First Letter from America


First Letter from America

Published online: 27 January 2014

Journal of European CME (JECME) 2014. © 2014 Murray Kopelow. This is an Open Access article distributed under the terms of the Creative Commons CC-BY 4.0 License (, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for any purpose, even commercially, provided the original work is properly cited and states its license.

Citation: Journal of European CME 2014, 3: 23753 -


I thought this first “Letter from America” should be on independence—the independence of continuing medical education from industry. In the United States, accredited continuing medical education is free of the control of entities that produce, market, re-sell, or distribute health care products or services used by or on patients. This independence is very important to us. It has become part of the brand identity of accredited CME in the United States. Independence is one of the tactics put in place to support two overall strategic imperatives regarding the validity of accredited CME.

The first imperative is to ensure that accredited CME is never again used as part of an industry campaign to make or to expand a market for a product. The second imperative is to ensure that accredited CME never again appears as if it is being used to make a market for a product or to expand the market for a product. Before 1990, there were concerns that CME was promotion disguised as education. There were hearings in the US Congress to address these issues. Since then industry, the health professions, and the US government's legislative, judicial, and executive branches have all weighed-in with rules, regulations, guidelines, and laws in support of one or both of these imperatives. These rules and regulations form a framework to preserve the credibility and the public interest focus of accredited CME. As I said, independence together with content validity is part of the brand identity of accredited CME in the United States.

Interestingly, in 2008 and 2009, it became apparent to the CME community that a conflict had developed when some CME providers tried to fully incorporate the ACCME's independence regulations by preventing industry representatives from serving as CME faculty. The requirements were identified as a barrier, preventing industry from reporting its research at accredited CME events. The CME leadership of accredited organizations correctly said, “No industry speakers.” The research leadership said, “The ACCME is blocking the dissemination of important new science.” We were at an impasse because the research leadership would not consider excluding industry presentations on research from accredited CME and the ACCME would not drop its independence requirement.

We found a solution. You can read the complete text of these clarifications at There you will find that we determined that people who work for industry can speak at accredited CME events within certain limits. They can speak about the discovery process itself, about topics that do not relate to their firm's business lines, or about research results that are not about products. In addition, the ACCME accommodated industry reporting about some product research if a rigorous set of internal controls is in place to control content.

Raynard S. Kington, MD, PhD, then Deputy Director of the National Institutes of Health, and now President of Grinell College, in 2010 said to the ACCME: “We applaud the Accreditation Council for Continuing Medical Education's efforts to provide additional guidance for ensuring research independence and a free flow of scientific exchange, while safeguarding accredited CME from commercial influence. Your vigilance in this important matter contributes to the best practices of unbiased information-sharing and will benefit, ultimately, the health of the American public.”

This comment was in recognition of the ACCME's actions to provide clarifications on how to accommodate the reporting of industry's discovery and innovation—while preserving the independence of accredited CME.

Industry cannot control the content of accredited CME and industry employees cannot be faculty—except under very narrow and relatively rare circumstances.

In America, accredited continuing medical education is free of the control of entities that produce, market, re-sell, or distribute health care products or services used by, or on patients. Independence is important to us.

Murray Kopelow
President and Chief Executive Officer
Accreditation Council for Continuing Medical Education
515 North State Street, Suite 1801
Chicago, Illinois 60654, USA

About The Author

Murray Kopelow

United States

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