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335 Lewis A. Miller, Leonard Harvey, Bernard Maillet, Alfonso Negri, Robin Stevenson, and Egle Zebiene chapter 29 Continuing Medical Education and Continuing Professional Development in Europe: The New Reality The most exciting place to be in the world of continuing medical education (CME) is just that: the world. CME is becoming a fact of life—and of continued practice—for physicians in many countries , especially those in the European Union (EU). Despite a lack of evidence that mandating CME as a requirement to maintain a medical license provides proof that a doctor is competent , an increasing number of European nations have imposed such a requirement. As a result, CME administrative structures, regulations, and courses have been multiplying. Live education, particularly in national and international congresses , is still the norm. However, a clear trend toward electronic CME (eCME) is developing across the EU. The accepted paradigm for CME in the United States and Canada is slowly becoming adopted in most European countries. That paradigm includes needs assessment of the target audience; development of appropriate content and a delivery method independent of a funding source; and outcomes assessment (though seldom progressing beyond physician satisfaction). The EU is moving rapidly toward acceptance of this paradigm in part because of the work of the European Union of Medical Specialists (UEMS) and its subsidiary body, the European Accreditation Council for CME® (EACCME). Some specialty societies have set up their own CME accreditation boards, most notably in cardiology and pneumology. Additionally , there is a trend toward going beyond CME and onward to continuing professional development (CPD). The CME structure for general practitioners, as compared to specialists, has been less well defined, though the European Union of General Practitioners (UEMO) and the European division of the World Organization of Family Doctors (WONCA) are making strides to catch up. The work of the UEMS, the Global Alliance for Medical Education (GAME), and the less formal Rome Group has promoted the concept of CME harmonization in the EU and around the world. The challenge for the future is to implement such a concept and to encourage all nations to join in an e√ort to improve the quality of health care for their citizens through evidence-based, learnerbased , and patient-based CME. The European Union of Medical Specialists The European Union of Medical Specialists (UEMS) was established in 1958, following the signing of the Treaty of Rome in 1957 by the six founding countries.∞ In the Treaty of Rome, harmonization and mutual recognition of diplomas is foreseen as a part of the free movement principle . The objective of the UEMS has always been bringing together the medical specialists of the 336 emerging themes and forces in cme TABLE 29-1 UEMS Charters Charter Name Adoption Year Objective Charter on Continuing Medical Education 1994 Sets out the basic structure of CME and points the need for the profession to taking a leading role Charter on Quality Assurance in Specialist Practice 1999 Includes the need for CME to maintain quality assurance Charter on Visitation of Training Centres 1997 Assesses and improves the quality of graduate training Charter on Continuing Professional Development (also called the Basel Declaration) 2001 Defines CPD as the educative means of updating, developing, and enhancing how doctors apply the knowledge, skills, and attitudes required in their working lives; categorizes CPD as essential to ongoing specialty training Declaration on Ensuring the Quality of Medical Care (also called the Budapest Declaration) 2006 Emphasizes the profession’s responsibility for regulating physician practice; states that ‘‘the continuum of medical education provides the means, at all stages of a doctor’s career, of imparting high standards of medical practice’’ Source: http://admin.uems.net/uploadedfiles/174.pdf; http://admin.uems.net/uploadedfiles/175.pdf; http://admin.uems .net/uploadedfiles/179.pdf; http://admin.uems.net/uploadedfiles/35.pdf; http://admin.uems.net/uploadedfiles/875.pdf. member states and reaching consensus on content and quality of medical specialist training and practice. The outcome of this process was meant to serve as the foundation for EU legislation. The specialist sections—now numbering 52— were established from 1962 onwards, and the UEMS with its sections was instrumental in the shaping of the Doctors Directive in 1975, which established mutual recognition of medical diplomas between the member states of the EU.≤ The start was slow, but in the 1970s the EU moved towards legal provisions in this matter. In the follow-up, however, little attention was paid to the contributions...

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