Society for Academic Continuing Medical Education (SACME) last week released their response to the Institute of Medicine Committee on Conflicts of Interest in Medical Research, Education and Practice. It is clear from what they submitted that SACME members rejected many of the controversial recommendations made by the Macy Conference Summary; and held to a general consensus that commercial support for CME is beneficial for the intuitions and their physician learners.
The report gave several challenges to changes in the present CME system. Their points represent major hurdles to changing our system:
Funding: “Many academic institutions provide little or no funding to CME, but rely on units to fund themselves or raise funds for the institution. Loss of current funding from commercial interests may result in fewer educational activities with increased cost to the institution.”
Institutional role “…continuing education is often not a focus of the educational system. Expectations point more to CME’s marketing role in representing the institution…”
Cultural change “In addition to the issue of CME as a support for hospital activities, most physicians have been trained in an environment in which lectures and conferences are provided at no cost. Asking physicians to bear more of the cost of their professional development comes with the challenge of developing activities that are more effective. Though changing, many learning opportunities demand little of participants. Many physicians lack practice in learning using different modalities, and experience a level of discomfort.”
“…Lectures are a cost effective way to present information, requiring relatively little of planners and participants. Using approaches that have been shown to be more effective, and linking CME to quality initiatives, requires expertise on the part of planners as well as faculty. CME professionals with skills in instructional design, evaluation, and teaching/learning to support faculty are essential, but require more time and money.
In preparation for their response they conducted a survey of their members. Perhaps of most interest, just less than a quarter, (24.4 %) of the academic CME providers supported eliminating support for CME by commercial enterprises.
Here’s the question and responses Funding from commercial interests must be eliminated from academic CME .
Response Percent Count (actual number of respondents)
Strongly disagree 24.4% 22
Disagree 36.7% 33
Neutral 14.4% 13
Agree 12.2% 11
Strongly agree 12.2% 11
On a somewhat related issue, the group opposed by an even wider margin eliminating faculty members with commercial connections.
Only 19.8% of academic educators agreed with the idea of eliminating those with commercial connections.
Faculty must not teach in academic CME if they have relationships with commercial interests.
Response Percent Count (actual number of respondents)
Strong disagree 14.3% 13
Disagree 47.3% 43
Neutral 18.7% 17
Agree 13.2% 12
Strongly agree 6.6% 6
At the same time, a majority of the group (60%) opposed offering free lunches and gifts associated with CME activities. One can only wonder if this will actually serve the purpose of increasing the quality and participation in CME .
All gifts, including free lunches, must be eliminated from activities with CME credit.
Response Percent Count *actual number of respondents)
Strong disagree 5.6% 5
Disagree 21.1% 19
Neutral 13.3% 12
Agree 32.2% 29
Strongly agree 27.8% 25
SACME is the professional organization for educators and physicians in medical schools, academic health science centers, professional/specialty organizations, and other interested academically based professionals. SACME’s mission is to promote research, scholarship, evaluation and development in continuing medical education ( CME ) to enhance the performance of physicians and other healthcare professionals.
For a complete copy of the report: http://www.sacme.org/site/sacme/assets/pdf/SACME_Report_IOM_COI_April_17_2008.pdf