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[Long-life learning for medical specialists doctors in Europe: CME, DPC and qualification].

The Union européenne des médecins spécialistes (UEMS) has a mandate to lead the quality of care in Europe and harmonise the qualifications of specialists doctors. In 2000, UEMS has set the European Accreditation Council for Continuing Medical Education (EACCME), with the objective to accredit educational events and facilitate the reciprocity of CME credits obtained by attending international medical conferences. In 2010, UEMS has set the European Accreditation Council for Medical Specialist Qualification (EACMSQ). This 2-year pilot project concerns three specialties with the goal to harmonise the competencies' assessment. In 2010, 35 countries are UEMS members, corresponding to 1,5 millions specialists doctors. Each of the 38 medical specialties has a 'section' and a four-members' board. Since 2000, the Europe developed the CPD concepts, and definitions were customised per country and health systems. The Rome group defined the CPD: "Continuing professional development is the educative means of updating, developing and enhancing how doctors apply the knowledge, skills and attitudes required in their working lives. This includes CME, professional and managerial (non-clinical) competencies, and all elements of Good Medical Practice". The learning concepts must be better developed in the health care systems as it has been done in other sectors of activity. Learning is the concept considering that it's no more possible to characterise the learner as a sponge absorbing information. The virtuous cycle of CME is well-known: assess his professional needs; set the needs and objectives; implement an educational plan with the right methods; conduct the actions and get the data; assess the events according to levels (participation, satisfaction, learning, performance, patient's health, population's health). Financing of events usually is shared between payers: state, insurers, industries, doctors but in fine, the public is the major payer. Education must be independent from all influences and recommendations should be set. Countries have mandatory or voluntary CME/CPD systems but it's not a criterium of a better performance. National authorities accredit organisms or events, and that does not make any difference.

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