Implementing CME policy that is right for Europe

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Published: 17 Dec 2014
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Dr Edwin Borman - Chair of EACCME

Dr Borman talks to ecancertv at the European CME (Continuing Medical Education) forum about his involvement in setting criteria and implementing policy for European CME. He compares the European model to the American model and comments on quality assurance. 


I’ve been involved in European CME for, oh heavens, fifteen years now and in fact before that in junior doctor continuing education. But for specialist consultants in the United Kingdom I’ve been involved for fifteen years and have been involved in setting the criteria and the educational background for the basis for continuing medical education and professional development.

Could you give us some information on your role in accreditation?

My current activities are twofold: on the one hand, as Secretary General of the UEMS, the organisation that represents medical specialists throughout Europe, my responsibility is to set policy and to ensure the implementation of policy for continuing education throughout Europe. But then the second component of that is as the Head of what’s called the EACCME, the European Accreditation Council for Continuing Medical Education, which has the responsibility of accrediting both live educational events and e-learning throughout Europe. So it’s a dual role – part policy setting and part quality assurance.

Do you think the European model of accreditation will become more like the American model in the future?

The American model is presented in a monolithic way that it’s all provider accreditation. It isn’t, it’s actually an open secret that many people prefer not to actually acknowledge that the American system isn’t entirely provider accreditation based, there’s a huge component of it that’s based on event accreditation in the same way as much of the European system is based. What’s different between the two systems, and let’s celebrate that difference, there are a whole lot of things that we don’t want to do in Europe that the Americans have done - we don’t want to replicate their mistakes, for example - is that we’ve got many different countries; sure, they’ve got states but, broadly speaking, their system is equivalent. Our countries aren’t and we have a fundamental principle that’s applied by the European Union called subsidiarity that recognises that difference between states. In fact, we see this as a positive because it encourages diversity, it encourages different approaches and innovation and it also recognises that the healthcare structures within Europe are different. The system in the United Kingdom, which is based on a dominantly privately funded and privately provided healthcare system, is very different from some of the systems that occur on the continent where they’re dominantly privately funded and privately provided or insurance based. So they’re not all the same so you can’t impose one system that applies to all.

How can we make the system more responsive?

Part of the reason why the UEMS-EACCME has been involved in this area is to encourage high standards of practice, not just so that we can quality assure so that when we know doctors are going to go to conferences that they’ll get the best possible education there. But it’s also to encourage providers to deliver high standards of education. We’re trying to raise those standards incrementally so in a couple of years’ time, yes, those standards will become more stringent, we will be saying it’s not just about putting on a conference, now show us what the doctors are going to be learning and how potentially they’re going to be applying in their own practice what they’ve learned. It’s about raising standards of medical practice, not just medical education.

Anything else you’d like to add?

I’d very much like to see one of the really big differences between Europe and the United States put into greater focus. In Europe we still have the opportunity to self-regulate, in other words, the pharmaceutical industry, the medical devices industry, providers and the medical profession itself to take ownership for delivering high standards of practice, for being ethical providers and ethical consumers of medical education. In the United States much of that has been lost with the Sunshine Act where big government came in and imposed a big government solution. We don’t want that in Europe. In truth, I don’t think it’s likely to occur in Europe because of subsidiarity, because of the differences in healthcare but we need to be able to show, as an educational community, that we can take responsibility for appropriate standards for high ethical delivery of education and that the problems that there undoubtedly have been in the past simply will not happen again.