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Conflict of Interest in Medical Research, Education, and Practice
The committee recognizes that the evidence on the effectiveness of educational programs of this sort on physician attitudes and behaviors is not strong, but it believes that a basic level of education supports the development of core competencies and prepares students and trainees for future practice. The establishment of educational standards will help ensure that such education is of high quality and receives appropriate attention.
Accredited Continuing Medical Education
The members of the committee had extensive internal discussions about industry support for accredited continuing medical education. Overall, there was general agreement that continuing medical education has become far too reliant on industry funding and that such funding tends to promote a narrow focus on products and to neglect the provision of a broader education on alternative strategies for managing health conditions and other important issues, such as communication and prevention. Given the lack of validated and efficient tools for preventing or detecting bias, industry funding creates a substantial risk of bias, to the extent that industry-reliant providers want to attract industry support for future programs. Although the committee did not reach agreement on a specific path to reform, it concluded that the current system of funding is unacceptable and should not continue.
RECOMMENDATION 5.3 A new system of funding accredited continuing medical education should be developed that is free of industryinfluence, enhances public trust in the integrity of the system, andprovides high-quality education. A consensus development processthat includes representatives of the member organizations that createdthe accrediting body for continuing medical education, members ofthe public, and representatives of organizations such as certificationboards that rely on continuing medical education should be convenedto propose within 24 months of the publication of this report a fundingsystem that will meet these goals.
One option is for this broad-based consensus development process to be convened by the member organizations of ACCME. As described earlier in this chapter, they represent medical specialty boards (American Board of Medical Specialties), hospitals (AHA and the Association for Hospital Medical Education), organized medicine (AMA), medical schools (AAMC), medical specialty societies (CMSS), and state licensure boards (Federation of State Medical Boards). Although these organizations have interests in continuing medical education and in ensuring that continuing education is