Serious medical education on a cruise ship? Yeah, right. Any possibility of real learning would be drowned out by the siren calls of exotic ports, tropical breezes, poolside views — not to mention the attendees' kids yelling “Watch me!” And besides, who wants to have their breakout in the lounge broken up early because the ship's staff needs to set up for the evening bingo game?

That's what some people think about cruise CME. Are they right? Bruce Hart, vice president, International Professional Meeting Coordinators (, Stevens Point, Wis., says it just ain't so.

“It's a little annoying that people perceive cruise CME as being a junket,” says Hart, whose company handles logistics for the cruise CME programs of academic organizations like the University of Wisconsin. “If you were there on our recent cruise to Alaska, you would have seen the 50 or 60 physicians taking the CME course lining up at 7:30 in the morning to get into the sessions.”

Too Much Fun?

“Before I did this, I had a fear about losing people to distractions, but it turned out to be baseless,” says Marc Comstock, vice president of North Andover, Mass.-based Fitzgerald Health Education Associates, Inc. (, which specializes in providing cruise CME programs for nurse practitioners. “It's the audience's attitude toward continuing education that counts. The people who will stay for the program on land will stay for the program at sea.”

Some planners even find they get better attendance at sea. “More people attend our sessions on cruise ships than the ones at land-based meetings,” says Miami-based Anna Izaguirre, an office manager who has helped plan six cruises for Baptist Health System of Southern Florida, most recently a 19.5-credit course in July on diabetes management and technology that took attendees to Greece and Turkey. “It helps that, on board a cruise ship, we have a captive audience.”

Of course, content is key. “We do a cruise every two years, and they get more popular each year, in part because we offer very well-known keynote speakers. The docs like that it's an intense meeting in a casual atmosphere,” says Izaguirre.

“If anyone attended one of our courses and came back and said it was just a junket, I'd refund them every dime,” says Sandra Scheitinger, president of Continuing Education Inc. ( in St. Petersburg, Fla. Continuing Education Inc. is an ACCME-accredited provider of medical programs; the firm's other division is Cruise Meetings/University at Sea (, a for-profit company that works with medical planners to set up shipboard meetings. “We work hard to recruit good speakers with good content, and attendees just don't want to leave,” she says.

Cruise CME planners across the board stress the importance of being meticulous in tracking who is actually attending the CME. “You sit for the program, you get your CME,” says Comstock. “You don't sit for the program, and we'll adjust the hours accordingly. We're an ACCME-accredited provider, and we take our accreditation very seriously.” Hart echoes that sentiment: “There are sign-in sheets for every session. You don't go, you don't get credit.”

Run a Tight Ship

One of the most important ways to rein in potential wanderers is to make sure your courses are scheduled around the ship's activities.

“You have to plan your meeting around the port times,” says Scheitinger. “Attendees bring their families with them, and when the ship pulls into port, they're going to want to go ashore. It doesn't pay to compete with Cozumel.”

It's not always just a port that will pull them away, either. Comstock says that if they're doing an Alaska cruise, they're not going to hold class while the ship's in a fjord with ice breaking off the glaciers. “Everyone would be on deck watching — it would be stupid. We try not to have the CME interfere with the fun things people want to do.”

For a typical seven-day cruise, Scheitinger says CME attendees can easily get between 16 and 24 hours of credit while still seeing all the ports. But you really shouldn't do more than 14 hours on a four-day cruise, she warns, or you'll burn out your attendees. “I tell the planners that if you're going to work them the whole time, don't put them on a ship.”

Cruising also can satisfy a planner's inner control freak because it is such a tightly managed environment. “I find that my agendas are easy to handle because ships operate on such a stringent schedule,” says Scheitinger. “I'm in charge of every room on that ship.” While about half of the meetings she handles do have exhibits, she doesn't have to worry about pharmaceutical company representatives siphoning attendees off to a private reception.

“If I'm the meeting planner, the ship will not set up a space for a pharma company educational or social event without me knowing about it,” she states. While CME providers complain that pharma companies lure attendees away from land-based meetings onto cruises, the reverse really isn't an issue because cruise CME isn't occurring when the ship is in port.

High Costs on the High Seas?

Some planners think cruise CME sounds too luxurious to be cost-effective, but that's not the case. Hart says that the per diem for a cruise is around $200, which includes all meals and shipboard entertainment.

“If you price it out and compare it to a resort where you're paying $150 a night plus food and entertainment, a cruise is a better value,” he says. Plus, there is a much greater range in accommodation prices, from inexpensive indoor cabins up to deluxe penthouse cabins. In a resort, “you're stuck with what they have available,” he says.

OK, but what about the possibility that your meeting could get booted for bingo? While that might have been an issue 20 years ago, today's meeting-friendly cruise lines like Norwegian, Holland America, Celebrity, and RCCL typically have purposely designed conference rooms that offer theater-style seating and hold about 200 people. Ships nowadays also have state-of-the-art AV equipment and lounges outfitted with high-end lighting. Scheitinger says she's working now with a planner who wants to have a total of 40 breakouts, with AV in every room. “I can do that in Holland America's S-Class ships.”

Izaguirre warns that, while there are great ships out there, it's important to give yourself lots of time to investigate. “It has to be a state-of-the-art ship, because docs don't like anything old or outdated. And if it doesn't have a conference center, we don't book it,” she says.

