Continuing Medical Education

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Continuing Medical Education

• Dr. Myint Myint Khin
• Myanmar Medical Association

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Transition epidemiology/ Demographic changes
Advances in Science Technology
Public expectations/ Patient empowerment
Health System Health Care Delivery
Medical Education

• CME (CPD)
• Relevance
• Outreach
• Timelines
• Comprehensiveness
• Effectiveness

Post graduate
Undergraduate
CME Continuing Medical Education CPD
Continuing Professional Development
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Continuing Medical Education

• "all experiences after initial training that
  help health care personnel to maintain or learn
  competencies relevant to the provision of
  healthcare, from initial training to retirement".

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Principles Characteristics

• Outreach - must be accessible to everyone who
  needs CME
• Relevance local needs conditions
• Timeliness adapt according to changed
  situations
• Comprehensiveness
• Effectiveness - evaluation for ultimate outcomes

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Other requisites

• Language (medium of instruction)
• Co-ordination and co-operation between different
  providers, preferably - a "system" of CME rather
  than ad hoc measures
• Needs assessment, an essential initial step and a
  prime requisite
• Evaluation and monitoring of programs.

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CME providers -

• Ministries of Health
• Professional associations, organizations
• Academic groups, bodies,
• societies, universities
• Medical schools institutes
• Accreditation councils, boards
• Commercial enterprises (USA) such as MESS
  (Medial Education Service Suppliers)

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Methods and Formats

• Didactic lectures and variations eg.
  conferences, courses
• Interactive
• Mixed
• Print media
• Information technology methods
• - CD ROM, Online medical info. Service, www
• - Questions selection of issues and items to
  be presented
• - Ethics
• - Cost and cost-effectiveness

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Designing and Planning

• Objectives
• - changes in behaviour at practice, leading to
  - improved performances
• - improved health outcomes
• Pay attention to learners' characteristics
• Should be learner-centred, active/interactive,
  reinforcements, feedback
• Multiple sequenced interventions rather than
  single one-time efforts
• Needs assessment before planning

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Content of CME

• Include topics on newer "issues" eg.
• - Communication skills
• - Patient-doctor relationship
• - Ethics
• - Professionalism
• - Legal issues
• Others
• - cost of drugs, cost of healthcare
• - appropriate use of costly technologies
• - appropriate use of antibiotics
• - future problems relating to genomics

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CME and Recertification

• Recertification/revalidation for fitness to
  continue practice eg. USA, UK, EU countries etc.
• CME credits a primary requisite
• ASEAN countries recertification very likely
• Need for coordination to facilitate recognition
  and permission to practice

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CME and the Medical Industrial Complex

• Commercial funding a major source of financial
  support in CME
• Commercialisation of CME most widespread in US
  (new industry of Medical Education Communication
  Companies, Medical Education Service Suppliers)
• Question of ethics
• ACCME's task force to revise within "standards
  for commercial support in CME"
• MASEAN need to be vigilant about safeguarding
  ethics

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Evaluation of CME

• intrinsic element of all CME, but commonly not
  emphasized enough
• studies unanimous in proving positive impact of
  interactive methods and failure of didactic
  methods to attain behavioural change
• relatively weak representation of clinical
  content, more of therapeutic medicine
• need for local CME evaluation to promote
  effective and need-responsive planning and design
  of CME

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Situation Report (Myanmar)

• MOH training courses from time to time
  especially catering to the needs of specific
  areas such as campaigns , projects, programs
  others symposia, workshops (sometimes in
  collaboration with organizations such as WHO,
  UNICEF, UNDP, etc.)
• - one-year diploma in general practice by
• MOH
• Myanmar Academy of Medical Science holds
  occasional symposia, workshops and orations

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Contd . . .

• Myanmar Medical Association holds
• Annual Conferences
• Speciality Conferences by various speciality
  societies
• Periodic workshops, seminars and symposia
• Publishes a journal

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Conclusion

• CME will grow and expand in ASEAN countries
  especially with increasing prospects of
  recertification
• Need for organisation of systems of credentials,
  credits and evaluation studies and research
• Need for efficient coping mechanism for
  management of plethora of information

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• Where is the life we have lost in living?
• Where is the wisdom we have lost in
• knowledge?
• Where is the knowledge we have lost in
• information?
• T.S. Eliot (1934)