The Royal College of Surgeons in Ireland has always held the belief that continuing medical education (CME) is a professional imperative. For this reason, the Continuing Professional Development (CPD) programme was launched by the college.
Recently, the continuing Medical Education and Postgraduate Committee was renamed the Committee for Continuing Professional Development, and over the last year CPD has changed emphasis. CPD consists of continued medical education, such as updating skills, partaking in programmes of personal and medical development, and keeping abreast of scientific and medical developments that are taking place.
The Joint Committee on Continuing Medical Education (of the Senate of Surgery of GB and Ireland) is discussing issues such as practice profile/portfolio, revalidation, reflective learning, personal development plan, clinical governance, risk management, peer review and competencies and outcomes. The CPD credit system will be one part of the profiling of a clinician for revalidation.
Each practitioner will most likely have a personal portfolio, which will be based on the following: job plan or personal development plan; a record of CPD activity; an audit of clinical activity. There are many advantages to the personal development plan in that it would be self-directed, recognise clinical governance, link with revalidation and recognise the different career stages. The RCSI plays a central role in this for surgeons and the college is linked in many ways to similar programmes throughout Europe. Each year, it runs a number of relevant activities, such as postgraduate education courses, management and computer programmes and meetings.
THE college also has an interactive website where surgeons have their own domain enabling them to partake in distance learning. "We are merging information technology and medical education thereby keeping the pace with new developments in the medical sciences," says Professor Gerry O'Sullivan, chairman, Committee for Continuing Professional Development. "A knowledge explosion is taking place and we want to be part of it." The CPD committee has recommended the introduction of a system which will allow consultant surgeons to record details of their CME activities on the RCSI website. It is envisaged that each consultant will be given a RCSI registration number.
They can then log onto the CPD section of the website and key in their security code. The CPD diary will come up on screen and the user can then input his or her activities. This system is expected to be in operation within the next couple of months. Today, there is a modest uptake in the number of practising surgeons registering, bringing the figure to approximately 70 per cent. Although this figure is very positive, at the end of 1998 only 40 per cent of registered surgeons were providing evidence of compliance with the requisite level of CME activity. The college addressed this situation by setting targets for CME uptake for 1998/'99. This plan sought to increase the number of CME returns from 40 per cent to 60 per cent and the percentage of consultant surgeons registering from 70 per cent to 80 per cent.
By June 30th, 1999 CME returns had risen to 50 per cent, and next year the college hopes to achieve 100 per cent compliance. "Continuing professional development is something that has always existed," says Prof O'Sullivan. "Today, the college insists that all surgeons in the community fulfil a formal protocol of CPD on an ongoing basis." Considerable discussion has taken place at the college, focusing on whether CME should be voluntary or mandatory. It is currently accepted that in the future CME is likely to carry a mandatory element. In the meantime, the college has recommended the publication of a white list of practising surgeons complying with CME, which will be published at the end of a five-year cycle, in 2003.
The Medical Council has proposed that specialist registration be time-limited and that revalidation be based on specialists demonstrating competence to practise. For this purpose, consultants would be asked to provide information to assist appraisal, including a record of CME activity, clinical audit and peer review of practice.
In Britain, where specialist registration is required for consultant posts, the General Medical Council has decided to bring in revalidation and this will be based on a portfolio containing elements such as those listed above.
According to Prof O'Sullivan, it is quite difficult for the RCSI and other medical bodies and professions to keep abreast of the medical developments taking place in today's fast-paced world of technology. Therefore, the need for a committee such as the CPD committee is absolutely imperative.
