Adapting to Decreased Industry Support of CME: Lifelong Education in an “Industry-Lite” World

The continuing medical education (CME) enterprise in academic medicine is changing rapidly because of a number of important factors: the change in CME doctrine promulgated by the Accreditation Council for Continuing Medical Education (ACCME) (1), the refinement of the criteria for maintenance of certification (MOC) by the American Board of Medical Specialties (ABMS) (2), and alterations in patterns of commercial sponsorship for educational events by pharmaceutical and device industries. This article focuses on how alterations in the patterns of commercial support for educational events at academic medical centers and universities are changing the CME opportunities for faculty and trainees associated with academic departments of psychiatry. Historically, commercial funding has subsidized and supported considerable CME activity in academic medical centers. A 2006 survey (3) indicated that 49% of CME course costs at academic centers were funded by industry. Commercial sponsorship of CME has taken several forms. Commercial companies, either directly or through their educational intermediaries, have sponsored Grand Rounds speakers in academic departments, either as members of speakers’ bureaus or via individual grants. These companies have also helped underwrite the costs of CME conferences sponsored by academic departments through their universities. Also, commercial companies have sponsored journal clubs and dinner meetings with speakers for practitioners in the community, often at reasonably attractive restaurants, as well as travel funds for faculty, residents, and fellows to attend national and international meetings. Through “medical education and communication companies,” which have frequently partnered with academic departments of psychiatry, industry has sponsored educational activities with online options, teleconferences, and videoconferences and the development and production of CME events in conjunction with professional-association meetings. Traditionally, these offerings feature top names and excellent media production, and they draw large audiences. Thus, increased levels of commercial support have helped proliferate different approaches for physicians to receive free CME. At times, these presentations may become vehicles for commercial entities to “educate” practitioners in a manner that is conducive to acceptance of a product or a specific class of agents for treatment interventions. In 2008, pharmaceutical and medical-device companies funded half of the $3 billion CME industry, and much of this money was directed to for-profit medical-communication companies that organize CME programs and symposia (4). Well-warranted concerns about ethics issues and the educational implications of marketing biases and academic leaders’ industry ties (5), raised by public scrutiny, Congressional investigations, and leaders in the medical profession, have led pharmaceutical and device companies to revise their funding patterns and practices. The overall effect has been a severe curtailment of industry funding of CME activities. Academic departments and organizations that relied on commercial largess have been increasingly deprived of the funds previously available for CME activities. According to industry sources, many providers now Received December 20, 2009; revised March 7, 2010; accepted March 8, 2010. Dr. Yager is affiliated with the Department of Psychiatry at the University of Colorado, Denver. Dr. Silverman is affiliated with the Department of Psychiatry at Virginia Commonwealth University in Richmond, VA. Dr. Rapaport is at the Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, and the Department of Psychiatry and Bio-Behavioral Sciences, University of California, Los Angeles. Address correspondence to Joel Yager, Department of Psychiatry, University of Colorado, 13001 E 17th Pl, A011-04, Aurora, CO 80045; jyager@unm.edu (e-mail). Copyright © 2011 Academic Psychiatry