Presented in seminar on continuing medical education at capital Hospital, Islamabad

1. A Review of CME (Continuing Medical
Education ) and PM&DC Guidelines
Dr. Ghulam Saqulain
M.B.B.S., D.L.O., F.C.P.S
Head of Department of ENT
Capital Hospital, Islamabad

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What is CPD and CME ?

3. CPD
 The term CPD acknowledges the wide-
ranging competencies needed to practice
high quality medicine/ dentistry, including
medical, managerial, ethical, social and
personal skills.
 It Incorporates
 CME which generally is taken to refer only to
expanding the knowledge and skill required by
the doctors.
 CDE, for dental surgeons

4. 4
CME (Continuing Medical Education)
Consists of educational activities which
serve to maintain, develop, or increase
the knowledge, skills, and professional
performance and relationships that a
physician uses to provide services for
patients, the public, or the profession.

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Why Should we Care?
But we are doctors.
We already have had years of training,
Why do we need more education?

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Because
As in any field, things change.
New problems
New guidelines
New Protocols
New discoveries
New interventions
This makes it hard to catch up with these changes

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CME is one way to remain up-to-date, both in their
specialty and in medicine in general.

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So doctors have a moral obligation to continue
their education. We do attend:
Some conferences
Some workshops
Some Courses

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Over, the course of time, CME, like many
other areas, has become regulated.
CME

10. In The West
CME training is compulsory for re-
certification.
Virtually every hospital requires that a
physician obtain CME credits for hospital
appointments and re-appointments
(credentialing).

11. In Pakistan
Recently PM&DC has also announced to
re-certify registration, on the basis of
CME.
Doctors need to complete 5 CME hours in
6 months to maintain their licence to
practice effective from 1st January 2015

12. Problem:
This has also created an anxiety among
doctors because:
It’s a new concept
It’s not in place
Implementation of the decision has
been made prior to making approved
CME’s in place
Costly
But it has to be followed, Why??

13. PMDC and LAW
 CPD as a mandatory requirement under
section 16B of PM&DC (Amendment) Act
2012 for the renewal of license to
practice.
 According to this;
License to practice be given only to those
medical/ dental practitioners/ specialists who
have completed at least 5 credit hours/ years
(for GPs) and 10 credit hours/ year (for
specialists)

14. Ways to earn CME:
Problem?
 Conferences
 Live Courses
 In-hospital programs
 Enduring Materials (DVDs), Journals
 CME Online

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And yes, there are RULES -
a lot of them!
ACCME
AMA

16. PMDC ACCREDITATION
 These accredited organizations shall
provide opportunities of continuing
professional development to the
registered medical/ dental doctors.

17.  Certificate of Continuing Medical
Education (CME) of only those DAI/
Institutions will be entertained which shall
be registered with PM&DC.
 No renewal of PM&DC registration will be
considered without certificate of CME

18. PMDC will:
 Charge Fee of Rs 50,OOO/-for granting
accreditation to it for 5 years.
 Yearly review (Performance Audit)
 Accreditation will be given maximum for 5
years subject to review every year.

19. Where possible?

21. 21
More RULES -
ACCME
AMA

22. ACCREDITED ORGANIZATIONS
Can be held responsible for:
 Irregularities in the program
 Non Maintenance of adequate standards
 Excessive fee: Fee be intimated to PMDC
along with application

23.  List along with registration number be
submitted upon completion of the
Course/ Workshop/ Seminar, etc. duly
attested by the CME Secretary and Head
of the Institute.
 Every branch of the organization/
organization will have to apply separately.

24.  The organizations should provide the
schedule (in detail) of each CME/ CDE
activity.
 Organizations should make arrangements
for advance publicity to the targeted
group of participants.

25.  The methodology of feedback:
Evaluation program by a standard
feedback form [of each delegate] duly
signed by organizing secretary and
observer will have to be maintained

27. The organization should undertake to:
 Publish handouts,
 Bring out a brief report of each CME/ CDE
and
 Prepare a list of participants and
delegates.
 The Attendance sheet [with registration
numbers] duly signed by organizing
secretary and observer will have to be
sent to PM&DC within 15 days of
completion of Program.

