Education And Debate

Continuing medical education: Global health, global learning

BMJ 1998; 316 doi: (Published 31 January 1998) Cite this as: BMJ 1998;316:385
  1. Dave Davis, associate deana (
  1. a Continuing Education Faculty of Medicine University of Toronto Toronto ON M5S 1A8 Canada


    CME—continuing medical education—has become an international discipline. Defined as any and all ways by which doctors learn after the formal completion of their training,1 CME is being shaped by several forces. Foremost among these are the globalisation of health2; cross disciplinary movements such as evidence based medicine; common trends in medical education and the assessment of professional competence; and the impact on health care and professional education of the identification of the determinants of health.3 4 Add to these electronic mail and the internet allowing instant global communication and virtually unlimited access to medical information and it is not hard to see why CME has become an international concern.5 This paper reviews the main published work on CME, identifies major themes in its development, and points to ways that may help standardise and support the provision of CME internationally.


    To gather information for this article, I searched the Research and Development Resource Base in CME extensively for articles (published 1986-96) that describe CME activities worldwide, excluding North America and the United Kingdom.6 At the time this article was written, it contained references to over 7000 articles and monographs devoted to continuing health professional education. I also searched Medline, eric, embase, and other databases for articles (published 1986-96), using terms and phrases such as world health, global health, international cooperation, and international educational exchange and continuing medical education terms combined with geographical names. Then I circulated the results of the literature searches and a brief questionnaire to key informants in the field, to identify other articles and to add their opinions about forces for and trends in continuing medical education.

    Summary points

    Health is a global issue; hence continuing medical education is an integral phenomenon

    International CME is more than conferences and courses—it includes projects in needs …

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