In the United States, commercial support for continuing medical education has grown steadily over the past decade. In 2006 it provided more than half, about $1.5bn (£0.75bn, €0.95bn) or 60%, of the income for educational programmes doctors must take to maintain their medical licences. 1 Evidence shows that commercial support distorts what doctors learn.

In 2007 I chaired the Josiah Macy, Jr conference on Continuing Education in the Health Professions: Improving Healthcare Through Lifelong Learning ( www.josiahmacyfoundation.org). A major recommendation emerging from the conference was that organisations providing accredited continuing education should not receive commercial support from drug or medical device companies.

The Macy report, from the conference, summarised the ethical concerns. Commercial support places doctors and nurses who teach continuing education activities in the untenable position of being paid, directly or indirectly, by the manufacturers of healthcare products about which they teach. Commercial entities have an …