Medical meeting planners in other countries are struggling with the very same dilemmas we face: How do we conduct CME in a fashion that best serves the physician community and patient well-being, and yet still remains of interest to commercial supporters? The model here in the United States is often a base, or at least a strong reference, for programs in other nations. In fact, some CME standards from the U.S. are adopted in markets where CME is not even mandatory.

South Africa's New System

It is interesting to look at the case of South Africa, as they are just becoming the 15th nation in the world to make CME mandatory for physicians. A loose system of voluntary credits is now transforming into a centralized accreditation process with one main body, for the whole nation, able to accredit providers. Those providers can then sanction individual CME activities.

Under this new system, the burden falls on physicians to keep a portfolio of attendance certificates from all CME activities for the previous two years. Before the new system was in place, it was up to the central body to electronically track attendance from CME activities around the country. Now, randomly selected samples of physicians will be subject to an audit each year. Those who fail to produce the certificates will first be warned and then may even lose their ability to practice.

Lecturers, content, and sometimes even commercial supporters are quite deeply connected right now. The new regulations for 2006 seem to point more heavily towards making physicians attend accredited CME events (and stay for the entire event), rather than focusing on separating content from supporter influence. While marketing-oriented meetings arranged by pharmaceutical companies do not qualify for CME credits, sessions for training physicians on how to use a company's technology or explaining the proper dosing for a new drug are acceptable CME activities, as long as they are conducted together with an accredited provider. Pharmaceutical companies may also sponsor physicians to attend international congresses, provided that they follow a fair and transparent process for granting these scholarships.

Fear-Driven CME?

I recently led a workshop on CME trends around the globe in Pretoria. Many people were shocked at the degree to which we go in the United States to separate content from commercial support. Medical meeting planners at my workshop expressed a deep concern over “fear-driven CME.” Indeed, in the eyes of someone from another country, our system can seem harsh — when commercial support is decided in tandem with lawyers, when lecturers must sometimes even account for the interests and professions of their spouses and children, and when the bottleneck of red tape can sometimes result in funds never reaching the programs the companies would like to support.

Workshop attendees seemed surprised that top medical lecturers would be disqualified from leading CME courses because they participate in major clinical trials (which are funded by pharmaceutical companies). Pharmaceutical company representatives expressed confusion over whether or not they would be able to continue key opinion-leader programs and still support CME initiatives. Yet, on the other hand, some product managers, hearing about CME guidelines from the United States, finally understood why corporate headquarters had implemented new policies that forbade local physician meetings at resort locations.

The main lesson here is to keep in mind that the rules and regulations we implement here in our country today will ultimately have an impact in other places. All the more reason to keep a healthy dialogue going as we struggle with the best way to serve the needs of physician education.

Jennifer Goodwin is president of The Goodwin Group, a global medical communications agency in Arlington, Mass. Reach her at