Nearly 25 years ago, when Continuing Medical Education (CME) at Yale was created to develop programs that present the most current information and research to a broad range of medical professionals, the practice of medicine was very different. Advances in medicine did not occur at such a rapid pace, managed care had not permeated the medical landscape and 15-minute office visits were not yet the norm.
Today, as physicians try to keep up with their profession in a changed medical environment, Yale CME is overhauling its continuing education activities, which include courses and conferences, regularly scheduled grand rounds and two newsletters (The Medical Letter and Diabetes Newsletter) that include tests on their content for CME credit. Its goal is to build CME at Yale into an educational clearinghouse that acts not only as a resource, but as the facilitator of new information.
“One of the challenges in the environment is that physicians, because of managed care, find it increasingly difficult to leave the practice and go to a meeting,” said Lawrence S. Cohen, M.D., HS ’65, the Ebenezer K. Hunt Professor of Medicine, special advisor to the dean and chair of the CME Faculty Advisory Committee. In response, Yale CME is taking advantage of the Internet to streamline many of its activities. A revamped website allows participants to register for conferences online and access The Medical Letter and its corresponding exams at their convenience. (The Diabetes Newsletter will be available online sometime next year). In addition, physicians will be able to take online courses and examinations for CME credit within the next few months.
“On a practical basis, we are formalizing activities that have been ongoing at the School of Medicine, such as grand rounds and tumor boards (which meet to discuss cancer cases), and making them easily accessible to CME for credit,” said Cohen. “Most importantly, we are uncovering, not surprisingly, a wealth of investigators/educators who are in the process of putting together programs appropriate for CME at Yale.”
A major issue is compliance with guidelines set by the Accreditation Council for Continuing Medical Education (ACCME), including standards for commercial support that outline the steps that must be taken when accepting financial support from sources such as drug companies and device manufacturers. Two years ago the program’s accreditation was at risk over shortcomings in its record keeping and compliance with ACCME rules. Then Mary D. Marcarelli became director of CME, which is now up-to-date on ACCME standards and has trained almost 50 departmental coordinators to ensure compliance. In July the Yale CME program learned it received full accreditation from the ACCME through June 2008.
Plans under consideration for the future include video coverage of grand rounds on the Web; a lecture series focusing on research that can be directly translated to patient care; and the production of a CME program through the cable channel Discovery Health to offer CME credit to those unable to travel to conferences. The next few years may also usher in the use of handheld personal digital assistants to deliver CME course materials and the revival of the Mini-Med School Program, begun in 1995, which presented a series of lectures to the general public.
CME at Yale has become a high-profile project, and will continue to evolve as new technologies, research and treatments become available. “Medicine moves forward,” said Marcarelli. “We’re moving with it.”