Continuing Medical Education in Portugal

Ana Margarida Neves, MD, MSc, PhDAssociate Professor, Faculty of Medicine, Lisbon University

Head of Pediatric Allergy Unit, Department of Pediatrics, Santa Maria HospitalVice-President of European Academy of Paediatrics

Paediatric Section of the Union of European Medical Specialties

Index

1 – Introduction

2 –CME in Portugal

3 – Medical Careers

4 – UEMS

5 – Conclusion

Maintaining lifelong knowlegdge and skills is essential for a safe clinicalpractice

To Err is Human REPORT 1999 Bristol Inquiry 1996

Patient safety

Continuing Medical Education (CME) for Specialist Recertification

Core component Continuous Professional Development (CPD)

Introduction

Ahmed K et al The effectiveness of continuing medical education for specialistRecertification Can Urol Assoc J. 2013 Jul-Aug; 7(7-8): 266–272.

Definition- Recertification of Specialist

CME- established and reliable method that can facilitate lifelong learning

- Knowledge- Skills - Competent practice- Patient safety

Recertification (Netherland)Maintenance of Certification (US, Canada)Specialists Revalidation (UK)

Up-to date

Patient centered

Evidence-based care

PATIENT OUTCOME monitoring a positive change in performance

Practice Based Learning and Improvement (PBLI)

CME Curricula

An overview of methods for CME

Comparison CME

Netherland UK Malta Portugal

Mandatory Legal frame Legal frame

Voluntary Ethical Code Obligation

Not mandatory Incentives/AbsentLegal frameSelf directed

Structure

5-5 yearsIDP Appraisal200 CME/5 y

Loss License

5-5 yearAnnual Appraisal

Portofolio byOfficers

Loss License

Financial incentives 2 Weeks Congress

Pre and Pos Graduate

Medical CareerAppraisal:

Specialist Degree Graduate Degree Senior Degree

2 Weeks Congress

Portofolio -Proof Competence by Officers

Adapted: Sehlbach C et al,“Certified … now what?” On the Challenges of Lifelong LearningJ Eur CME. 2018; 7(1): 1428025

Many countries in Europe are in the process of reforming their CME systems

In Portugal CME is structured as Medical Careers

• Followed

• Not mandatory but with economic career progression incentives

• Good healthcare outcomes (13th NHS in the world)

CME in Portugal

In Portugal MDs are the professionals that are submitted to more

public exams and evaluations during their lifelong careers.

Health Care Authorities (legislation) and the National Medical

Association (technical support) regulate the medical careers with a

hierarchy of EC, Ethics, Specialty Councils.

Scientific Pediatric Society –National Congress, Meetings, Courses

Medical Careers

Law 177/2009 - DEGREES

Specialist Degree: 3 days exam - CV, practical and theoretical

Graduate Degree: 2 days exam – CV, 5 years later, proof competence evaluation

Senior Graduate Degree – 1 day exam - CV, leadership, development project - POSTE

Annual repport and evaluation

Last decade - Healthcare: shifted from public to private sector...

Special Medical Careers

Certification of Specialists

Differences in training requirements and certification in Europe

eg length of training, timing of exam

Pediatric European Exam 2019

Certification of Specialists

Sehlbach C et al,“Certified … now what?” On the Challenges of Lifelong Learning: Reportfrom an AMEE 2017 Symposium J Eur CME. 2018; 7(1): 1428025.

Specialist (Law 13/2018)

National Access Exam to Specialization

Detailed Training Program (3 years Common Trunk + 2 years Subspecialty

Options), defined by Law, yearly and continuous evaluations in

Departments recognized by visitations, tutors...

Certification National Specialist Exam- CV, patient centered practical and

theoretical discussion (3 days)

Certification of Specialists in Portugal

Graduate Degree Evaluation - National Juries

Evaluation

Evaluation

Evaluation

Graduate Degree: 1st day - CV discussion 2nd day - Proof of competence

National CME Council is studying the alignment and integration of the

portuguese medical careers with the models already established in

other countries introducing guidelines to regulate the CME program

for each specialty in Portugal

Medical Careers

UEMS supports CME and offers an Accreditation System

EUROPEAN ACCREDITATION COUNCIL for CME- EACCME

- Assures the quality for CME program

CPD/CME accreditation of events and activities - application form

- Allocation of credits/year – 40/year-200 CME per 5 years

European Union Medical Specialist-UEMS

Continuous not occasional or casual medical education;

Useful in the short and long term;

Focus on excellence of patient care and outcomes;

Funding by healthcare authorities is desirable to have independent

education and regulation

Conclusion CME

Thank you for your attention

amneves@hotmail.com