The continuing professional development obligation is still largely little-known
The continuing professional development (CPD) obligation requires doctors to take predefined training courses set out in a reference framework established for each speciality, and to record them in a traceability document held in an individual account. During the last three-year cycle 2020-2022, only one in seven doctors met this obligation.
This does not mean that doctors don’t train themselves, but rather that they are not complying with their obligation to report on the activities in which they are taking part so that the medical regulatory authority, which is responsible for monitoring the application of the scheme, can
assess whether they are complying with their continuing education obligation.
This also means that the training courses taken outside the CPD system do not always offer sufficient guarantees of compliance with the reference coursework, and that we cannot be sure of their educational and scientific quality, or their independence from the pharmaceutical
industry.
A new periodic certification obligation to be defined
Periodic certification of practitioners came into force on 1st January 2023, but the necessary implementing decrees have still not been issued. As a result doctors still don't know how to comply with this requirement.
This delay should be used as an opportunity to reflect on the system as a whole, and first and foremost on the overlap of the two obligations of continuing professional development and periodic certification. These two systems have the same objectives - to ensure that doctors are up to date with the knowledge they need to practise - and they mobilise the same resources. If they were both maintained, the different procedures governing them could lead to more complex contradictory decisions. To this end, they should be unified, by simply abolishing the CPD obligation in favour of periodic certification.
Other improvements could also be made. Harmonisation of the 48 certification standards for each medical speciality is therefore crucial in the first instance, as it should make it possible to set up systems that are fair between specialities and clear for practitioners. Secondly, the
monitoring of periodic certification could be made more effective by defining more closely the responsibilities of those involved in continuing training. Finally, the public authorities must clearly define the expectations in terms of the quality of the information needed to validate the
certification procedures for healthcare professionals.
Strengthening and standardising the conditions for regulating training
Whatever the system, CPD or certification, it is essential that the training provided offer full guarantee of independence from the healthcare industry, so that economic interests do not take precedence over those of patients.
The rules of transparency imposed on professionals need to be strengthened because the level of risk is high. Between 2017 and 2022, companies working in the field of human medicines declared just over €5 billion in remuneration paid to healthcare professionals, more than half
of which went to "foundations, academies, learned societies and consultancies". In addition, conflicts of interest persist. Some national professional councils, which are the bodies responsible for defining benchmark training courses, recommend attending conferences that
they organise directly.
The regulation of continuing medical education by its operators is subject to varying criteria, resulting in varying standards of scientific rigour and independence from the pharmaceutical industry.
A single label could be introduced to harmonise the actions of operators and employers, based on criteria guaranteeing the quality and independence of training courses. Checks and penalties should also be stepped up.
Redefining funding arrangements to control costs and improve efficiency
The financial equilibrium of continuing training schemes is currently maintained, with expenditure of at least €140 million per year between 2019 and 2023, with the exception of 2020 and 2021 due to the health crisis. But the gradual implementation of the new periodic certification requirement, which is likely to lead to a sharp increase in training, will put pressure on the financial resilience of the system. To prevent some of these problems and increase the efficiency of the medical training in the hospital sector, Public authorities must be vigilant about the effective use of funds made available to operators. public authorities.
