October 27th, 2019

The Enduring Appeal of Live, Face-to-Face, Real-Time Continuing Medical Education

These guys clearly have no future.

Around 15 years ago, after high-speed internet became a de facto part of work life and was rapidly becoming more widely available at home, I attended a meeting with other medical educators to decide what to do about our various post-graduate courses.

The wisdom in the room was that most continuing medical education (CME) would soon migrate online, replacing live courses.

It just made too much sense — CME could be done at home, or from the office, and would not require the cost or hassles of travel, parking, and hotels. Online CME would minimize time away from the office, and would also be more family-friendly.

The message I took away from this meeting about our beloved courses?

They were doomed.

My wife, a practicing primary care pediatrician, agreed — why would anyone travel to go to CME courses when they could get the same required credits in the comfort of their own homes? And she’s hardly ever wrong.

But this is one of those rare times where everyone got it wrong. Live CME courses never went away. In fact, in the annals of bad predictions, the anticipated demise of face-to-face CME is right up there with Decca records’ choosing not to sign a certain Liverpool-based rock band because “guitar groups are on their way out.”

Yes, there are plenty of online CME opportunities. But live CME remains extraordinarily popular — in a survey done of clinicians by a marketing company, 80 percent reported that live conferences were the CME activities they participated in most often. Live CME was also the format they preferred above all others.

I’m thinking about this today because tomorrow is the first day of our annual course, “Infectious Diseases in Primary Care”. Not only have we had steadily increasing attendance for years, we’ve also been able to add an additional optional symposium on HIV and viral hepatitis for the PCP. The attendance at our course is twice what it was 15 years ago.

And we’re hardly alone. (Though I like to think our trying to get our very best teachers cover the most important topics are at least possibly responsible.)  Our hospitalists at the Brigham started a course a few years ago that has been staggeringly successful — so big it sells out every year. I hear from my colleagues at other academic medical centers that they also continue to have excellent demand.

So what gives? I can think of a few explanations.

  • People concentrate better and retain more information when they’re away from the distractions of work and home life.
  • People value networking with colleagues as much as the educational content.
  • With a shift toward salaried positions and away from traditional fee-for-service, CME is built into the contract as a benefit; also, time away from the office is no longer a negative for personal revenues.
  • Physician Assistants, Nurse Practitioners, PharmDs, and other non-physician health professionals increasingly want the same medical education, greatly increasing the pool of participants.

Any others? Whatever the reasons, it seems that live CME is here to stay, at least for now.

And for the record, I would have signed them.

6 Responses to “The Enduring Appeal of Live, Face-to-Face, Real-Time Continuing Medical Education”

  1. Douwe A.A. Verkuyl, FRCOG says:

    Yes, I agree, however we have to change our lifestyle because of the danger to our climate. CME needs to take place near a bus or train station. Not after flying (to an exotic location) or driving a car for many miles if at all possible. We have to forgo quite some pleasures we thought we were entitled to, in order to give our grandchildren a future.

  2. Srinivasan Ramesh says:

    Dear DR SAx
    I agree with your reasoning about the persistent popularity of live CMEs’.There is the added attraction of live interaction with a legend in any field of research or practice .This often clarifies any doubt or misgiving one may not be able to voice in a recorded event.

  3. Philip Bolduc says:

    Hi Paul – I agree completely! Whatever happened to that great Intensive AIDS Case-Based course that you and the folks at MGH used to run every winter? Would love to see that one come back. – Phil

  4. Mark S Voysey says:

    Yes- IRL>on line. FOMO? JOMO!! LOL. ( Can I log 0.1 CME for this post?)

  5. Jaan Naktin says:

    I would have to point out that the ELECTIVE CME may be opted for in a live content, but a lot of CME is now de facto electronic, so I think the predictions are still correct that the preponderance of CME is obtained by means OTHER than live, in person education. In Pennsylvania, for example, we are required to have 100 CME hours in two year, of which 20 are to be category one. We are also required to have several hours of opioid and pain training, and child abuse recognition training, much of which is ONLY offered online. Of the 100 credits, most of what I get I claim from Up to Date which offers easy credits simply for accessing and reading, much if which is done in the course of patient care. None of that could have been done pre-internet. Also, I recently took my ID boards, and will be claiming CME for the GWU course that I took online. It would have been logistically impossible for me to spend the four or five days in Virginia to do so in person (although I commend the online content for being very complete and digestible).

    So SOME of the CME is elected to be done in person, and it is valuable and useful time, but MOST of the CME that is taken or required is done so electronically, like it or not.

    In today’s world, the Beatles would have been on Spotify, You Tube or Apple Music and probably would have been digested and assimilated by big music electronic industry, so we are probably lucky that they arose in the analog age of music, as so many legendary groups and individual did at the time. I think that is why we do not have “good music” these days, in my humble opinion, as the saying goes…

  6. Darcy says:

    This is a great piece with insight on the educational process and how we learn. Interestingly, live CME is in contrast to what we are seeing in medical schools during the pre-clinical years. In-person lectures and other learning opportunities are becoming less popular, with self-directed and problem-solving approaches taking over. I wonder if the difference between medical school education and continuing medical education is a consequence of a generational difference (i.e. Boomers vs Gen-Xers vs Millennials) or a life-stage difference (i.e. getting away to a change of scenery to attend a conference as a practicing physician is more of treat than it is to a medical student).

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HIV Information: Author Paul Sax, M.D.

Paul E. Sax, MD

Contributing Editor

NEJM Journal Watch
Infectious Diseases

Biography | Disclosures | Summaries

Learn more about HIV and ID Observations.