A Review of CME (Continuing Medical Education ) and PM&DC Guidelines

Dr. Ghulam SaqulainM.B.B.S., D.L.O., F.C.P.S

Head of Department of ENTCapital Hospital, Islamabad

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What is CPD and CME ?

CPD The term CPD acknowledges the wide-ranging

competencies needed to practice high quality medicine/ dentistry, including medical, managerial, ethical, social and personal skills.

It Incorporates CME which generally is taken to refer only to

expanding the knowledge and skill required by the doctors.

CDE, for dental surgeons

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CME (Continuing Medical Education)

Consists of educational activities which serve to maintain, develop, or increase the knowledge, skills, and professional performance and relationships that a physician uses to provide services for patients, the public, or the profession.

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Why Should we Care?

But we are doctors. We already have had years of training, Why do we need more education?

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Because

As in any field, things change.

New problems New guidelinesNew ProtocolsNew discoveriesNew interventions

This makes it hard to catch up with these changes

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CME is one way to remain up-to-date, both in their specialty and in medicine in general.

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So doctors have a moral obligation to continue their education. We do attend:

Some conferencesSome workshopsSome Courses

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Over, the course of time, CME, like many other areas, has become regulated.

CME

In The West

CME training is compulsory for re-certification.

Virtually every hospital requires that a physician obtain CME credits for hospital appointments and re-appointments (credentialing).

In Pakistan

Recently PM&DC has also announced to re-certify registration, on the basis of CME.

Doctors need to complete 5 CME hours in 6 months to maintain their licence to practice effective from 1st January 2015

Problem:This has also created an anxiety among

doctors because:

It’s a new conceptIt’s not in placeImplementation of the decision has been made

prior to making approved CME’s in placeCostlyBut it has to be followed, Why??

PMDC and LAW

CPD as a mandatory requirement under section 16B of PM&DC (Amendment) Act 2012 for the renewal of license to practice.

According to this;License to practice be given only to those medical/

dental practitioners/ specialists who have completed at least 5 credit hours/ years (for GPs)

and 10 credit hours/ year (for specialists)

Ways to earn CME:

Problem?

Conferences Live Courses In-hospital programs Enduring Materials (DVDs), Journals CME Online

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And yes, there are RULES - a lot of them!

ACCME

AMA

PMDC ACCREDITATION

These accredited organizations shall provide opportunities of continuing professional development to the registered medical/ dental doctors.

Certificate of Continuing Medical Education (CME) of only those DAI/ Institutions will be entertained which shall be registered with PM&DC.

No renewal of PM&DC registration will be considered without certificate of CME

PMDC will: Charge Fee of Rs 50,OOO/-for granting

accreditation to it for 5 years. Yearly review (Performance Audit) Accreditation will be given maximum for

5 years subject to review every year.

Where possible?

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More RULES -

ACCME

AMA

ACCREDITED ORGANIZATIONS Can be held responsible for:

Irregularities in the program Non Maintenance of adequate standards Excessive fee: Fee be intimated to PMDC

along with application

List along with registration number be submitted upon completion of the Course/ Workshop/ Seminar, etc. duly attested by the CME Secretary and Head of the Institute.

Every branch of the organization/ organization will have to apply separately.

The organizations should provide the schedule (in detail) of each CME/ CDE activity.

Organizations should make arrangements for advance publicity to the targeted group of participants.

The methodology of feedback: Evaluation program by a standard feedback form [of each delegate] duly signed by organizing secretary and observer will have to be maintained

The organization should undertake to: Publish handouts, Bring out a brief report of each CME/ CDE and Prepare a list of participants and delegates. The Attendance sheet [with registration

numbers] duly signed by organizing secretary and observer will have to be sent to PM&DC within 15 days of completion of Program.

Purpose of accreditation ?

The organization should evaluate CME/ CDE to indicate the benefits accrued to participants by way of updating of knowledge, upgrading their ability and benefit to the patients.

PM&DC will appoint maximum 2 observers for each CME/ CDE.

There will be arrangement for online submission of application for CME/ CDE with facility for uploading the data.

The certification will preferably be paperless.

Manual application will have to be made preferably one month in advance.

Minimum 15 days in advance application will be required.

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More RULES -

ACCME

AMA

PMDC Guidelines for CME/ CDE

Any professional organization or body or institution making to hold CME/ CDE should apply for accreditation to the PM&DC. The Council on verifying the credentials of the organization will give certificate of accreditations to those bodies to hold CME/ CDE.

It will also apply to the PM&DC on a designed application form for the program. The application should be accompanied by the Complete program of the CME/ CDE /Conference including the names, designation and Country of the speakers and the subject of speech.

Accredited bodies which hold regular CME/ CDE will have to inform Pakistan Medical & Dental Council, the date & time of the CME/ CDE, at least is days in advance, so that the PM&DC can send observers for the CME/ CDE.

In the application sent to PM&DC, duration given to each speaker should also be mentioned along with the topic of the lecture while applying for the credit hours.

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CREDIT HOURS

So we need CME, But who decides how much credit, if any, a CME activity is worth?

Credit hours to be awarded will be the sole discretion of the organization and will depend upon the subject matter, Status of the speaker, Quality of the papers to be presented in the CME/ CDE/ Conference.

Credit hours will be based on the composition of the faculty participation, quality and the contents of the subject matter.

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CME credits are generally designated based on the actual time spent in the educational portion of the activity.

GUIDE LINES FOR CREDIT POINTS

One Credit Point is equal to 2 credit hours One Credit Hour is equal to 3 hours session

Maximum 6 hours duration per day shall be 2 credit hours is equal to one credit points

Observers will be entitled for 1 extra point plus the concerned CME/ CDE points.

