Letter from America


Letter from America

Published online: 20 January 2015

Journal of European CME (JECME) 2015. © 2015 Murray Kopelow. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 Unported (CC BY 4.0) License (http://creativecommons.org/licenses/by/4.0/), 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 2015, 4: 27103 - http://dx.doi.org/10.3402/jecme.v4.27103


CME accreditation systems in Europe and the United States are very different from each other. The majority of accredited CME in Europe comes from individually accredited activities either by the national accreditation authority or by the UEMS, while in the United States, the majority of accredited CME is delivered by CME providers, accredited within the Accreditation Council for Continuing Medical Education (the ACCME) system. CME activity accreditation is also important in the United States. It has been provided by the American Academy of Family Physicians (AAFP) for decades and activity accreditation is growing in relevance and proportion now that the American Medical Association (AMA) and the Maintenance of Certification (MOC®) system accredit individual activities for inclusion in their own credit systems. A decade ago, a health IT person told me that the reason that US physicians did not have computers on their desks was because they did not need computers on their desks. Perhaps, this is why the United States and Europe are so different in this regard. Perhaps, there are no accredited CME providers in Europe because European physicians just do not need accredited providers. In the United States, hospitals and health care providers make up almost 60% of ACCME-accredited CME providers. Our system of state medical societies, and the ACCME itself, strive to ensure that physicians have access to high-quality, accredited CME/CPD in these institutions. A big driver in our system is the direct link between accredited CME and the physicians’ maintenance of licensure and specialty certification. Virtually every doctor in the United States is involved in a professional regulation system that requires, or expects, participation in accredited CME. A recent article by Solé1 describes a system of regulation of medical licensure in Europe that does not seem to speak with a unified “licensure voice” and does not have uniform CME/CPD requirements. In the United States, there is also no single voice or single set of requirements – but I think we are closer to it. The members of the Federation of State Medical Boards of the US, Inc., pretty well all require CME for re-licensure and to carry the imprimatur of one of the major credit systems of the AAFP, AMA or American Osteopathic Association (AOA) which in turn require the CME to be accredited by one of the national CME accreditation systems (ACCME, AAFP or AOA). These uniform regulations affect more than 90% of the licensed physicians in the United States. The ACCME system has always been a provider-based system and remains so because of the economies of scale and scope it offers in addressing the task of the quality assurance of so many activities every year. This provider-based system has been an efficient distribution channel for a single CME standard applied to the 130,000+ ACCME-accredited CME activities offered by 2,000+ providers for 24 million physician and non-physician registrants per year.

Perhaps, a step forward in Europe would be a single set of CME/CPD accreditation standards, promulgated by a committee whose members represent the various types of CME provider organisations that could exist in Europe. This list might include representation from the places where physicians are trained such as medical colleges and teaching hospitals, as well as the medical and surgical specialty societies, the professional organisations, the licensing authorities and the for-profit education companies that refuse to participate in any industry, marketing or promotional activities. This organisation need not accredit activities or providers but rather it could simply oversee the accurate application of its requirements by other organisations which it has deemed acceptable accreditors. A historical model exists. In 1980, the AMA graciously invited six other organisations to join them in creating an ACCME – to ensure a single national standard for CME. Perhaps now the UEMS, having worked to establish CME accreditation in Europe, could similarly invite other European organisations to form a similar entity which would not accredit itself but would set and oversee a single European CME/CPD standard that would be available for incorporation into the professional regulations of Europe. From this system, two things may very well emerge: first, a network of organisations seeking accreditation as CME providers so that their CME/CPD could “count” for maintenance of licensure; second, a uniform CME/CPD standard across Europe as the regulators of more and more countries adopt the single standard. There will be CME providers because the physicians will need CME providers. As Solé et al.1 wrote, “Participation in CPD/CME is only one aspect of maintaining professional competence but it is the only one common to all countries. Thus, there is a need to bring clarity to this confused landscape” (p. 633).

Murray Kopelow
Accreditation Council for Continuing Medical Education
Chicago, IL, USA
Email: mkopelow@accme.org


  1. Solé M, Panteli D, Risso-Gill I, Döring N, Busse R, McKee M, et al. How do medical doctors in the European Union demonstrate that they continue to meet criteria for registration and licencing? Clin Med 2014;14:633–639. Publisher Full Text
About The Author

Murray Kopelow
Accreditation Council for Continuing Medical Education
United States

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