Medicine is an ever-changing field where new guidelines and protocols are released every few months. Now a days new discoveries  are increasing at ever-increasing rate. This makes it hard for doctors to catch up with these changes, since they are already overwhelmed by their clinical duties. To encourage doctors to keep their knowledge up-to-date concept of continued medical education (CME) was introduced.

This is not a new concept in western world where CME training is compulsory for re-certification from last many years. But recently Pakistan Medical and Dental Council (PM&DC) has also announced that to re-certify registration, physicians need to complete 5 CME hours in 6 months. This rule is in effect from 1st January 2015 and all the physicians are required to present certificate of CME completion for renewal of license to practice.

 According to statement released by PM&DC:

License to practice be given only to those medical/ dental practitioners/ specialists who have completed at least credit hours/ years (for GPs) and 10 credit hours/ year (for specialists) of training of CMEThese training shall be conducted by recognized DAI/ professional body

Although it is a wise and long-awaited decision but it has also created an anxiety among young physicians who are not aware of the concept of CME. In this article I will try to explain what is CME and what is the meaning  of different terms associated with it. I will also briefly explain how to earn credit points during your working schedules.

Continued Medical Education (CME)

Continuing Medical Education (CME) or Continuing Dental Education (CDE),  refer to an event organized to expand the knowledge and skills required by the doctors. CME/CDE programs are meant for graduated board certified doctors who have completed their formal training. It includes not only classes and conferences but also ACLS/BLS classes and live operative workshops.

All CME/CDE  should have a brief session on national health programs on relevant subjects i.e. community oriented preventive medicine, along with adequate exposure to recent advances, changing modalities of treatment, adequate exposure of consumer protection and medical insurance laws, record keeping, community oriented preventive medicine and medical audit.

Credit Hour

Credit hour is the time spent during a conference or workshop. One 3 hour session will be awarded 2 credit hours. It should be kept in mind that one day session of a conference is limited to 6 hours or 2 credit hours.

Credit Point

Credit point measures the amount of effort you have during a particular CME/CDE. Different activities have different credit points. Maximum credit point earned from one CME/CDE are 4 points which are awarded to speakers of the conference. Following is a list of different activities and credit points that can be earned from them:

Guest Speaker in International/National Conferences 4 Credit Points
Paper Presentation (Oral Poster) in International/ National Conferences 2 Credit Points
Participation in International Conference as Delegate 2 Credit Points
National Conference organized by Recognized accredited National Professional Organization 2 Credit Points
Outside CME/CDE/Symposia organized by recognized professional bodies 2 Credit points 2 Credit Points

Specialty Distribution of CME

PM&DC has defined which specialty doctor can attend which subject CME/CDE. Details of this is given below:

Speciality  CME/ CDE
Preclinical Anatomy, Physiology, Biochemistry, Pharmacology etc.
Para-clinical Pathology, Microbiology, Community Health, Dental Materials, Dental Pathology etc.
Surgical Surgical and Allied disciplines
Medical Medicine and Allied discipline including pediatrics
Gynecology/Obstetrics Gynecology, General Surgery, General Medicine, Anesthesia, Radiology

Exception to the above restrictions are:

  • ACLS/BLS  workshop which can be attended by any doctor.
  • CME/CDE consisting of sessions from multiple specialty can be attended by doctors from any specialty.
  • General practitioner and those who work in hospital administration can attend any CME/CDE.

Accredited CME/CDE Organizers

The need to attend certain Credit points for renewal of license can not be successful without creating a framework to conduct CME/CDE. For this PM&DC has invited all Medical Dental institutions/ organizations in Pakistan to get registration as accredited organization for CME/ CDE. These accredited organizations shall give opportunities of continuing professional development to the registered medical/ dental doctors.

However, at this point, there are few institutes accredited to conduct CME/CDE, as listed on PM&DC website. PM&DC is actively encouraging institutes to apply for accreditation and eventually all the institutes affiliated with PM&DC will be accredited to organize CME/CDE concept in Pakistan.

Non-Accredited CME/CDE Organizers

According to PM&DC, CME/CDE organized solely by drug or medical device company to promote some drug or device will not be an accredited CME activity. Also, if live-operative workshops will be performed by foreign trained faculty members without registration then it would not be accredited as CME too.

Requirement of Credit Point for Renewal of Licence

  • For General Practitioners, 5 credit hours/ years of CME training is required for renewal of license .
  • For Specialists,  10 credit hours/ years of CME training is mandatory for renewal of license.
  • Extra credit point earned in a year can be forwarded to next year.
  • Forwarding of extra credit points is not permissible after 5 years.
  • Renewal cycle of 5 years is from the date of fresh registration or renewal date.

FAQ About CME Courses and PM&DC Approved Activities

1. Who can create CME courses and activities?

Continuing medical education (CME) activities are created and delivered by different organizations, such as professional associations, hospitals, medical education agencies, and educational institutions, like universities, nursing, and medical schools, as well as at-home study continuing education providers.

2. What are the different classifications of CME activities?

CME activities are classified into Formal Learning Activities, such as live planned programs and web-based content programs. Also, it includes Process Improvement CME (PI-CME), which is defined by the American Medical Association (AMA) and Informal Learning Activities, as online professional communities or journal clubs evaluating published research for mutual benefit and awareness.

For instance, if you want to earn an executive degree in Master’s of Health Administration, you can learn more about this field through online and offline accredited education and CME providers.

3. Could MOOCs be used to address CME provider shortage in Pakistan?

There are only a few web-based CME providers launched in Pakistan. This shortage can be addressed by Massive Online Open Courses (MOOCs), which are easily accessible through online courses regardless of resources and geographical boundaries.

It is a useful tool to provide continuing medical education to physicians. However, the problem lies in how MOOCs can be credited from PM&DC that needs to be explored further.

4. What is the role of Shifa International Hospital (SIH) in implementing CME activities?

Shifa International Hospital (SIH) has different departments that follow and implement extensive CME programs. These programs are scheduled independently or without a central coordinating body. PMDC has demanded SIH that all CME activities must be carried out, approved, and credited.

The Office of Post Graduate Medical Education (PGME) is the coordinating center of all CME activities and programs at Shifa International Hospital.