Skip to main content
Log in

Continuing Medical Education and Professional Development in the European Union

Evolution and Implications for Pharmaceutical Medicine

  • Review Article
  • Published:
Pharmaceutical Medicine Aims and scope Submit manuscript

Abstract

Continuing medical education (CME) and its broader term continuing professional development (CPD) are indispensable as part of lifelong learning and may be regarded as equally or more important than undergraduate and postgraduate medical education. Pharmaceutical medicine occupies common ground between the clinical and healthcare professions, pharmaceutical industry and government, and thus, the same principles are applicable. However, the global status of CME/CPD education in pharmaceutical medicine is alarming. Surveys conducted among pharmaceutical medicine associations from 22 countries and pharmaceutical physicians in the US showed that a relatively low number of CME/CPD activities are developed across countries, a high percentage of pharmaceutical physicians lack formal postgraduate education in pharmaceutical medicine and, additionally, training needs in basic knowledge areas were detected. It is evident that further education efforts are necessary. The CME system has many variations across countries. The CME/CPD model, including credits or hours, is the currency by which regulatory bodies often assess competence all over the world. Accreditation systems have been developed primarily in the US and Europe in an attempt to self-regulate and advance practice standards, as well as to respond to environmental pressures for advancement of healthcare quality and insulation of any commercial influence on education. Initiatives for a European and/or global CME harmonization have been developed. However, the major problem is that the various CME systems are very different and fragmented. In spite of the tremendous amount of resources spent on maintaining and upgrading physicians’ knowledge and skills, the effectiveness of CME in producing changes in practice has been questioned. It has been argued that CME programmes, as currently practiced, do not adequately focus on improving clinical performance and patient health outcomes. The emphasis is put on measuring acquired knowledge based on training hours, instead of assessing competences and skills as a result of professional development. A new CME/CPD outcomes-based model for performance improvement through individualized and standardized education has been proposed, including physician’s self-assessment, self-reflection and practice-based learning. PharmaTrain is a public private partnership sponsored by the EU’s Innovative Medicines Initiative including 24 universities, 13 learned societies/associations and several partner training organizations. PharmaTrain aims to provide courses that are designed to meet the needs of pharmaceutical physicians and other professionals working in medicines development (basic diploma, masters and CME/CPD). The PharmaTrain CPD platform will include diploma and master extension and elective modules, both course based and standalone, aimed to facilitate lifelong learning. The successful development and use of the PharmaTrain CPD platform provides a valuable new opportunity to meet the current standards and expectations for CME/CPD posed by stakeholders and society at large.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Table I
Table II
Fig. 1

Similar content being viewed by others

References

  1. Accreditation Council for Continuing Medical Education 2007. Definition of CME [online]. Available from URL: http://www.accme.org/dir_docs/doc_upload/8f4b847a-5917-4e4f-ae5f-ca0dc231dda7_uploaddocument.pdf [Accessed 2011 Dec 29]

  2. American Medical Association. Physician recognition award, 2007 [online]. Available from URL: http://www.ama-assn.org/resources/doc/cme/prabooklet.pdf [Accessed 2011 Dec 29]

  3. Stanton F, Grant J. The effectiveness of continuing professional development. London: Joint Centre for Medical Education, Open University, 1997

    Google Scholar 

  4. World Federation for Medical Education. Continuing professional development of medical doctors: WFME global standards for quality improvement. Copenhagen: WFME Office, University of Copenhagen, 2003

    Google Scholar 

  5. Stonier PD, Silva H, Lahon H. Pharmaceutical medicine: history, global status, evolution and development. Int J Pharm Med 2007; 21 (4): 253–62

    Article  Google Scholar 

  6. Silva H. Emerging needs in pharmaceutical medicine education: is harmonization possible? Drug Information Association. 45th Annual Meeting. 2010 Jun 10–13 2010; Washington DC

  7. Stonier PD, Naraynassamy C, MacGilchrist KS. Curricular and training needs of pharmaceutical physicians in the United States. The Monitor 2011; 25 (6) 9–15

