
Any support, sponsorship or funding by commercial health care
organisations must not influence the structure or content of the
educational programme.
The provider / organizer must:
1.
Ensure there are outcome measures of education effectiveness expressed
in terms of meeting the knowledge, competence or performance
objectives of the activity.
2.
Be able to make available a confirmation of participation, at a frequency
and nature appropriate to regulatory requirements.
3.
Ensure that the teaching methods used are appropriate to the stated
learning objectives.
4.
Be able to show that they have evaluated the quality of any previous
education activities and have made improvements, where necessary
Allergy 2005 in press
Responsibilities of the learner
- to be fulfilled in order to claim credit -
Learners
have responsibility for:
1. Participating in CME/CPD that is based on their
individual educational needs.
2. Ensuring that the needs are relevant to their
professional practice.
3. Evaluating the extent to which their needs have been
met, in the context of a change in knowledge,
competence or performance.
4. Verifying that mechanisms are in place to keep
educational activities free of commercial bias.
Allergy 2005 in press
Does it Have Practical Application???
EUROPEAN ACADEMY
of
ALLERGY and CLINICAL IMMUNOLOGY
Chairman - G.W. Canonica
Members:
EAACI-CME AccreditationCommittee
I.Ansotegui
F.Braido
L.Delgado
J.Gayraud
K.L. Nekam
M.Larchè
H-J. Malling
S.Olsson
C.Öström
T.Popov
Continuing Medical Education:
an international reality
Braido F., Popov T., Ansotegui IJ., Gayraud J.,
Nekam K.L., Delgado J.L., Malling H.J., Olson S,
Larchè M., Negri A., Canonica G.W.
EAACI CME Accreditation Committee
In press 2005
Feel free to contact us at:
[email protected]
[email protected]
Thank You
Absolute Requirement
GLOBAL CME
GUIDELINES ARE
NECESSARY
JORDAN
• Licenses of the physicians
are for lifetime practices
and no additional education
after the university is required.
Responsibilities of the provider/organizer
to be fulfilled in order to grant credit,
1. Any commercial sponsorship or interests
of
the programme planner, presenters,
or
facilitators must be disclosed
to the provider /
organizer and the
learners.
2. Any support, sponsorship or funding by
commercial health care
organisations must not influence the
structure or content of the
educational programme.
The provider / organizer must,
1. Ensure there are outcome measures of education
effectiveness expressed in terms of meeting the
knowledge, competence or performance
objectives of
the activity.
2. Be able to make available a confirmation of
participation, at a frequency and nature
appropriate to regulatory requirements.
3. Ensure that the learning objectives are
specifically
defined in terms of knowledge
competence or
performance, and are
appropriate for the target
audience
4. Ensure that the teaching methods used are
appropriate to the stated learning objectives.
5. Be able to show that they have evaluated the
quality
of any previous education activities and
have made
improvements, where necessary.