“I'm the associate dean for academic affairs.”

“That's impressive. You must have a lot of responsibility.”

“I'm the dean of student affairs.”

“Wow. You have a chance to shape students' careers.”

“I'm the assistant dean for CME.”

“What's that? I didn't know there was such a position. Did no one else want it?”

We may not actually hear these reactions explicitly, but I can tell you, that is what many physicians think.

Physicians lack understanding about CME management in part because there is little physician leadership in CME. As I go to numerous CME professionals' conferences, I can count the number of MDs in the room on one hand, and it's rare to see a physician represented on a panel. When I have noted my observations, some people have commented that the management of CME is best left to educators, and physicians aren't trained in educational methods.

Physicians Are Educators

Granted, few physicians can accurately describe adult-learning principles or list the various stages of outcomes measurements, but to say that physicians are not educators is just plain wrong. The whole process of medical education involves lifelong learning and teaching. Medical students educate their younger colleagues, residents educate interns, attending physicians educate residents. In academic centers, teaching is a major mission, and even at community hospitals and practice locations, physicians focus on learning, especially regarding new information and guidelines.

This concept of lifelong learning should raise the importance and prestige of CME positions. After all, a dean of students or academic affairs is only involved with medical students and residents. In contrast, a dean of CME is involved with physicians from the time they graduate from medical school until they retire. Given that most physicians practice for 40 years, deans of CME need to develop a range of educational interventions in order to be effective.

R-E-S-P-E-C-T

Unfortunately, CME offices have little prestige in academic centers or hospitals. Many physicians feel they already know how to learn, or that CME is simply a perfunctory task to maintain one's license. In addition, CME directors have little visibility within the dean's or CEO's office.

Given all the publicity and debate about commercial funding of CME, physician leadership is critical. Don't take this the wrong way, but I don't presume that I should tell lawyers or accountants how they should maintain their professional knowledge. Similarly, I don't think nonphysicians should be solely responsible for creating CME policies and procedures. There's definitely a role for nonphysician leadership in CME, but right now physician leadership is almost nonexistent.

Academic medical centers need to bolster the prestige of the dean of CME by choosing more senior academicians for the position as well as increasing its visibility and perhaps financial remuneration. Medical education companies need to include physicians in their daily operations and organizational leadership, not just on advisory panels. Physicians also need to participate more in the debate about CME. Government agencies are affecting professional education. We would be remiss if we leave it to others to shape the future of medicine's educational continuum.

John Whyte, MD, MPH, is vice president, CME, Discovery Health Channel, in Silver Spring, Md. He formerly served as a senior official in the U.S. Department of Health and Human Services. Reach him at John_Whyte@discovery.com.

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To submit a guest opinion or advice piece, please contact Editor Tamar Hosansky at (978) 466-6358 or e-mail her at thosansky@meetingsnet.com.