ACCME - Accreditation Council for Continuing Medical Education
The Accreditation Council for Continuing Medical Education (ACCME) sets and enforces standards in physician education within the United States. It acts as the overseeing body for continuing medical education (CME) credit, which is offered through its constituent member organizations.
ACCME Standards for Commercial Support
Standards to ensure independence in planning and implementing CME activities. (ACCME, 2010) For an activity to be eligible for AAFP CME credit, CME providers must attest on the AAFP CME application form that they will fully comply with the Standards. Individual activities may be selected in random post-event audits to confirm compliance.
The overall CME program, including all components that make up the activity (i.e., learning objectives, faculty, dates, facility information, sessions, etc.).
The person responsible for the educational content of the CME activity.
AMA PRA Category 1 CreditTM
American Medical Association Physician Recognition Award designation that may be used when a CME provider is accredited by the ACCME. Activities that are approved for Prescribed credit can also be reported to the AMA as AMA PRA Category 1 CreditTM.
The entity responsible for creating the educational activity for which AAFP CME credit is being sought. This definition includes AAFP committees, publications and chapters, as well as not-for-profit organizations, medical schools, volunteer agencies, specialty associations and commercial producers of CME (e.g., health care communications companies). The definition excludes proprietary health care-related entities such as pharmaceutical companies and medical equipment manufacturers, as well as health care communications companies that are employed by a proprietary entity. Activities produced by such entities are not eligible for AAFP CME credit.
A personal judgment in favor of a specific proprietary business interest or a commercial interest (ACCME, 2010).
Any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. The ACCME does not consider providers of clinical service directly to patients to be commercial interest. A commercial interest is not eligible for ACCME accreditation or AAFP certification.
Financial or in-kind contributions given by a commercial interest, which are used to pay all or part of the costs of a CME activity. Guidelines regarding roles and requirements when commercial support is received are outlined in the ACCME Standards for Commercial Support. (ACCME, 2010)
Complementary and Alternative Medicine (CAM)
CAM is a group of diverse medical and health care systems, practices, and products that are not generally considered to be part of conventional medicine. While scientific evidence exists regarding some CAM therapies, for most there are key questions that are yet to be answered through well-designed scientific studies—questions such as whether these therapies are safe and whether they work for the purposes for which they are used.
Complementary medicine is used together with conventional medicine. An example of a complementary therapy is using aromatherapy, a therapy in which the scent of essential oils from flowers, herbs, and trees is inhaled to promote health and well-being to help lessen a patient's discomfort following surgery.
Alternative medicine is used in place of conventional medicine. An example of an alternative therapy is using a special diet to treat cancer instead of undergoing surgery, radiation, or chemotherapy that has been recommended by a conventional doctor.
The AAFP’s Commission on Continuing Professional Development (COCPD) has authority and oversight of the AAFP CME certification process and all AAFP-sponsored and AAFP-produced CME/CPD, including compliance with rules and regulations set by the AAFP and other regulatory bodies. The COCPD is responsible for exploring future directions and innovative concepts in lifelong learning, and making recommendations regarding the future of AAFP CME/CPD programming. The COCPD also proposes AAFP policies in matters of CME/CPD education.
Conflict of Interest
When an individual's interests are aligned with those of a commercial interest, the interests of the individual are in "conflict" with the interests of the public. The ACCME considers financial relationships to create actual conflicts of interest in CME when individuals have both a financial relationship with a commercial interest and the opportunity to affect the content of CME about the products or services of that commercial interest. The potential for maintaining or increasing the value of the financial relationship with the commercial interest creates incentive to influence the content of the CME and incentive to insert commercial bias.
Continuing Medical Education (CME)
Consists of educational activities which serve to maintain, develop or increase the knowledge, skills, and professional performance and relationships that a physician uses to provide services for patients, the public or the profession. The content of CME is that body of knowledge and skills generally recognized and accepted by the profession as within the basic medical sciences, the discipline of clinical medicine, and the provision of health care to the public. (ACCME, April 2010)
Customary and Generally Accepted (CGA) Medical Practice
Diagnostic and therapeutic interventions that are accepted by the practicing medical community for given indications in individual patients, families and communities. CME content is acceptable as customary and generally accepted medical practice if it is consistent with one or all of the following:
- Diagnostic and therapeutic recommendations presented in the books or review articles from the journals listed in the Brandon Hill Selected List of Books and Journals for the Small Medical Library, excluding texts 16 through 24, and also excluding the Journal of Alternative and Complementary Medicine. (In this context, a "review article" is one that presents an overview of a specific medical topic by discussing the results of many research articles published by various authors; the purpose is not to present the author's personal research.)
- Expert consensus statements of governmental agencies and institutions of the United States where the evidence has not been graded.
- Original scholarship, including research methodology and findings, as well as case reports, represents the customary and generally accepted educational practice of presenting new and valuable information that is not yet based on acceptable levels of evidence. CME content based on original scholarship is eligible for credit if disclosed as such.
Credit type obtainable for activities designed primarily for other health professionals with content of interest to physicians that will improve a physician's professional ability but need not directly influence patient care or its delivery. These activities do not require AAFP member input. Activities awarded Elective credits are not eligible for AMA credit.
Printed materials, programmed texts, audiotapes, videotapes, slides, CDs, online content, etc., used alone or in combination. Enduring materials include education disseminated by teleconferences, broadcasts by satellite, online or through software. These independent learning materials must, in themselves, constitute a planned CME activity. Handout materials designed to accompany a live presentation are not considered enduring materials by themselves. Enduring materials are designed primarily as self-study activities that may be used over time with different mediums.