    Google Scholar 

  8. Accreditation Council for Continuing Medical Education. ACCME 2010 Annual Report: analysis of commercial support distribution and long term CME trends [online]. Available from URL: http://www.accme.org/dir_docs/doc_upload/fd69f7be-1379-4559-83ef-f6b734eaa636_uploaddocument.pdf [Accessed 2011 Dec 29]

  9. Ruiz JG, Mintzer MJ, Leipzig RM. The impact of e-learning in medical education. Acad Med 2006; 81: 207–12

    Article  PubMed  Google Scholar 

  10. Cook DA, Levinson AJ, Garside S, et al. Internet-based learning in the health professions: a meta-analysis. JAMA 2008; 300 (10): 1181–119

    Article  PubMed  CAS  Google Scholar 

  11. Cook DA, Levinson AJ, Garside S, et al. Instructional design variations in internet-based learning for health professions education: a systematic review and meta-analysis. Acad Med 2010; 85: 909–22

    Article  PubMed  Google Scholar 

  12. Institute of Medicine. Redesigning continuing education in the health professions. Washington, DC: The National Academic Press, 2009 [online]. Available from URL: http://www.iom.edu/Reports/2009/Redesigning-Continuing-Education-in-the-Health-Professions.aspx [Accessed 2011 Dec 29]

    Google Scholar 

  13. ACCME. Accreditation criteria: the ACCME’s essential areas and their elements, 2008 [online]. Available from URL: http://www.accme.org/dir_docs/doc_upload/f4ee5075-9574-4231-8876-5e21723c0c82_uploaddocument.pdf. [Accessed 2011 Dec 29]

  14. Sriharan A, Murray R, Pardell H, et al. An overview of CME/CPD credit systems around the world. J Med Market 2009; 9: 145–50

    Article  Google Scholar 

  15. Miller LA, Jain S, Moylan S, et al. Continuing medical education for the world: spreading to Latin America, Asia, Africa and the Middle East. In: Wentz DK, editors. Continuing medical education: looking back, planning ahead. Hanover (NH): Darmouth College Press, 2011

    Google Scholar 

  16. Mansouri M, Lockyer J. A meta-analysis of continuing medical education effectiveness. J Contin Educ Health Prof 2007; 27 (1): 6–15

    Article  PubMed  Google Scholar 

  17. Davis D, O’Brien M, Freemantle N, et al. Impact of formal continuing medical education: do conferences, workshops, rounds and other traditional continuing education activities change physician behaviors or health care outcomes? JAMA 1999; 282 (9): 867–74

    Article  PubMed  CAS  Google Scholar 

  18. Fletcher SW. Chairman’s summary of the conference. In: Hager M, editor. Continuing education in the health professions: improving healthcare through lifelong learning. Bermuda, New York: Josiah Macy Jr Foundation, 2008

    Google Scholar 

  19. Frenk J, Chen L, Bhutta Z, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet 2010; 376: 1923–58

    Article  PubMed  Google Scholar 

  20. Aretz HT. Some thoughts about creating health care professionals that match what societies need. Med Teach 2011; 33: 608–13

    Article  PubMed  Google Scholar 

  21. American Board of Medical Specialties. ABMS white paper on MOC CME. 2011 [online]. Available from URL http://www.abms.org/Maintenance_of_Certification/MOC_competencies.aspx [Accessed 2012 Jan 25]

  22. Jackson MJ, Gallis HA, Gilman SC, et al. The need for specialty curricula based on core competencies: a white paper of the conjoint committee on continuing medical education. J Contin Educ Health Prof 2007; 27 (2): 128–8

    Article  Google Scholar 

  23. Klech H, Brooksbank C, Price S, et al. European initiative towards quality standards in education and training for discovery, development and use of medicines. Eur J Pharm Sci 2012; 45 (5): 515–20

    Article  PubMed  CAS  Google Scholar 

  24. Moores LK, Dellert ED, Baumann MH, et al. Introduction. Effectiveness of continuing medical education: American College of Chest Physicians evidence-based educational guidelines. Chest 2009; 135: 5S–7S