The institutions should be responsible for deciding/ designating credit hours CME/ CDE workshop of minimum three hours duration shall be eligible for

maximum of one credit hour. CME/ CDE workshop of six hour duration shall be eligible for two credit hours.

Speaker at any conference/ CME/ CDE/ workshop/ training program will be given One credit hour per lecture given If they attend the whole CME/ CDE as a delegate, then they will be given the

approved points oft he CME/ CDE. The doctors may attend the international CME/ CDE

Conference held overseas as delegates. On the production of the certificate of attendance. CME/ CDE credit hours will be given as per equivalence formula.

CME/ CDE EXEMPT FROM CREDITPOINTS

The CME/ CDE organized solely by a drug I equipment company for promotion of the drug/ equipment will not be entertained/ considered.

Credit shall not be given to Live Operative Workshop (LOW) performed by foreign faculties in Pakistan unless they obtain temporary registration from PM&DC.

Requirement of Credit Points for Renewal 5 credit hours/ years of CME training is mandatory for General Practitioners.

10 credit hours/ years of CME training is mandatory for Specialists

No carry forward of extra credit points is permissible after 5 years.

For any CME/ CDE Symposium/ Conferences of any duration, not more than 4 credit points will be awarded.

Renewal cycle of 5 years is from the date of fresh registration or renewal date.

A criterion for recertification of medical/ dental practitioner license should be established comprising of compulsion of BLS for each candidate aspiring of recertification

CERTIFICATE AND FEEDBACK Associations/ Organizations should strictly

issue the certificate to the delegate who has attended the CME/ CDE.

No certificates should be distributed on the first day at the time of registration for the CME/ CDE/Conference.

The certificates should be distributed/ awarded only on the last day after completion of CME/ CDE/ Conference/ Workshop.

Associations/ Organizations will be duty bound to maintain the feedback of the delegates and the list of the delegates who have attended the CME/CDE/ Conference for 5 years.

In case it is found by the Council that the certificate is false then the accreditation certificate of issuing Organization /Organization will be cancelled.

Associations/ Organizations will be duty bound to maintain the feedback of the delegates and the list of the delegates who have attended the CME/CDE/ Conference for 5 years.

If required PM&DC can seek additional information

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The hospital must then issue a CME certificate with the number of credits claimed (but not more than the maximum) for the activity.

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Information regarding credits issued to physicians must be maintained by the CME Office for 5 years.

CME/ CDE Committees

PM&DC will have an Accreditation Committee who will monitor, control and audit the CME/ CDE.

They will also cooperate in overseeing proper conduct of CME/ CDE

These committee will help for smooth decentralized implementation of CME /CDE

Which specialty doctor can attend which subject CME/CDE ?

Composition of CME’S for Graduate Doctors: A brief session on national health

programs on relevant subjects ie., community oriented preventive medicine, etc.,

Adequate exposure to recent advances, Changing modalities of treatment, Adequate exposure of consumer protection

Medical insurance laws Record keeping, Community oriented preventive

medicine and medical audit.

Observers for CME / CDE

PM&DC may appoint observers in consultation who will be having specialty knowledge of the concerned subject.

Stay & Transport to be borne by the organizers

PM&DC may nominate maximum 2 observers for each CME/ CDE.

The organization hosting the CME/ CDE will have to make the observers as Hon. Delegate and arrange for hospitality including transport & stay wherever required.

Observers will have to authenticate the attendance sheet, Feedback forms & Summary of CME/ CDE& submit it to PM&DC secretariat.

Observers will have to maintain highest standards of decorum and they will have to ensure that the CME/ CDE is conducted properly and as per prescribed norms and there is no false attendance and that excess fees is not charged.

Senior PM&DC official can also be appointed as one of the observer.

DO WE NEED TO ACCREDIT ?

For Betterment of our employees – If they loose their licence hospital functioning can be affected.

For Betterment of patients. It’s a post graduate teaching Institute

If We Want to AccreditWHAT ARE THE WORK TARGETS ?

WORK TARGETS

A. Apply and acquire accreditation

In process It is in PMDC’s

court

B. Fee structure or funding from CDA

Deputy Director Audiovisual staff/

Librarian Clerical staff / Record

Keeper (Record needs to be kept for more than 5 years)

C. Nomination and notification of

Organizing Secretary with intimation to PM&DC

Some other staff

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D. Design CME Programs

E. Select speakers/ delegates

We should have a multi speciality program with topics for graduate doctors.

Occasional conferences

If you come across ideas for potential CME activities, let us know!

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You also need to pick the right instructors for the activity.

F. Apply to PMDC for the each program

One month in advance

G. Design and print

Brochures Certificates (for

delegates, speakers) PMDC Format

H. Preparation of summariesA. Submission to PMDCB. Record

I. Record KeepingA. PresentationsB. AttendanceC. Credits given to every

speaker/ delegate with dates. A. Hard copiesB. Soft copies

J. Presentations:

Topics of presentations have to be decided before applying to pm&dc

Coding of all future presentations after approval of CME

Steps must be taken to ensure that presentation is well balanced.

REGARDING THE ACTIVITY

You have done your homework - You: Identified the gap & the target audience Selected the best activity method Picked the most suitable instructor(s) Wrote clear and measurable learning

objectives to address the gap Created an appropriate evaluation method

to measure the activity’s success

Now you just need to figure out...

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How to get people to come to the activity!

New CME

Activity!

Advertising is the Answer!

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Wow, Now, you just need to figure out how to pay for it all!

Charging Registration fee from the delegates

Taking help from pharmaceutical companies

Help from parent department

CME Activity

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Drug and Device companies often contribute. It is legal and acceptable as long as the company does not control any part of the activity or provide any guidance on the content of the activity or on who should deliver the content.

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Message from E.D, Capital Hospital:

We are here to help you with your CME activities.