|CPD - Continuing
Professional Development of General Practitioners in Europe
General Practice enjoys ever greater recognition within health care systems in Europe. In parallel with this, demands for quality in the health care services delivered by General Practice are also increasing.
The continuing professional development (CPD) of General Practitioners is an inevitable prerequisite for the maintenance and development of this quality.
The term CPD in this document is used to mean the maintenance and development of the professional competence of the individual general practitioner.
CPD should be understood as the activity by which the individual doctor updates his knowledge about, orientation on, and responsible practice of medicine in general practice including management, communication and relationship issues.
Evidence has shown that general practitioners make considerable efforts to maintain their competence in the daily work. Expertise in new competencies grounded in the needs which becomes evident within the daily professional challenge are set in focus while competencies not central to that challenge are set aside.
It is the responsibility of the individual general practitioner to make optimal use of resources (time, finance, the profession's taking care of) which in the given national system are set aside for CPD. This is achieved by enabling the GPs themselves explicitly identify their personal learning needs and select their CPD activities accordingly. Explicit evaluation of the success of this process as well as registration of the activities are necessary links in the quality assurance of the CPD process.
It is the responsibility of the professional organizations to cooperate in securing and developing an effective framework for the individual physician's CPD. This includes mutual responsibility for the determination of an annual minimum amount of CPD, which should be reflected in the resources (finances, time, CPD offers), made available nationally for this purpose.
As various teaching methods have different strengths and weaknesses, the broadest possible range of learning opportunities should be offered. The individual doctor must be able to choose the methods which are most relevant for him or her in the context of the identified learning needs to have the skills to be updated or learned, and challenge the attitudes that may impede patient care.
It is the responsibility of all stakeholders – patients, societies and politicians to cooperate in securing the necessary finances and time as well as the establishment of frameworks which can satisfy the requirement for competence that society is generally aiming for.
The choice of the individual GP of concrete CPD activities must be independent of influence from the financing and regulating authorities - that is, the public authorities, the various insurance systems and the pharmaceutical industry. The individual physician's CPD takes place in his or her zone of mastery; thus, only the individual doctor can evaluate the relevance of his or her choice of CPD.
However, at the same time, GPs must be accountable for the quality of their CPD and for their use of resources. In cooperation with the professional organisations, the process should be organized so that the individual GP is able to develop his or her personal learning plan in the light of external evaluation and audit in order to ensure that unrecognized educational needs are identified. Attendance at CPD activities must be allowed during regular office hours. Financing of CPD provision cannot be the sole responsibility of general practice.
Within this general framework each GP should have access to participation in appropriate CPD throughout his or her professional career.
The assurance of high quality must build upon criteria established by the profession in close cooperation with the academic organizations and universities. The establishment of quality requirements must furthermore involve the other interested parties - patients, public authorities, insurance systems, and politicians.
A broad array of CPD activities both with regard to form and content is a prerequisite for a high quality CPD. Explicit definitions of the content, high teaching standards and the use of recognized educational methods, all help to maximize the quality of the individual CPD activities.
Accreditation in accordance with established criteria of the individual CPD activities for GPs can be a method for securing quality. Obligatory CME does not guarantee quality. The principle of voluntary choice is the only way of ensuring that the individual needs are covered in the best possible manner and that the resources earmarked for CPD are used effectively.
Society, through the relevant regulatory authority, may look to a physician's recorded CPD as evidence of his/her continued competence. If this is to be the case then the imposition of measures to ensure competence in general practice requires a legislative framework, the provision of resources to provide the educational structure, an appeals mechanism and a remedial education program for those physicians who ‘fail’ to meet the criteria set. The academic colleges may facilitate their individual G.P. members to satisfy the regulatory authority’s competence assurance measures, but will not act in a surrogate policing role (of their member’s license to practice) on behalf of others.
Individual electronic registration or manually maintained logbooks of the individual CPD activities are useful. Such documentation sharpens the individual's attention to his or her own CPD activity and is a prerequisite for an effective personal learning plan. Anonymised registration information held in a central database can provide a basis for the quality assurance of CPD system.
UEMO DECLARATION ON CPD