The Changing Face of American Continuing Medical Education

As physicians we are all aware of the changing face of American Continuing Medical Education. It was only a few years ago, around 2003 that spouses could attend some pharmaceutical education programs (i.e. dinners). Soon thereafter invitations to CME dinners were changed to "healthcare professionals only." And in recent year, pharmaceutical sales people have almost lost the ability to provide CME dinners altogether.

In a similar vein, I can remember a rural family physician several boxes of shotgun shells in the closet of his medical office. They all had little "Pfizer" stickers on them. When I inquired as to why the MD has "Pfizer" stickers on his shotgun shells, he reported "because the Pfizer guy knows I like to hunt." Well, as go the shotgun shells, so went the education.

In 2011 I attended a most interesting "CME" meeting, if it can be called such. It definitely was Continuing Medical Education in that I received some of the best surgical training I had every received at a CME meeting. However, there were no CME credits offered. Why? Because Continuing Medical Education guidelines dictate that no CME credit can be offered for "off label use" of any device or drug. The meeting organizer, Dr. Bobby Osher, realized that cutting edge medicine is not dictated by federal government regulations, but is created through individual innovation which may require some "off label use" or even "compassionate use" of certain pharmaceuticals or surgical devices. Thus, he decided to create a meeting that would truly "educate" physicians whether or not federally approved CME credits were offered.

The strangest thing is this. Of any continuing medical education meeting I ever attended (excluding resident grand rounds presentations), this was the least biased meeting I had ever been to. It was about surgeons sharing surgical techniques and experiences, rather than some forced contrivance trying to make pharmaceutical marketing appear as though it were "education." The meeting was sponsored by several surgical and pharmaceutical companies, though. So, why so unbiased? The truth is that Bobby Osher, by throwing off the chains of "Big CME" (similar to "Big Oil" or "Big Government" or "Big (insert your least favorite industry here)") created an anything goes atmosphere where physicians could feel free to teach and to learn without constantly looking over their shoulders wondering if they had broken some written or unwritten law of a credit offering CME conference.

So - Hat's off to Bobby Osher!

In an effort to find Continuing Medical Education activities that are relatively free of bias, I would suggest the following:

1. Go to a resident presentation (i.e. grand rounds). Their main sponsor is their spouse or parents. 
2. Attend a Board Review course in your specialty. These tend to be aimed at residents and are relatively free of bias. 
3. Purchase a Board Review course on DVD and watch at your leisure. 
4. If you are looking for true "education" you might attend a "CME" meeting like Dr. Osher's which offers no CME credit. Ironic isn't it. 

Additionally you can find a list of 1000's of hours of CME programs in over 40 specialties on the continuing medical education compare page of ApolloAudiobooks.  Finally the most comprehensive list of CME I have found on the web is at CMElist.com.