Need for CME highlighted

Need for Continuing Medical Education highlighted.
Dr. C. V. Alert.
“Coroner calls for medical guides” was the title of an article in the Weekend Nation (Barbados) of February 19th 2010. In making this recommendation, the coroner noted that currently in Barbados any doctor could practice any speciality of medicine that he wished; and that there were no regulation governing standards of clinics and private operation rooms to ensure certain facilities were in place.

These comments were made while delivering the verdict in the case where a young lady died on the operating table while undergoing an ENT procedure, in which the ENT Surgeon was assisted by another physician (who performed the role of anesthetist). This case has been referred to the Director of Public Prosecution (DPP) office, and so the course of justice is still running.

The coroner continued: “We must in this 21st century have a specialist register. It cannot be that with no formal exposure to anesthetics, save a few lectures in the 1960’s [as in this instance], a person is able to set oneself up as an anesthetist There perhaps should be a regulation that requires doctors to be examined – whether they be mentally or physically fit to practice….  This could be automatic beyond a certain age and where there is a known disability. There is a need for specialist qualification and proper regulation. This would be able to ensure that such practitioners know the boundaries of their competence and stay within them. In these days when there is so much knowledge to be acquired, it is risky to attempt a speciality without proper training.”

The Daily Nation of Monday February 19th 2010 had another headline “Plan to make docs stay up to date”. The (Barbadian) Minister of Health noted than “the government is planning to tighten up the practice of medicine, including making it clear who can and can’t operate as specialists in the field. We are going to establish, for the first time, a specialist register which will indicate who qualifies to be registered as a specialist in the medical profession. Whether it be law, accounting, engineering or medicine, there ought to be a measure of continuing education and all we are saying to medical practitioners is that it will be a prerequisite for your continuing registration as a medical practitioner in Barbados”. The Minister also underscored the need to make continuing education part of the condition for being allowed to keep a medical practice open.

He also noted that it would “soon become mandatory for doctors to continue their medical education to stay on the register”. When used by politicians, the word “soon” has broad interpretation, and previous Ministers of Health have given the same assurances.

Nonetheless, the comments of both the Coroner and the Minister of Health are congruent with the philosophy of the Caribbean College of Family Physicians, and although made in Barbados are applicable to the entire Caribbean.  Some doctors have already taken CME to heart; it is regrettable that an unfortunate incident which ultimately leads to the death of a young patient has propelled the need for ongoing CME into the public arena.  Voluntary CME is ideal; mandatory CME is essential where practitioners ignore voluntary CME. And mandatory CME may be a bitter pill for some physicians to swallow.