How France messed up CPD/CME for healthcare professionalsBMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g6171 (Published 17 October 2014) Cite this as: BMJ 2014;349:g6171
- Hervé Maisonneuve, consultant in medical education
- 1Paris, France
For the past 20 years, French decision makers have tried to implement a continuing professional development/continuing medical education (CPD/CME) system for healthcare professionals. The current system, which was implemented in 2012, is about to collapse. French decision makers tried to implement a top-down system; health professionals had little responsibility for implementation.
France enacted large scale reforms of CPD in 1990, 1996, 1998, 2002, 2004, and 2009. However, each of them failed, mainly because of conflicts of opinion between powerful unions, schools of medicine, and to a lesser degree medical societies. The current system was included in an ambitious July 2009 law called Hôpital, Patients, Santé et Territoires (Hospital, Patients, Health and Territories). The full description takes 160 pages,1 but it is essentially based on evaluating professional practices (using the Deming quality cycle) and promotes evidence based practices. More than 2000 providers are registered, rather than accredited.
Overambitious and underperforming
Unlike the previous systems, which were designed for the country’s 220 000 physicians, the current system includes 1.5 million healthcare professionals from 19 professions. The objective was that each professional should perform one CPD activity a …