Continuing medical education in the 21st century
BMJ 2008; 337 doi: https://doi.org/10.1136/bmj.a119 (Published 22 August 2008) Cite this as: BMJ 2008;337:a119
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Just how many Big Pharma adverts were there in this particular
edition of the BMJ?
Competing interests:
None declared
Competing interests: No competing interests
Every consultation can produce several possible issues for continuing
education. If we assume at every step of our decision making process that
we are likely to be ill informed, the possibilities for continuing
education are virtually infinite.
The NHS still (rightly in my view) values productivity in doctors. Without
that productivity the system would grind to a halt.
The levels of productivity required in the NHS are incompatibile with the
possible levels of continuing education described.
With internet access through PCs and PDAs, continuing medical education
and reference to evidence databases are possible during each consultation.
Accessing internet based medical information during most consultations is
incomptabile with the levels of productivity required in the NHS.
Case based continuing medical education with references added to medical
records can demonstrate adequate learning in individual doctors.
Presentation of medical records with evidence of learning through patient
contact is a reasonable way to present evidence of continuing learning and
competence. This combines demonstration of quality of care and continuing
learning, if references were added to medical records.
Patient contact rates in the NHS would have to signficantly reduce for any
of the above to be acceptable.
Finally, confident doctors may have less self awareness as regards
possible failings, but they do make the current system work!
Competing interests:
None declared
Competing interests: No competing interests
White Knights in Medical Education
I have had the privilege of organising the post-graduate medical
education for the past 14 years in Stoke-on-Trent. In this time we have
attracted some of the most authoritative and inspirational speakers in the
English-speaking world (see www.medicalmasterclass.com) and this has been
reflected in the attendances by the doctors - usually 60 - 100 - at each
lunchtime meeting.
The choice of topic and speaker has been predicated by the educational
needs of the doctors, though the meetings have been financed solely by the
pharmaceutical companies, whose quid-pro-quo is to have a stand at the
meeting and a couple of minutes with the doctors who chose to visit their
stand.
In 35 years of General Practice, the true revolutions in quality of
patient care have been delivered by these much maligned companies, and the
more up-to-date and informed a G.P. is, the more likely he is to implement
these advances; ergo, Drug Companies do have a vested interest in Post-
Graduate Education at a very high ethical level.
Sadly, support for our meetings is now declining from pressure on
companies and the disempowerment of G.P.s. who are now largely the box-
ticking apparatchiks of botched governmental re-disorganisations. Good
medical
meetings are not just educational: they are empowering and morale-
boosting, with meetings and exchanges between colleagues being almost as
important as the main lecture itself! Such benefits do not produce a tick
in any box
which "matters" and it seems that the golden age of General Practice has
been slowly strangled to death. As we become increasingly de-skilled and
demoralised by political incompetence, I mourn the demise of the "White
Knight" of ethical pharmaceutical sponsorship; the "Black Knight" of
Whitehall's meddling has much to answer for.
Bernard Shevlin
Regional post-graduate tutor
Competing interests:
None declared
Competing interests: No competing interests