President's Perspective March 2013

Jordan GrossmanThe Last Parity Frontier: Podiatric CME
By Jordan P. Grossman, DPM, FACFAS, ACFAS President

Since its evolution into a profession 100 years ago, podiatry has been striving and succeeding to achieve full professional parity with allopathic and osteopathic medicine.

In 2008, APMA’s Vision 2015 was organized to push podiatry over the “parity goal line,” especially in podiatric medical school standards; and then, in 2010, CPME formalize three-year residencies. Forty-five states now include the ankle in their scope of practice statutes. And today, in California, the MD, DO, and DPM medical societies are working collaboratively on a common license; which if successful, could be the model for the nation. Without question, full professional parity is within reach for all podiatrists.

What has been missing up until now, however, is a similar push for parity in the podiatric profession’s standards for continuing medical education. CME could be viewed as the last frontier of training parity.

Last fall, the Council on Podiatric Medicine Education (CPME), which accredits CME sponsors via their Document 720 and 730 standards, unveiled significant changes tha would move podiatric CME closer to MD and DO CME standards, but ACFAS believes more could—and should—be done, now, at this unique point in the Vision 2015 timeline. So, the College recently submitte comments as part of CPME’s revision protocol.

ACFAS believes that CPME’s CME standards should be equivalent or more stringent than allopathic CME requirements if podiatry is serious about professional parity. In som cases we are also calling for substantial measures to provide greater enforcement and disciplining of CME providers. Such steps are sorely needed. We fully recognize that these proposed changes would requir additional revenue and staff, so ACFAS encourages CPME to assess the necessary fees to cover the costs of stronger standards.

Our Recommendations
A key recommendation we propose is the elimination of third party (or affiliate) accreditation. There is currently a strong movement in allopathic medicine to eliminate third party accreditation and ACFAS believes podiatry should take the lead. We believe that third party sponsorship should be eliminated to: 1) raise the professionalism of podiatric CME sponsoring organization and their leaderships, 2) ensure better compliance of CPME standards, and 3) signal to the public that our profession takes lifelong learning and practice improvement as seriously as allopathic medicine.

A summary of ACFAS’ enhancement to CPME’s proposed revisions:

  • Clearly define the types of organizations that may sponsor activities and the types that may not.
  • Eliminate third party/affiliate sponsorship (see above).
  • Require that educational activity design be connected to data demonstrating an educational need.
  • Require that activities attempt to change more than the knowledge of attendees, establishing Moore’s Level of Outcomes 3 as the minimum requirement.
  • Ensure independence of activities from all commercial interests.
  • Add a participant whistleblower process that must be advertised to all attendees.
  • Increase the level of scrutiny during the approval and re-approval process.
  • Increase the authority of the CPME in monitoring compliance and requisite enforcement.
  • Simplify and reduce the requirements regarding test validation of online or enduring education.
  • Ensure confidentiality of materials provided to CPME.
Bottom Line: We Need a Stronger Sheriff
As podiatry stands on the cusp of full professional parity, the profession must ensure that CME standards are equal if not more stringent than allopathic medicine’s standards And, frankly, this arena needs a “sheriff” with vastly more authority – and the will to use it. You can view CPME’s proposed revisions (in red or purple) and ACFAS’ recommendations (in blue) at www.acfas.org/CMEreforms We welcome your comments on anything regarding the efficacy, ethics, and leadership of the podiatric CME in general by writing me at president@acfas.org.


ACFAS Comments on CPME 720 CME Standards
ACFAS Comments on CPME 730 CME Procedures

Questions for Dr. Grossman? Write him at president@acfas.org.

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