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Mon 1 Jan 2007 11:31 AM

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CME: milestone or millstone?

The UAE government's decision to introduce compulsory medical education for healthcare professionals has been greeted as a milestone for the region's healthcare industry.

The UAE government's decision to introduce compulsory medical education for healthcare professionals has been greeted as a milestone for the region's healthcare industry. Patients can sleep more soundly in their hospital beds at night; medicolegal agencies, employers and insurers will all rest safe in the knowledge that their clinicians' knowledge is up-to-date, relevant and of good standing. Malpractice suits will fade away in the face of glossy, embossed certificates of accreditation.

But then, of course, there is the trade-off. Firstly, there is no evidence that current approaches to CME, whether enforced or voluntary, result in better practice patterns. All the government has achieved by entwining education with licence renewals is a guarantee of higher delegate numbers for conference companies. CME regulations cannot enforce learning, only attendance. Secondly, in a fledgling CME industry, where Arab Health is the one bright light on a rather sparse educational calendar, the government is in line for a backlash from nurses, pharmacists and technicians who have no means of accruing the required hours. No events means no participation.

Lastly, in the fanfare that accompanied the announcement, potentially the biggest issue for medical staff was neatly overlooked. Until now, hospitals have been responsible for enforcing their employees' medical education requirements. By making staff shoulder the responsibility of CME quotas and answer directly to the regulatory authorities, the government has neatly relieved hospitals of the obligation to provide time and reasonable funding to their physicians, nurses, pharmacists and dentists; particularly those in the less glamorous, non-consultant grades. After all, it is no longer their problem. Those in the private sector now must cover costs, take leave and source suitable events (from the minority of accredited courses held in the UAE) without the obligatory backing of their boss.

I accept that medical professionals have an ethical and professional obligation to keep their educational development up-to-date and I realise that the informed professional awareness that (hopefully) accompanies regular attendance at CME events can only be of benefit to practitioners and patients. But mandatory CME requirements should be accompanied by changes in infrastructure that allow staff to implement them; and that means investing money and time in creating well-designed educational programmes, and in encouraging healthcare professionals to attend. If the goal is better medicine, nothing less will do.

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