28. Purpose of accreditation ?
 The organization should evaluate CME/
CDE to indicate the benefits accrued to
participants by way of updating of
knowledge, upgrading their ability and
benefit to the patients.
 PM&DC will appoint maximum 2 observers
for each CME/ CDE.

29.  There will be arrangement for online
submission of application for CME/ CDE
with facility for uploading the data.
 The certification will preferably be
paperless.

30.  Manual application will have to be made
preferably one month in advance.
 Minimum 15 days in advance application
will be required.

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More RULES -
ACCME
AMA

32. PMDC Guidelines for CME/ CDE
 Any professional organization or body or
institution making to hold CME/ CDE
should apply for accreditation to the
PM&DC. The Council on verifying the
credentials of the organization will give
certificate of accreditations to those
bodies to hold CME/ CDE.

33.  It will also apply to the PM&DC on a
designed application form for the
program. The application should be
accompanied by the Complete program
of the CME/ CDE /Conference including
the names, designation and Country of
the speakers and the subject of speech.

34.  Accredited bodies which hold regular CME/
CDE will have to inform Pakistan Medical &
Dental Council, the date & time of the CME/
CDE, at least is days in advance, so that the
PM&DC can send observers for the CME/ CDE.
 In the application sent to PM&DC, duration
given to each speaker should also be
mentioned along with the topic of the lecture
while applying for the credit hours.

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CREDIT HOURS
So we need CME,
But who decides how much credit, if any, a
CME activity is worth?

36.  Credit hours to be awarded will be the sole
discretion of the organization and will depend
upon the subject matter, Status of the speaker,
Quality of the papers to be presented in the
CME/ CDE/ Conference.
 Credit hours will be based on the composition of
the faculty participation, quality and the
contents of the subject matter.

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CME credits are generally designated based
on the actual time spent in the educational
portion of the activity.

38. GUIDE LINES FOR CREDIT POINTS
 One Credit Point is equal to 2 credit hours
 One Credit Hour is equal to 3 hours session
 Maximum 6 hours duration per day shall
be 2 credit hours is equal to one credit
points

39.  Observers will be entitled for 1 extra point
plus the concerned CME/ CDE points.

40.  The institutions should be responsible for deciding/ designating
credit hours
 CME/ CDE workshop of minimum three hours duration shall be eligible for
maximum of one credit hour.
 CME/ CDE workshop of six hour duration shall be eligible for two credit hours.
 Speaker at any conference/ CME/ CDE/ workshop/ training
program will be given
 One credit hour per lecture given
 If they attend the whole CME/ CDE as a delegate, then they will be given the
approved points oft he CME/ CDE.
 The doctors may attend the international CME/ CDE
Conference held overseas as delegates. On the production of
the certificate of attendance. CME/ CDE credit hours will be
given as per equivalence formula.

41. CME/ CDE EXEMPT FROM CREDITPOINTS
 The CME/ CDE organized solely by a drug
I equipment company for promotion of
the drug/ equipment will not be
entertained/ considered.
 Credit shall not be given to Live Operative
Workshop (LOW) performed by foreign
faculties in Pakistan unless they obtain
temporary registration from PM&DC.

43. Requirement of Credit Points for
Renewal
 5 credit hours/ years of CME training is
mandatory for General Practitioners.
 10 credit hours/ years of CME training is
mandatory for Specialists
 No carry forward of extra credit points is
permissible after 5 years.

44.  For any CME/ CDE Symposium/
Conferences of any duration, not more
than 4 credit points will be awarded.
 Renewal cycle of 5 years is from the date
of fresh registration or renewal date.
 A criterion for recertification of medical/
dental practitioner license should be
established comprising of compulsion of
BLS for each candidate aspiring of
recertification

45. CERTIFICATE AND FEEDBACK
 Associations/ Organizations should strictly issue
the certificate to the delegate who has
attended the CME/ CDE.
 No certificates should be distributed on the first
day at the time of registration for the CME/
CDE/Conference.

46.  The certificates should be distributed/ awarded
only on the last day after completion of CME/
CDE/ Conference/ Workshop.
 Associations/ Organizations will be duty bound
to maintain the feedback of the delegates and
the list of the delegates who have attended the
CME/CDE/ Conference for 5 years.

