Feature Continuing Medical Education

End of the free lunch?

BMJ 2008; 337 doi: http://dx.doi.org/10.1136/bmj.a1399 (Published 26 August 2008) Cite this as: BMJ 2008;337:a1399
  1. Mark Gould, freelance journalist
  1. 1London
  1. mark{at}hickorywind.demon.co.uk

    As one big drug company cuts spending on continuing education in the United States, Mark Gould assesses the implications for the United Kingdom

    Doctors in the United States should brace themselves for a substantial decrease in conference dinners but a big increase in the quality of drug industry sponsored education. Responding to criticisms of the way that continuing medical education is funded by the drug industry and run by profit making, third party companies, Pfizer last month decided to cut education funding in 2008 from $80m to $60m (£43m to £32m; €55m to £41m). Its decision indicates a sea change in sponsorship of continuing education in the US that could have implications for the United Kingdom.

    “Our analysis demonstrated that higher quality grants would increase the percent of funding that directly benefited learning while reducing expenditures on non-educational expenses like meals,” the company stated. By September it says some 90% of its funding will go into educational programmes run by academic institutions, hospitals, or medical societies.

    In January, a report by the influential Manhattan based philanthropic institution, the Josiah Macy Foundation, went even further, concluding that drug manufacturers should not support continuing medical education.1 It says industry sponsorship affects the independence of doctors, invites bias, endangers professional commitment to evidence based learning, and promotes and validates an “entitlement” mindset among doctors that education should be paid for by others. It also says the conference lecture circuit isn’t improving patient care, it’s simply about “promotion and physician welfare.”

    UK climate

    In the UK around half of continuing medical education is industry funded, but the climate is changing as doctors move to setting their own learning agendas. Richard Tiner, the medical director of the Association of the British Pharmaceutical Industry says: “Pharma finances around half of all continuing professional development in the UK, …

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