    Article  PubMed  Google Scholar 

  25. Davis DA, Mazmanian PE, Fordis M, et al. Accuracy of physician self assessment compared with observed measures of competence: a systematic review. JAMA 2006; 296 (9): 1094–102

    Article  PubMed  CAS  Google Scholar 

  26. Desbois J, Pardell H, Negri A, et al. Continuing medical education in Europe: evolution or revolution. Paris: MedEd Global Solutions, 2010

    Google Scholar 

  27. Horsley T, Grimshaw J, Campbell C. Maintaining the competence of Europe’s workforce. BMJ 2010; 341: 706–8

    Google Scholar 

  28. European Commission High Level Group on Health Services and Medical Care. Report on the work of the high level group in 2006. HLG/2006/8FINAL European Commission health and Consumer Protection Directorate-General [online]. Available from URL http://ec.europa.eu/health/ph_over-view/co_operation/healthcare/docs/highlevel_2006_007_en.pdf [Accessed 2012 Jan 13]

  29. Petersen LA, Woodard LD, Urech T, et al. Does pay-for-performance improve the quality of health care? JAMA 2006; 145: 265–72

    Google Scholar 

  30. European Union of Medical Specialists. Continuing professional development of general practitioners in Europe [online]. Available from URL: http://www.uemo.eu/uemo-policy/113.html. [Accessed 2011 Dec 29]

  31. Miller LA, Harvey L, Maillet B, et al. Continuing medical education and continuing professional development in Europe: the new reality. In: Wentz DK, editors. Continuing medical education: looking back, planning ahead. Hanover (NH): Dartmouth College Press, 2011

    Google Scholar 

  32. EACCME. The accreditation of e-learning materials. Brussels: European Union of Medical Specialists, 2011

    Google Scholar 

  33. Continuing professional development integration of formal CME and quality improvement initiatives. Policy document of EQUIP and EURACT. European Academy of Teachers in General Practice and Family Medicine [online]. Available from URL: http://www.euract.eu/others/finish/20-others/102-integration-of-formal-cme-and-quality-improvement-initiatives-2001-policy-document-of-equip-and-euract [Accessed 2011 Dec 29]

  34. Weisshardt I, Stapff I, Schaffer M. Increased understanding of medical education pathways in Europe as a potential quality factor in CME: a comprehensive assessment of the current landscape [open access]. J Eur CME 2012; 1: 9–17

    Google Scholar 

  35. Maillet B, Maisonneuve H. Long-life learning for medical specialists doctors in Europe: CME, DPC and qualification [in French]. Presse Médicale 2011a; 40: 357–65

    Article  Google Scholar 

  36. Maillet B, Maisonneuve H. An ambitious European challenge: harmonize the medical specialists’ education with reciprocity agreements between countries [in French]. Presse Médicale 2011b; 40: 333–5

    Article  Google Scholar 

  37. Kellner T. UEMS-EACCE and European CME forum: European CME/CPD leadership synergy needed. J Euro 2012; 1: 7–8

    Google Scholar 

  38. The Innovative Medicines Initiative (IMI) Research Agenda. Creating biomedical R&D leadership for Europe to benefit patients and society, 2008 [online]. Available from URL: http://www.imi.europa.eu/ [Accessed 2011 Dec 29]

  39. PharmaTrain. Manual curriculum standards and best practices, 2010 [online]. Available from URL: http://www.pharmatrain.eu/ [Accessed 2011 Dec 29]

Download references

Acknowledgements

Dr Bühler has received honoraria and grants from the European Commission and IMI PharmaTrain. Hervé Maisonneuve is employed by the University of Lyon, and is an associate of Wentz Miller Global Services, which provides consultancy on CME/CPD. Dr Miller has consulted with the European Society of Cardiology on their CME programme. The remaining authors have received no funding. All authors have no conflicts of interest to declare that are directly relevant to the content of this review.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Honorio Silva MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Silva, H., Bühler, F.R., Maillet, B. et al. Continuing Medical Education and Professional Development in the European Union. Pharm Med 26, 223–233 (2012). https://doi.org/10.1007/BF03262479

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03262479

Keywords

Navigation