of Continuing Medical Education
income of $2.38 billion.1In 1998, the income was $889 mil-
of the income for CME providers has come from industry.2
drupled between 1998 and 2006–from $302 million to $1.2
billion–and doubled from other sources.1In 2006, the com-
and exhibit income) represented 60.6% of total income. An
The profit margin for ACCME-accredited providers in-
creased from 5.5% in 1998 to 31.0% in 2006.1The 3 main
types of CME providers are physician member organiza-
tions, publishing and education companies, and medical
schools. In 2006, their margins were 46.3%, 34.7%, and
revenue to subsidize other activities.
Continuing medical education has become so heavily de-
pendent on support from pharmaceutical and medical de-
may inherently distort education and practice to the detri-
and other approaches to funding are discussed below.
Robert Steinbrook, MD
ONTINUING MEDICAL EDUCATION(CME) IS A MULTI-
billion-dollar industry. In 2006, the CME provid-
tinuing Medical Education (ACCME) had a total
Funding for Different Types
of CME Organizations
providers, such as hospitals. Publishing and education com-
cian member organizations received 23.0% of their CME in-
ing and exhibit income for CME.1
cal societies had an income of $134.5 million and expenses
of $136.5 million; 29.3% of their income was from com-
mercial support.1These CME providers were responsible
for 349696 hours of instruction (including jointly spon-
sored activities); medical schools for 331298 hours; phy-
sician member organizations for 147308 hours; and pub-
lishing and education companies for 61404 hours.1
Continuing Education and Marketing
Patients and payers, however, may ultimately pay the bill.
CME events or to organize them may have extensive finan-
cial relationships with companies, and pharmaceutical com-
may be overlap between the material presented at promo-
tional events such as dinner lectures and satellite symposia
thereby biasing “the overall curriculum of topics,”5regard-
less of their importance to improving care.7
The accreditation of medical education and communi-
cation and communication companies may organize and
ing and education companies, a category that includes
medical education and communication companies, re-
See also p 1003.
Author Affiliations: Dartmouth Medical School, Hanover, New Hampshire; and
Veterans Affairs Outcomes Group, White River Junction, Vermont.
Department of Veterans Affairs Medical Center, 215 N Main St (111 B), White
River Junction, VT 05009 (email@example.com).
JAMA, March 5, 2008—Vol 299, No. 9 (Reprinted)
©2008 American Medical Association. All rights reserved.