47.  In case it is found by the Council that the
certificate is false then the accreditation
certificate of issuing Organization /Organization
will be cancelled.
 Associations/ Organizations will be duty bound
to maintain the feedback of the delegates and
the list of the delegates who have attended the
CME/CDE/ Conference for 5 years.
 If required PM&DC can seek additional
information

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The hospital must then issue a
CME certificate with the number
of credits claimed (but not more
than the maximum) for the
activity.

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Information regarding credits issued to physicians
must be maintained by the CME Office for 5
years.

50. CME/ CDE Committees
 PM&DC will have an Accreditation
Committee who will monitor, control and
audit the CME/ CDE.
 They will also cooperate in overseeing
proper conduct of CME/ CDE
 These committee will help for smooth
decentralized implementation of CME
/CDE

51. Which specialty doctor can attend
which subject CME/CDE ?

52. Composition of CME’S for Graduate
Doctors:
 A brief session on national health
programs on relevant subjects ie.,
community oriented preventive medicine,
etc.,
 Adequate exposure to recent advances,
 Changing modalities of treatment,
 Adequate exposure of consumer
protection

53.  Medical insurance laws
 Record keeping,
 Community oriented preventive medicine
and medical audit.

54. Observers for CME / CDE
 PM&DC may appoint
observers in
consultation who will
be having specialty
knowledge of the
concerned subject.

55.  Stay & Transport to be
borne by the
organizers
 PM&DC may
nominate maximum 2
observers for each
CME/ CDE.

56.  The organization hosting the CME/ CDE
will have to make the observers as Hon.
Delegate and arrange for hospitality
including transport & stay wherever
required.
 Observers will have to authenticate the
attendance sheet, Feedback forms &
Summary of CME/ CDE& submit it to
PM&DC secretariat.

57.  Observers will have to maintain highest
standards of decorum and they will have to
ensure that the CME/ CDE is conducted
properly and as per prescribed norms and
there is no false attendance and that excess
fees is not charged.
 Senior PM&DC official can also be
appointed as one of the observer.

58. DO WE NEED TO ACCREDIT ?

59.  For Betterment of our employees – If they
loose their licence hospital functioning
can be affected.
 For Betterment of patients.
 It’s a post graduate teaching Institute

60. If We Want to Accredit
WHAT ARE THE WORK TARGETS ?

61. WORK TARGETS
A. Apply and acquire
accreditation
 In process
 It is in PMDC’s
court
B. Fee structure or
funding from CDA

62.  Deputy Director
 Audiovisual staff/
Librarian
 Clerical staff / Record
Keeper (Record needs
to be kept for more
than 5 years)
C. Nomination and
notification of
 Organizing
Secretary with
intimation to
PM&DC
 Some other staff

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D. Design CME
Programs
E. Select speakers/
delegates

64.  We should have a multi speciality
program with topics for graduate doctors.
 Occasional conferences
If you come across ideas for
potential CME activities, let us know!

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You also need to pick the right
instructors for the activity.

66. F. Apply to PMDC for
the each program
 One month in
advance
G. Design and print
 Brochures
 Certificates (for
delegates, speakers)
 PMDC Format

69. H. Preparation of
summaries
A. Submission to PMDC
B. Record
I. Record Keeping
A. Presentations
B. Attendance
C. Credits given to every
speaker/ delegate with
dates.
A. Hard copies
B. Soft copies

70. J. Presentations:
 Topics of presentations have
to be decided before
applying to pm&dc
 Coding of all future
presentations after approval
of CME
 Steps must be taken to
ensure that presentation is
well balanced.

71. REGARDING THE ACTIVITY

72. You have done your homework - You:
 Identified the gap & the target audience
 Selected the best activity method
 Picked the most suitable instructor(s)
 Wrote clear and measurable learning
objectives to address the gap
 Created an appropriate evaluation method
to measure the activity’s success
Now you just need to figure out...

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How to get people to come to the activity!
New CME
Activity!
Advertising is the Answer!

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Wow, Now, you just need to figure out
how to pay for it all!

75.  Charging Registration fee from
the delegates
 Taking help from
pharmaceutical companies
 Help from parent department
CME
Activity

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Drug and Device companies often contribute.
It is legal and acceptable as long as the
company does not control any part of the
activity or provide any guidance on the content
of the activity or on who should deliver the
content.

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Message from E.D, Capital Hospital:
We are here to help you with your CME
activities.