Intended for healthcare professionals


Rethinking continuing medical education

BMJ 2008; 337 doi: (Published 14 August 2008) Cite this as: BMJ 2008;337:a973
  1. Alfredo Pisacane, director of continuing medical education unit
  1. 1Università di Napoli Federico II, Naples 80131, Italy
  1. pisacane{at}
  • Accepted 19 May 2008

Drug company funding of continuing medical education may affect doctors’ independence. Alfredo Pisacane argues that it can and should be stopped

Continuing medical education has become so heavily dependent on support from drug and medical device companies that the ethical underpinnings and the reputation of the medical profession may be compromised. In industrialised countries, drug companies support more than half of continuing medical education activities, and it has been shown that such support can distort the topic selection, embellish the positive elements as well as play down the adverse effects of some interventions, and influence doctors’ prescribing habits.1 2 3 4

To reduce the risk of conflict of interest in continuing medical education, it has been proposed that sponsors should not have any influence over the choice of speakers and scientific contents; moreover, providers and speakers of educational events should provide a full disclosure of the support received. Such disclosure, however, does not protect against the risks of an invisible influence of drug companies on providers, speakers, and participants.5

Continuing medical education is compulsory in Italy, and the Ministry of Health has recommended that local health authorities spend 1% of their total budget on educational activities. Nevertheless, most authorities spend much less than the recommended amount and up to 60% of the money comes from drug companies.

Because commercial support represents a substantial part of the resources available for educational activities, it may seem essential. However, for the past five years I have organised educational events at an Italian university hospital with no financial support from drug companies. Here, I present seven proposals for limiting the commercial support to continuing medical education.

Concentrate on small groups

One of the reasons for the high costs of continuing medical education is that most is based on conferences, meetings, and workshops. These are expensive and …

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