Continuing Professional Development-For What? (2000)

The medical profession has a long tradition of lifelong continuous learning and development. To become a competent doctor or specialist, one needs to go through a prolonged period of training and examinations. The Hong Kong College of Psychiatrists has taken on the role of ensuring that our trainees and newly qualified psychiatrists are up to international standards. In order to maintain ourselves as competent clinicians, most of us continue to educate and develop ourselves. We read journals and books, attend conferences and lectures, exchange views with our peers, participate in training workshops, or even take the lead in developing new technology or treatment. We are all under the pressure of constantly keeping abreast of recent advances and developments in psychiatry. Until recently, this was done spontaneously and most of us had accepted this as part of our professional lives and even enjoyed the process. There is increasing pressure from society to improve the system of ensuring our clinical standards. Increasingly, the public and the media criticise doctors for charging high fees or being highly paid, while providing less than satisfactory services. This trend of 'doctor bashing' is further fuelled by occasional medical mishaps. The Medical Council has considered the option of re-certification and has rightly decided that this should not be through examinations. Other professionals such as lawyers, engineers, and accountants are also moving in the same direction. Our College, together with the Hong Kong Academy of Medicine has completed its first three-year cycle of continuing medical education (CME). Despite initial resistance, the majority of our Fellows have fulfilled the Academy requirements. CME, however, is not without its problems. The two most frequently cited criticisms are: firstly, such mandatory programmes for practising specialists has changed what used to be an enjoyable and spontaneous activity into something less palatable, and secondly, there is no evidence that CME changes practice for the better or enhances the competency of practising specialists. We regard our Fellows as mature, independent, and conscientious clinicians. In ensuring professional standards for a practising specialist, however, we cannot rely solely on one's spontaneity. More importantly, the public cannot be assured if we do not have a structured self-regulatory programme. It is quite clear that most of our Fellows can fulfil their CME requirements. We have witnessed an increase in attendance of CME activities. CME is indeed a friend and not an enemy. (1) Unfortunately, we cannot say with equal confidence that CME can change practice and enhance competency. In fact, there are some strong views on it and this has been one of the main driving forces for 'continuing professional development' (CPD). Unfortunately, there is as yet no agreed definition of CPD. In some countries, it is used interchangeably with CME. In others, it incorporates a number of other activities such as clinical audit, peer review, credentialling of hospitals and practices, etc, in addition to CME activities. Our College has expressed to the Academy that we support the general direction of developing a CPD programme. …