Continuing Medical Education in six European countries: a comparative analysis.
OBJECTIVE
We examined Continuing Medical Education (CME) systems in a sample of six EU countries: Austria, Belgium, France, Italy, Norway, and the UK. The aim of this comparative study was to assess the main country-specific institutional settings applied by governments.


METHODS
A common scheme of analysis was applied to investigate the following variables: (i) CME institutional framework; (ii) benefits and/or penalties to participants; (iii) types of CME activities and system of credits; (iv) accreditation of CME providers and events; (v) CME funding and sponsorship. The analysis involved reviewing the literature on CME policy and interviewing a selected panel of local experts in each country (at least one public manager, one representative of medical associations and one pharmaceutical manager).


RESULTS
CME is formally compulsory in Austria, France, Italy and the UK, although no sanctions are enforced against non-compliant physicians in practice. The only two countries that offer financial incentives to enhance CME participation are Belgium and Norway, although limited to specific categories of physicians. Formal accreditation of CME providers is required in Austria, France and Italy, while in the other three countries accreditation is focused on activities. Private sponsorship is allowed in all countries but Norway, although within certain limits.


CONCLUSIONS
This comparative exercise provides an overview of the CME policies adopted by six EU countries to regulate both demand and supply. The substantial variability in the organization and accreditation of schemes indicates that much could be done to improve effectiveness. Although further analysis is needed to assess the results of these policies in practice, lessons drawn from this study may help clarify the weaknesses and strengths of single domestic policies in the perspective of pan-European CME harmonization.
Garattini
Livio
L
CESAV - Centre for Health Economics, Mario Negri Institute for Pharmacological Research, Villa Camozzi, Ranica (BG), Italy. lgarattini@marionegri.it
Gritti
Sara
S
De Compadri
Paola
P
Casadei
Gianluigi
G
D001317:Austria; D001530:Belgium; D002568:Certification / Q000458:organization & administration; D002983:Clinical Competence / Q000592:standards; D004502:Education, Medical, Continuing / Q000331:legislation & jurisprudence / Q000458:organization & administration / Q000592:standards; D005602:France; D007558:Italy; D009664:Norway; D006113:United Kingdom