Report on Proceedings of the Sixth Annual Meeting of the European CME Forum, London, UK, 14–15 November 2013


Report on Proceedings of the Sixth Annual Meeting of the European CME Forum, London, UK, 14–15 November 2013

Ron Murray

Independent CME/CPD Consultant, Pickering, North Yorkshire, UK


Delegates from around the world attended the sixth annual meeting of the European CME Forum in London between 14 and 15 November 2013. The participants discussed best practices in continuing medical education and continuing professional development (CME–CPD) delivery, reviewed CME provision by various medical specialist societies, and viewed examples of e-CME educational activities in CME–CPD. The details of a new code for disclosure by European pharmaceutical companies were unveiled, and the implications were discussed with expert panels comparing the CME landscape in the United States with that in Europe. Accreditation systems were compared, and a number of informal sessions allowed the delegates to consider issues relevant to physician learners, transparency and accountability in CME planning and implementation, and opportunities for collaboration.

Keywords: CME, Europe, proceedings, 2013, transparency, CPD, accreditation

Received: 17 December 2013 Accepted: 19 December 2013 Published online: 9 January 2014

Journal of European CME (JECME) 2014. © 2014 Ron Murray. This is an Open Access article distributed under the terms of the Creative Commons Attribution 3.0 Unported (CC BY 3.0) License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Citation: Journal of European CME 2014, 3: 23600 -


Delegates from Europe, Asia, and North America met for the sixth annual European CME Forum (ECMEF) in London on 14–15 November 2013 to consider a range of issues affecting continuing medical education and continuing professional development (CME–CPD) in Europe. Interactive sessions were interspersed with panel discussions and didactic presentations comparing accreditation systems and examples of CME offerings from a number of European stakeholders.

The forum began with members of the Good CME Practice Group (gCMEp) eliciting examples of the ‘good’, ‘bad’, and ‘ugly’ in current European CME practice. These included:

  1. Increasing awareness among physicians seeking quality CME (good);
  2. Wide differences in CME regulations in different countries (bad); and
  3. The complexity of accreditation (ugly).

This icebreaker continued with a basic case-based scenario to illustrate the ‘best practice’ stages of a CME activity. The exercise dovetailed well with gCMEp's new planning toolkit (see

Presentation of specific examples of CME provision by European specialist societies was opened by Martin Balzan, Secretary of the European Board for Accreditation in Pneumology (EBAP), who emphasised the complexity of interactions among European stakeholders and likened the relationships to a series of ‘thin red line’ separations. He then detailed specific agreements in respiratory medicine intended to blur some of the lines. These include:

  1. An agreement between the European Union of Medical Specialties–European Accreditation Council for Continuing Medical Education (UEMS–EACCME) and EBAP on principles of cooperation; and
  2. A memorandum of agreement on collaboration between the UEMS pneumology section and the European Respiratory Society on the society's curriculum and Board examination.

Wolfgang Grisold, representing the World Federation of Neurology (WFN), next described the development of the European Board of Neurology's (EBN) curriculum from various scientific panels and the e-learning resource ‘e-brain’ (see Professor Grisold described the wider reach of the examination in Asia, Africa, North America, and the Middle East and how WFN has adapted EBN's protocol to establish Training Centres in Peru and Morocco and link the Board examination to CME and CPD.

In a very well-received presentation, Susanna Price of the European Society of Cardiology (ESC) reflected on the changing world of cardiology and greater integration with primary care. She recognised the need for multiprofessional teamwork and described ESC's plan to tackle financial restrictions by integrating e-learning via its platform ESCeL. ESC is also implementing guidelines-based and interactive case-based education to improve patient outcomes. Her most salient point was the need for the individual specialist to obtain balanced CPD and be able to move out of his or her comfort zone.

The session illustrated the important role that specialist societies play in supporting their members during training and providing practice-linked CPD opportunities using an array of formats.

