Analysis Health Systems Perspectives

Maintaining the competence of Europe’s workforce

BMJ 2010; 341 doi: (Published 03 September 2010) Cite this as: BMJ 2010;341:c4687
  1. T Horsley, educational research scientist1,
  2. J Grimshaw, director23,
  3. C Campbell, director14
  1. 1Centre for Learning in Practice, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada
  2. 2Centre for Best Practices, Institute of Population Health, University of Ottawa, Canada
  3. 3Canadian Cochrane Network and Centre, Ottawa
  4. 4Office of Professional Affairs, Royal College of Physicians and Surgeons of Canada
  1. Correspondence to: T Horsley thorsley{at}
  • Accepted 21 August 2010

With increased professional and patient mobility across EU borders, T Horsley and colleagues argue that we need a common set of principles for continuing professional development and a more harmonised approach to accreditation

A cocktail of catastrophic events has politicised the movement of both patients and doctors within the European Union and put unprecedented scrutiny on the competence of doctors and the privilege of self regulation.1 2 3 4 5 European legislation dictates that national licensing authorities such as the General Medical Council must accept qualifications from within the EU, placing onus on the employer to ensure doctors are fit to practise. With striking heterogeneity between EU countries in how continuing professional development systems are currently regulated and delivered and the lack of mandatory requirements for periodic validation or participation in continuing professional development in some countries,3 regulation of continuous learning within the EU is gaining increased attention.6

This article, which is based on a longer report written for the European Union,7 describes the variation between continuing professional development systems across EU countries and argues for harmonisation of accreditation systems.

Variation across the EU

Despite the longstanding recognition in several countries (including the United Kingdom) that continuing professional development is a professional commitment to sustain the quality of medical practice, regulations across EU member states remains diverse. In 2008, Merkur and colleagues reported on seven key features of continuing professional development systems across 26 European countries (table 1).3 Although there have been some changes since then—for example, in France, the system is no longer run by professional bodies—the data provide a good picture of the variation.

View this table:
Table 1

 Requirements for revalidation of medical professionals in selected countries in WHO European region*3

Most countries require doctors to report a certain number of credits over a defined period, ranging from …

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