Rebuttal: Is CME a drug-promotion tool?

Drs Steinman and Baron make a cogent argument for the presence of bias in continuing medical education (CME) programs in the United States and for the fact that these programs have been used for marketing purposes. The Accreditation Council for Continuing Medical Education has adopted several policies in the last 3 years, which Drs Steinman and Baron did not address in their references, that have made these practices less likely.¹

Industry does play a major role in funding CME in Canada. An unpublished study conducted in 2004 at the College of Family Physicians of Canada revealed 70% of our accredited programs had pharmaceutical company funding, either by direct sponsorship or through exhibit fees. I do not believe that this is a troubling finding.

The end product we all strive for in CME is needs-based, relevant, accessible education that is balanced and unbiased and improves health care outcomes. Our goal is to provide that both in unsponsored and industry-sponsored programs. In Canada, industry funds CME that does not promote products and is increasingly willing to support programs on continuing professional development, such as counseling skills and physician health and well-being. Where educational grants are directed toward specific topics, the sponsorship fees from these sessions are used by providers to create programs on “orphan topics” (ie, those without sponsors). We do have for-profit medical education and communications companies in Canada, but unlike those in the United States, these companies cannot accredit their own programs.

The program accreditation process that we have in place, which includes peer and expert review of content and process along with ethical review, ensures that our programs cannot be used for drug promotion.