The forum's focus then shifted as examples of e-CME programmes were presented:

  1. Jörg Ansorg (Professional Board of German Surgeons) noted a recent decline in participation in the Board's surgical procedures courses through its portal and suggested that the decline might be reversed by the use of blended learning courses, mobile platforms, collaborative learning, and mental training similar to that used in Formula 1 racing.
  2. Peter Henning (Institute for Computers in Education, Karlsruhe University of Applied Sciences) discussed new paradigms for content, learning machines, interaction, delivery, and organisational systems.
  3. Elgin Lichtenauer-Kaligis of the European Association of Urology (EAU) listed EACCME's accreditation requirements for e-learning and the need for collaboration between content experts and instructional designers. An EAU pilot project (Structured Training Programme in Robotic Urology) was presented that emphasised the importance of easy navigation to enhance participants’ learning experience.

The first day concluded with an interactive panel session on the role of industry support of European CME in light of the new European Federation of Pharmaceutical Industries and Associations (EFPIA) transparency code ( An outline of the code was presented, and comparisons made with the recently published Sunshine Act in the United States. The main discussion points that arose were on code implementation, privacy laws in various countries, the definition of ‘transfer of value’, and possible inclusion of medical device companies. The panel agreed on the need for enhanced public awareness of the code and its implications.

Day 2 began with a review of the open access procedure for JECME and a request for submissions to the journal, and then moved on to a popular session where Murray Kopelow, Executive Director of the Accreditation Council for Continuing Medical Education (ACCME), conducted conversations with Edwin Borman (UEMS-EACCME), Maureen Doyle-Scharff (Pfizer), and Craig Campbell (Royal College of Physicians and Surgeons of Canada). Dr Borman described Europe's conglomerate nature and how similar political, economic, environmental, societal, and technological influences to those in the United States affect the delivery of accredited European CME. He urged a new, highly principled consensus model to facilitate this delivery. Ms Doyle-Scharff outlined Pfizer's strategy of commercial support for learning and change that conforms to the ACCME's Standards for Commercial Support even outside the United States. She also described the similarities in the United States to Dr Borman's list of influences and the many shared values among industry supporters. Dr Campbell described learner-centred professional obligation in Canada, exemplified by the Royal College's Maintenance of Certification (MOC) programme. He also cited systematic reviews that show the positive impact of group learning on outcomes.

Three different European accreditation protocols were then compared, beginning with the European Hematology Association CME Unit's somewhat restrictive accreditation system whereby only academic or scientific organisations are eligible to apply for accreditation and only a trained haematology specialist is eligible to represent an applicant organisation. A wider perspective was described in the approach of the European Board for Accreditation in Cardiology (EBAC), which is focused on shorter term outcomes and differentiating between ‘good’ and ‘excellent’ by awarding more points for higher quality CME activities based on defined quality criteria. An example provided was a simulation course in interventional cardiology. Dr Borman provided a review of requirements for learners among a number of European countries, as well as the legislation and politics that affect the funders and providers of CME–CPD, and he urged all stakeholders to accept the need for transparency and accountability. He encouraged agreements on self-regulation that may avoid the ‘blunt instrument of legislation’.

A Lunch with the Learners session allowed delegates to engage informally with two UK-based physicians, a GP and a gastroenterologist. They described their individual planning for CPD via annual appraisal and learning portfolios and both noted an increased use of e-learning platforms to access CPD.

Loosely based on the Dragons’ Den TV programme format, four delegates each submitted a planned CME activity to a panel representing various CME–CPD stakeholders – an accreditor, an educationalist, an experienced Programme Chair, a learner, and a commercial supporter. The experts and the audience provided unfiltered feedback for each presentation, and this helped all delegates consider the need for CME plans to be clearly thought out in terms of educational objectives, accreditation requirements, resources, and budgetary constraints.

The final ‘unsession’ featured Lawrence Sherman (Prova Education) reprising his master of ceremonies role. Discussion topics included the implications of the Sunshine Act on US physicians attending commercially supported CME activities in Europe, budgeting for grant applications, and the potential effects on learners of having to report ‘transfer of value’, as discussed in the EFPIA code.

Much informal discussion focused on the reluctance by some delegates to accept that lessons could be learned from the experiences of accreditation organisations and providers in the United States as the era of increased transparency and accountability arrives in European CME.

Full details of the presentations and support materials may be accessed at the European CME Forum website,

Declaration of interest

I have no financial relationships with any commercial interests.

Correspondence: Ron Murray, Independent CME/CPD Consultant, 17 Rosamund Avenue, Pickering, North Yorkshire YO18 8BZ, UK.

About The Author

Ron Murray
Independent CME/CPD Consultant
United Kingdom

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