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Continuing Medical Education Guidelines

CEJA Releases New Report on Industry Relationships with CME

The American Medical Association's Council on Ethical and Judicial Affairs has released a new report, 1-A-09 Financial Relationships with Industry in Continuing Medical Education, to be introduced at the AMA's Annual House of Delegates meeting in June. The report can be accessed on the AMA's website here.

The report differs dramatically from the one issued last year, most notably by eliminating the recommendation to ban industry support of CME completely. Instead, this report makes a distinction between what is ethically preferable, permissible and prohibited.

It is ethically preferable that:

"CME providers accept funding only form sources that have no direct finacncial interest in a physician's clinical recommendations and that that those involved in CME have no current, recent or potential direct financial interest in the subject matter and are not currently/have not recently been involved in a compensated relationship with a commercial interest in the educational subject matter."

However, the council recognizes "... that this ethical ideal cannot feasibly be implemented for all professional education". In certain situations, interaction with persons or organizations with a conflict can be ethically permissible. These situations include:

  1. CME providers accept funding from industry sources if the following conditions are met:
    a. the educational activity is planned by the provider based on needs identified independent of and prior to solicitation or acceptance of the funding; and
    b. the use of the funding is not restricted in any way; and
    c. the source of the funding is clearly disclosed; and
    d. the CME provider is not overly reliant on funding from industry sources.
  2. CME providers permit individuals who have modest financial interests in the educational subject matter to program, develop content for, or teach in CME activities if the following conditions are met:
    a. the existence and magnitude of any financial interests are clearly disclosed; and
    b. steps are taken to eliminate or mitigate the potential influence of those interests.
  3. CME providers permit an individual who currently has a direct, substantial, and unavoidable financial interest in the educational subject matter (e.g., as the inventor of a new device) to program, develop content for, or teach in a CME activity only if the following conditions are met:
    a. the individual is demonstrably uniquely qualified as an expert in the relevant body of knowledge or skills; and
    b. participants are clearly informed about the nature and magnitude of the individual’s specific financial interest in the subject matter; and
    c. there is a demonstrated, compelling need for the specific CME activity in the professional community that cannot otherwise be met; and
    d. steps are taken to mitigate the potential influence of the unavoidable financial interest to the greatest extent possible; and
    e. every effort is made to develop a pool of qualified, independent experts as quickly as possible.

If none of these conditions are met the financial relationship would be deemed ethically prohibited.

It is clear that great time and effort was put into this report (Over 35 references, plus a supplemental report) and the council did take the concerns of stakeholders into consideration