One big complaint attendees had in the past was that they had no way of communicating with the outside world, but that's changed, too. Now they have Internet cafés and telephones in the rooms. You can even send and receive faxes. One caveat to the high-tech capabilities of cruise ships: You have to think of everything beforehand. “We have a suitcase full of cords, adapters, and software that we always bring,” says Scheitinger. “One time a lot of speakers weren't able to get their materials on time, so we brought our own copier on board. You have to remember that there aren't any Kinkos around the corner.”

Another thing that is a little different about cruising, from a planner perspective, is that the marketing timetable is much longer than for a hotel meeting, according to Comstock. The reason? People tend to look at cruises as more complex trips than just hopping a plane to a resort for a few days. Plus they want to bring the family along, and so they have to arrange time off from work for spouses and work around the kids' school schedules.

For the Caribbean, Scheitinger says she likes to drop her brochure no later than six months out. For Alaska in the summer, she says, “I like to do it at eight months, because they're definitely bringing the kids on that cruise.”

A Taxing Concern

“If anyone attended one of our courses and came back and said it was just a junket, I'd refund them every dime.”
— Sandra Scheitinger

Lynne Tiras, CMP, president of International Meeting Managers Inc., a Houston-based independent planning firm that specializes in medical meetings, finds that one of the biggest reasons her medical societies don't want to cruise is that, in order for the accommodations to be tax-deductible as a business expense, they have to be on a ship that's registered as a U.S. flagship. While 95 percent of cruise lines aren't, there are some, such as American Classic Voyages Co. (, which operates United States Lines and American Hawaii Cruises; and Clipper Cruise Lines (, whose Nantucket Clipper and Yorktown Clipper are U.S.-registered.

But there are other ways around this restriction, according to Scheitinger. “If you read the tax codes, you'll see that if you hold an on-land meeting at one of the ports — say a two- or three-hour meeting at a hotel within walking distance of the ship — accommodations can be classified as luxury water transportation.” This means, she says, that attendees can deduct $300 to $400 per day, “which is a lot more than a cruise is going to cost them.” Be sure to consult with your tax attorney before making any plans, though, as tax laws tend to be in a constant state of flux.

Attrition Conditions

Scheitinger says that her biggest challenge is to convince her clients that there really aren't any hitches. “They think that there won't be any meeting rooms, or there will be a lot of hidden costs. One planner even said that the contract is too simple, that it needed to have lots more pages.”

Why is the contract so simple? There's no need for attrition clauses in cruise contracts, she says — if you work with a third-party company that has annual contracts with the cruise lines, that is (see sidebar, opposite page, for more about using a third-party firm to handle the cruise logistics). “The lines we work with are willing to hold the space without imposing any penalties up to about 60 to 75 days prior to departure, in some cases even closer in. After that time, sleeping rooms are available at the discounted group rate as long as there is space on the ship. The planner's contract is with us, so they are relieved of having the liabilities associated with having a direct contract with the line.”

The all-inclusive nature of cruise pricing means you don't have to sweat the small stuff when it comes to food and beverage, either. You can even profit from it by getting companies to underwrite the costs for meals and parties. They can pony up $25 or more per head for a little exposure, but the food, band, and space is yours for no extra cost.

“The lack of attrition is probably the biggest advantage to cruise meetings,” says Scheitinger. “I have a land meeting in November, and I have to worry about every little thing. On a ship, if I order 25 too many brownies, it doesn't matter because the price is all-inclusive. We do almost 100 meetings a year, and I have worried more over this one land meeting than I have all the cruise meetings put together.”

Third-Party Life Preservers

Chances are, you're in the education business, not the cruise business, and even the most experienced land-based CME planner can find that working with a cruise line has its unique — sometimes overwhelming — challenges.

“I'd recommend that anyone looking to do [cruise CME] use an outside firm, rather than try to deal directly with the cruise lines,” says Marc Comstock, vice president, Fitzgerald Health Education Associates, North Andover, Mass. Baptist Health System of Southern Florida's Anna Izaguirre says she also hires a third party to handle the logistics for her cruises. “Otherwise, it's just too much.”

These third-party cruise-management companies can provide services that include online and off-line marketing assistance, inquiry and reservation phone lines, air and rental car arrangements, on-board functions, and meeting management and contract negotiation with the cruise lines. They are subsidized by the cruise lines, not the sponsoring organization, so they don't cost you anything, according to Continuing Education Inc.'s Sandra Scheitinger. “We handle the inventory and the contract for the planner, so they get to take advantage of our experience with the lines,” she explains.

Because they do volume business with the cruise lines, they also can get you a better deal, and they can help decipher the sometimes nebulous cruise ship language. For example, says Scheitinger, if you ask a cruise line about meeting space, “they'll tell you about their meeting rooms in the conference center, but they probably won't mention their show lounge, which can be a beautiful presentation room.”

If you decide that you want to go it alone, or if you just want to check out who offers what, Cruise Lines International Association's Web site has a page where planners can plug in the meeting-related services they need, from AV to on-site coordinators. The site ( offers a list of the member lines that can provide the services. Other online resources include StarCite ( and mpoint by PlanSoft (