How essential is industry funding for university CME?

As originally reported in a New York Times article recently, with more coverage in MedPage Today, the University of Michigan School of Medicine has decided to end all industry support of CME as of January 1, 2011.

According to the dean of the medical school, “the decision was based on a review of literature about the influence on clinical faculty of industry-funded CME.” Apparently the decision was made after a series of “town hall meetings” at the university and after the Chairs of the academic departments voted to end commercial CME.

We are witnessing a very gradual falling of the dominos, since U Michigan is now the fourth major medical institution in the U.S. to end commercial support of CME. In February of 2008, the Sloan Kettering Memorial Cancer Center in New York gave commercial CME the heave-ho; East Carolina University’s Brody School of Medicine is rapidly weaning its CME programs of industry support, to the point where currently only 0.75% of their CME budget is from industry; and Kaiser Permanente’s mid-Atlantic region (which covers about 500,000 patients in Maryland, Virginia, and Washington DC) does not accept industry funding of CME. The new information on Brody School of Medicine and Kaiser was shared at Pharmed Out’s Prescription for Conflict conference at Georgetown University

Meanwhile, Stanford University is trying to distance itself from industry influence on CME, but is having a hard time giving up its addiction to the cash. While the dean had announced in August of 2008 that Stanford would no longer allow companies to sponsor specific courses, recently the University accepted a $3 million block grant from Pfizer for CME initiatives that would focus in certain specific areas of medicine, areas in which Pfizer markets pharmaceuticals. Presumably, Pfizer will have no influence on the content of the courses, but this is a line we have heard many time before, generally from for-profit Medical Education Communication Companies.

Unfortunately, the firewall between the drug companies’ promotional agendas and the educators’ offerings inevitably thins out, especially when it dawns on the grantees that if the sponsors doesn’t like the content of the courses, they’ll find someone else to fund the next time granting decisions are made. As if to emphasize this economic reality, the Pfizer grant is actually structured as sequential one million dollar grants to be spread out over three years, presumably with the option of reassessment before the next payment is made.

Carlat cynicism aside, it is commendable that Michigan has taken this courageous and principled step, and let us hope that other universities take note.

Daniel Carlat is a psychiatrist who blogs at The Carlat Psychiatry Blog and is the author of Unhinged: The Trouble with Psychiatry – A Doctor’s Revelations about a Profession in Crisis.

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