The AAFP has an equivalency agreement with the American Medical Association (AMA), wherein courses that are approved for AAFP Prescribed credit are equivalent to AMA PRA Category 1 CreditTM. Activities that are approved for
AAFP Elective credit are not recognized by the AMA. The AAFP also has an agreement with the American Osteopathic Association (AOA), wherein activities approved for AAFP credit (whether Prescribed or Elective) are equivalent to AOA Category 2 credit.
The process of examining an activity to determine the extent to which specified objectives are met. The evaluation should pertain to the educational content of the CME activity. The evaluation results do not need to be sent to the AAFP upon completion.
Evidence-Based CME (EB CME)
Clinical content presented that identifies learner's gap in knowledge, competency, and/or performance in medical practice.
The integration of current best research evidence with clinical expertise and patient values. (Sackett DL, Straus SE, Richardson WS, et al. Evidence-based medicine: how to practice and teach EBM. 2nd ed. London, England: Churchill Livingstone;2000.)
The medical specialty that provides continuing, comprehensive health care for the individual and family. It is the specialty in breadth that integrates the biological, clinical and behavioral sciences. The scope of family medicine encompasses all ages, both sexes, each organ system and every disease entity. (AAFP 1986, 2010)
Family physicians, through education and residency training, possess distinct unique attitudes, skills and knowledge which qualify them to provide continuing and comprehensive medical care, health maintenance and preventive services to each member of the family, regardless of sex, age or type of problem, be it biological, behavioral or social. These specialists, because of their background and interactions with the family, are best qualified to serve as each patient’s advocate in all health-related matters, including the appropriate use of consultants, health services and community resources. (AAFP 1975, 2009)
Family Physician Input
An AAFP Active, Suppporting (FP) or Life member who has direct involvement in the planning of a CME activity and attests that it is appropriate CME for family physicians. This activity may then qualify for AAFP Prescribed credit. Attestation is required on the CME application. An audit may be done to ensure the AAFP member was involved in the activity planning.
An approach to medicine that combines treatments from conventional medicine and CAM for which there is some high-quality scientific evidence of safety and effectiveness. It is also called integrated medicine.
A regularly published collection of articles intended for medical professionals to provide continuing medical education. Journal CME may be in a print, audio, video or online format.
State what the learner can expect to know or do after completion of the activity using medical terminology. Clear details about the learning objectives and intent of the topic will streamline the review and approval process. The learning objectives should result from the needs assessment data.
These involve two or more physicians and take place in “real time.” Typically, these are traditional didactic courses occurring as single, multiple site/date or series events. Broadcast and online activities, teleconferences and e-mail “chat groups” can be in this category if they are conducted in “real time” and have an interactive component. When a videotape is the major educational element of a live activity, a physician moderator must be available to provide a planned opportunity for interaction among the physicians in attendance. AAFP members are required to obtain a minimum of 25 Prescribed and/or Elective credits every three years from live learning activities.
Multiple Site/Date Activities
The same content is repeated at various locations or offered on different dates throughout a year.
Performed prior to developing CME activities to determine what health care providers need to learn. That is, the knowledge, skills, attitudes, or changes in practice behavior health care providers need. (Sometimes called Needs Analysis)
A credit type obtainable for activities designed primarily for physicians with content directly related to patient care, patient care delivery or selected non-clinical topics. A family physician who is an AAFP Active, Life or Supporting (FP) member must be directly involved in the planning of the activity.
Re-review of an application is necessary when the CME credits of an activity change. The processing fee is $100 for any CME application that needs to be re-reviewed by AAFP after the CME provider receives official credit determination from AAFP. This fee does not apply if there are changes to the date of the activity or the speaker(s), or when any additional dates are added. A re-review of an application will be completed within 30 business days.
CME providers have the option to pay a rush fee to have their CME application reviewed faster than the standard 30 business days (6 weeks). The rush fee is $500 plus the review fee. A rush review will completed in 3-5 business days.
A preplanned set of regularly scheduled (e.g. weekly, monthly, quarterly) conferences that occur at one location/institution in a one-year period. The conferences have different topics related to a unifying theme under an umbrella title (e.g., Family Medicine Grand Rounds, Tumor Boards, Issues in Primary Care, etc.). Global objectives also serve to unify the series. The conferences must be uniform in length and may not exceed four hours or 3.75 credits. AAFP requires segments of four hours or more in length to include a fifteen-minute break.
Each occurrence of an activity. For example, a series that occurs every Wednesday might have 52 sessions.
Statement of Purpose
A brief description of the purpose, scope and subject of the activity.
A review in which all the trials on a topic have been systematically identified, appraised and summarized according to predetermined criteria.
Training Programs (Mini-Residency/Fellowship)
A comprehensive activity designed for practicing physicians to upgrade knowledge that leads to skilled behavior in specific areas. Each activity must meet the AAFP CME criteria for approval of a live activity. These activities vary in length and may be arranged individually. They should allow enough time for the physician to learn the skills and demonstrate that he/she has achieved the defined objectives. The provider will define the skills to be taught beforehand and assess the skills acquired by the learner at the conclusion of the course. The director of the activity must provide the physician with written verification of attendance and the achievement of course objectives.
AAFP members may claim up to 50 credits per week (maximum: 150 per year) for participation in training programs for which formal applications of live activities have been reviewed and approved by the COCPD.