With the recent issuance of the new accreditation requirements, the Accreditation Council for CME has taken an important step toward assuring that continuing medical education activities address the individual learning needs of physicians and, by extension, the needs of their patients. The mandate for providers to participate more fully in the lifelong physician learning process, as based on self-assessment, challenges all in CME to develop new policies, practices, and procedures to assure and validate compliance.

While the ACCME will grant CME providers time to achieve compliance, the expectation is that the change process will begin immediately. The ACCME will assist providers with the issuance of a self-assessment, self-study guidebook.

As CME providers begin to understand and take ownership of the required self-evaluation changes, they also will come to the realization that the new rules are much more challenging to implement than other rules of the recent past, for example, disclosure and conflict of interest policies required by the updated Standards for Commercial Support.

Practical Considerations

The ACCME requirements, although needed and beneficial to the planning and delivery of quality CME, will demand new and different approaches from physicians, providers, and supporters. The self-assessment mandate seems to make great sense, building appropriately on existing ACCME Essentials and Standards, and certainly it will contribute to improved physician learning, retention, and knowledge application. Practically, however, physicians and those who provide and support CME have little formal training or experience in the self-assessment process. The ACCME guide will provide important help, but at the outset and until new systems are firmly in place, there will be a period of study, confusion, varying interpretations of satisfactory compliance, and trial and error.

Providers will have to retool their needs assessment and other procedures considerably, physicians will be unsure as to their exact contributions to the process, and supporters will choose differing approaches and interpretations of compliance. Industry attorneys can be expected to take a very conservative approach as they consider whether educational grants and proposals are approvable under the new rules.

Implementation will also depend on access to resources and funding. Larger provider organizations, for example, may be able to dedicate staff and funds toward quick incorporation of the self-assessment requirements, while smaller providers such as community-based hospitals or state medical societies may face a longer road to full compliance.

New Delivery Methods

After the self-assessment data are collected and compiled there will be another difficult challenge: how to merge the many different physician-identified needs into specific activity content and then determine the most appropriate method of delivery. Those who contribute to the self-study process will expect the opportunity to participate in educational activities targeted to their individual needs. Just how these expectations will be achieved will evolve as providers design new delivery methods and systems based on new advances in technology.

We should expect an adjustment period during which physicians, providers, and supporters can discuss, debate, and collaborate in order to achieve the best possible transition to compliance with the new requirements. Eventually, contributors to CME will become familiar and comfortable with the self-assessment process. The recipients and providers of CME will then be the beneficiaries of a much-improved educational system.


Robert F. Orsetti is the former assistant vice president, continuing education, University of Medicine & Dentistry of New Jersey in Newark. Orsetti, a 30-year CME veteran, is a member of the AMA's National Task Force on CME Provider/Industry Collaboration. Contact him at orsetti@aol.com. For more of his columns, visit meetingsnet.com/medical meetings.