“A small group of brave souls got together in Philadelphia a few years ago to talk about raising the CME bar,” said Jack Kues, PhD, CCMEP, president, National Commission for Certification of CME Professionals. He spoke on stage during a special event on October 21, held in conjunction with the National Task Force on CME Provider/Industry Collaboration annual conference in Baltimore. “Tonight is the culmination of a great deal of hard work,” he added, before raising a champagne toast to the 103 “pioneers” who were the first to earn the Certified CME Professional designation.

One by one, the names of the 103 CME professionals who passed the beta test in May and the first exam in June and September, were announced to hearty applause from the audience of fellow CCMEPs and supporters. Each newly credentialed professional received a plaque and a CCMEP lapel pin.

The certification program comes at a critical time, strengthening CME's credibility in the face of heightened scrutiny and criticism from government agencies, Congress, and the press, and an increased emphasis on performance and quality improvement by healthcare regulatory bodies such as the Joint Commission and the specialty boards.

“It's an important first step in validating CME as a profession,” said Lawrence Sherman, FACME, CCMEP, NC-CME's financial development chair; and president and CEO, Physicians Academy for Clinical and Management Excellence, New York, during the ceremony. “Everybody is a critic; this is how you combat the critics, by demonstrating your competence.”

From Talk to Action

A CME certification program had been discussed and debated in the industry for more than two decades. Some felt that since CME professionals' jobs are so highly specialized, a general program would not be meaningful or relevant to many in the field. Instead of going the certification route, the Alliance for CME established a maintenance of competency initiative, whereby CME professionals can assess and improve their knowledge in specific areas. It's currently working on a program to award certificates of proficiency in certain areas, such as outcomes evaluation.

But others felt that despite the inherent challenges, it was crucial to establish a CME credentialing program. “One day I was driving and I saw a van ahead of me that said: ‘Be sure that your chimney sweep is certified.’ And I laughed and I thought, chimney sweeps are certified but CME professionals are not. There's something wrong with this picture,” says Judith Ribble, PhD, FACME, CCMEP, the retired director of CME for Medscape who now serves as NC-CME's executive director, a full-time volunteer position.

Ribble first got the ball rolling in fall 2004. “A group of us had talked informally about certification and I realized that we needed to get together to see whether we could gather momentum — or if it was just an idea that would never bear fruit,” she says.

She sent invitations to a group of CME leaders, inviting them to attend a two-day retreat in February 2005 at a conference center near Philadelphia. Eleven volunteers attended, demonstrating their commitment to the idea by paying their own way.

The founding group reviewed certification programs that could serve as models, drafted a concept proposal, and adopted a mission statement. They did a SWOT (strengths, weaknesses, opportunities, threats) analysis. “And with each exercise we did, it became clearer and clearer that this was doable,” says Ribble.

“The burning question at that retreat was: Shall we move forward; is this a good idea? And after two days there was a unanimous vote of approval,” says Ribble. “So at the last session I was elected president, and I immediately invited everyone in the room to be on the board of directors.” (Ribble became executive director of NC-CME in December 2006.)

It took three years, with more than 70 volunteers from throughout the CME field working thousands of hours to bring their vision to fruition.

Finding Funding

In the spring of 2005, the board sent formal invitations to 18 organizations considered to be stakeholders in the CME enterprise, inviting them to send representatives to the NC-CME Advisory Board, which held its first meeting in June 2005 in New York City. During the next few months, the team created a Web site, drafted a three-year budget, and initiated a work plan.

To learn the fundamentals of how to incorporate as a not-for-profit organization, the team worked with the Foundation Group in Nashville, Tenn. NC-CME was formally incorporated in January 2006; they then received a 501(c)(3) designation from the IRS so that they could receive tax deductible donations.

The first group to step up was the Postgraduate Institute for Medicine, which pledged to give three years' worth of support. The North American Association of Medical Education and Communication Companies also pledged three years of support. To date, individuals and organizations have donated more than $95,000 to provide startup funding for the nonprofit, all-volunteer organization.

Spreading the Word

Ribble, Kues, and others spread the word about NC-CME by speaking and exhibiting at the annual conferences of the Alliance for CME, the National Task Force on CME Provider/Industry Collaboration, the National Medical Association, and at other meetings. More than 100 CME professionals attended an open forum during the January 2006 Alliance for CME conference. Their names and contact information formed the basis of an NC-CME database of potential volunteers.

Several organizations, including the Society for Academic CME and NAAMECC, posted notices on their Web sites and listservs. Eventually NC-CME had a database of more than 1,000 individuals interested in certification.

“We were encouraged because those who came to the workshops were asking: ‘When is this going to be available? What are the qualifying requirements going to be? What's going to be on the test? How do I prepare to take it? What is going to be a passing score?’ They were asking the kind of questions that somebody who intends to take the exam would ask,” says Kues, who became NC-CME president in December 2006 and is also assistant senior vice president for continuous professional development at the University of Cincinnati Academic Health Center in Ohio.

The Three E's

To determine the components of the credentialing process, NC-CME's founders researched the best practices of other professional organizations, joining the National Organization for Competency Assurance and adopting the National Commission for Certifying Agencies' Standards for Accreditation of Certification Programs. They found out that the three principal elements that determine a valid certification program, according to NOCA, are education, experience, and an exam. NC-CME followed that model, deciding that CCMEP applicants would submit a form summarizing their education and continuing education, work experience, and leadership qualifications. Each element is assigned a point value and applicants with the requisite point total are admitted to the exam. Regardless of their experience level, everyone must pass the exam before achieving the CCMEP.

“Although the board discussed it initially, people were very vocal in opposition to ‘grandfathering’ the credential,” says Karen Overstreet, EdD, RPh, FACME, CCMEP, who chaired the test-development committee and is now president-elect of NC-CME. Overstreet is also president of Indicia Medical Education LLC, North Wales, Pa. “Given the rapid pace of change in the field and the importance of having current knowledge of CME guidances and regulations, everyone with the credential needs to have demonstrated that [expertise].”