Radiologists cannot afford to ignore CME

October 13, 2004

Until recently, continuing medical education in Europe was largely a voluntary exercise conducted formally at conferences and informally outside the congress environment.

Until recently, continuing medical education in Europe was largely a voluntary exercise conducted formally at conferences and informally outside the congress environment.

Today, CME is mandatory in many European countries and forms an important part of recertification/revalidation procedures, by which doctors prove they are still competent to practice. CME deals with the upgrading of knowledge, skills, and competence, while issues relating to management, ethics, and communication are addressed in the broader field of continuing professional development. CPD relates to activities that enable doctors to take the lead in medical practice, act as advocates for their patients, and become involved in education.

Requirements for revalidation arose from the need for greater accountability to the public and a shift away from self-regulation of the medical profession toward control by external national authorities. The national and subspecialty medical societies will continue to be the primary providers, monitors, and standard setters for CME/CPD, albeit at a considerable financial and organizational cost.

In diagnostic imaging, the European Association of Radiology and the radiology section of the Union of European Medical Specialists (UEMS) updated their CME/CPD guidelines in 2000 and extended the opportunities for gaining CME credits. It is now generally accepted that doctors should acquire 250 CME credits over a five-year period, or 50 credits per annum, to keep their knowledge and skills current. Up to half of these can be Category 2 credits.

CME credits are awarded on the basis of one per hour of appropriate educational activity. Category 1 credits are earned by attendance at courses. Category 2 credits are granted for local educational activities, self-directed learning, and organized training secondments. The latter may be particularly appropriate for learning new interventional radiological techniques.

It should be possible to transfer knowledge and skills across the borders of individual European countries. While healthcare remains the primary responsibility of national governments, the European Commission is taking an increasing interest in health matters, due to the rapid rise in healthcare costs, the aging European population, and concerns about medical error. In April 2004, a high-level European group on health services and medical care made a number of recommendations, including the development of e-health facilities, transnational care, and structures for the health professions.

EU legislation underpins the free movement of goods and services and Europe-wide recognition of medical qualifications. Teleradiology is already having an impact on the delivery of radiological services across Europe, and radiologists are beginning to move between EU states.

The development of CME/CPD across Europe is essential to empower radiologists, defend the specialty, and underwrite their commitment to the best possible patient care. In recognition of this need, the UEMS and partner medical associations set up the European Accreditation Council for Continuing Medical Education in 2000. The EACCME aims to improve access to quality CME for European doctors and serves as a clearinghouse between different countries and specialties.

Challenges in delivering CME/CPD in Europe include costs in time and money. Entitlement to protected time and financial support for participation in CME/CPD should be contractual rather than discretionary. Other challenges include the need to encourage radiologists who most need CME/CPD to participate and the validation of distance learning. The Internet is proving useful as a tool for validation of self-directed learning. In its latest annual report, the Accreditation Council for Continuing Medical Education in Chicago reported an increase in the number of accredited Internet CME activities from fewer than 2000 in the year 2000 to more than 8000 in 2003. The number of physician participants in Internet CME activities during that period tripled from about 200,000 to 600,000.

Innovation in the provision of CME/CPD should be encouraged to maximize participation by busy European radiologists. Programs should allow participants to achieve critical competencies at their own pace and on their own schedules. Validated CME/ CPD opportunities that allow the development of personalized learning portfolios close to home, avoiding the cost and time investment in travel, will become increasingly attractive.

DR. HURLEY is former president of the European Association of Radiology and of the Union of European Medical Specialists radiology section. He recently retired from the post of consultant radiologist at Adelaide and Meath Hospital, Trinity College in Dublin.