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Canadians Tightening CME Standards
Reported by Christopher West, GAME Board of Directors
12/17/2004

As elsewhere, the role of "big pharma" in CME is a major issue in Canada. While a Code of Marketing Practices is in place and the valuable contribution of pharmaceutical firms is acknowledged, industry sponsorship has recently come under close scrutiny by government, medical organizations, the media and even industry itself. Two Canadian leaders in the field - Dave Davis, Associate Dean, Continuing Education, Faculty of Medicine, University of Toronto, and Bernard Marlow, Director of CME/CPD, College of Family Physicians of Canada (CFPC) - recently responded to the growing concern of bias in industry-funded CME.

In separate commentaries in the July 20, 2004, issue of the Canadian Medical Association Journal, Drs. Davis and Marlow propose some new models to tighten controls in CME.

Dr. Marlow recommends:

• having provinces pay physicians for lost income to attend CME programs
• giving government grants directly to universities and professional associations
• continuing to create and support cooperative models whereby providers and industry can educate physicians without bias, ensuring that unrestricted industry grants are truly unrestricted

The CFPC is also randomly auditing accredited programs and will use the results to implement new audit procedures for CME programs.

Dr. Davis suggests the following four action items as a starting point to help physicians to balance their learning needs with patient concerns:

• providing physicians with adequate training in critical appraisal and ethical decision-making
• broadening the definition of "full disclosure" to refer to the amount that industry and other sources have contributed to programming
• leveling the playing field; i.e., secure greater government and professional support for CME to balance the influence of industry (this diversification of funding sources has begun)
• establishing a national body to develop Canada-wide guidelines and monitor their application, and a process "with legs and teeth".

According to Davis, these recommendations are the first steps in giving physicians - the end-users of CME - the necessary information, skills and confidence to make informed CME decisions.

References

1. The future sponsorship of CME in Canada: industry, government, physicians or a blend? [commentary]. CMAJ 2004; 171(2), p.150.
2. CME and the pharmaceutical industry: two worlds, three views, four [commentary] CMAJ 2004; 17(2), p. 149.

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