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INTRODUCTION AND PREAMBLE

To practice Medicine/ Dentistry in Pakistan, all doctors are required by Law to be

registered and to have a license to practice

Good Medical Practice requires doctors to keep their knowledge and skills up to date

throughout their working and to maintain and improve their performance. Continuing Professional

Development (CPD) is a key for doctors to meet these professional standards and is one of the source of

information required for appraisal and revalidation/ recertification.

The term CPD acknowledges the wide-ranging competencies needed to practice high quality

medicine/ dentistry, including medical, managerial, ethical, social and personal skills. CPD therefore

incorporates the concept Continuing Medical Education (CME), which generally is taken to refer only to

expanding the knowledge and skill required by the doctors.

PM&DC has developed standards and guideline on use of CPD as a mandatory requirement

under section 16B of PM&DC (Amendment) Act 2012 for the renewal of license to practice.

According to which;

License to practice be given only to those medical/dental practitioners/ specialists who have

completed at least 15 credit hours/years (for GPs) and 30 credit hours/ year (for specialists) of

training of CME. These training shall be conducted by recognized DAI/professional body.

Importance of credit hours and updating knowledge of doctors has been globally accepted and

also been approved by all the Medical councils. This is necessary as the modern medical science is

growing leaps and bounds and the update for any medical doctor is necessary for overall social

betterment. The doctrine of patient “deserves the best” has to be respected.

To establish a robust regulatory framework of compulsory CPD being part of legislation, the

Medical/ Dental institutions/ organizations in Pakistan are invited to get registration as CME provider

organization. These registered Organizations shall provide opportunities of continuing professional

development to the registered medical/dental doctors by getting their CME activities accredited by the

Universities which are accredited by PM&DC to grant CME credit.

Certificate of Continuing Medical Education (CME) of only those DAI/Institutions will be

entertained which shall be registered with PM&DC.

From January,2015 the licence to practice will only be renewed on provision of required

certificate of CME credit hours by respective medical or dental doctor.

All Universities / Degree Awarding Institutes (DAI’s) and Postgraduate Institute which tends to

get registered with PM&DC will have to apply formally to PM&DC.

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PM&DC SHALL GIVE THE REGISTRATION TO THE CME INSTITUTE AS PER ITS GUIDELINES. EACH INSTITUTE HAS TO FULFILL THE FOLLOWING CRITERIA.

a) The university affiliation is mandatory requirement for CME accreditation.

b) The institutes must have a CME Cell which shall be run by a PM&DC registered practitioner who shall be a holder of major post graduate qualification.

c) Accredited institutes have approved program by PM&DC in respective subject.

d) To conduct CME accredited, institutes will give at least one month prior notice to the concerned University for their activity and to get accreditation (in case it is not a constituent Institute.

Guidelines for credit hours.

i. Fifteen credit hours equal to 15 clock hours for GP’s.

ii. Thirty credit hours equal to thirty clock hours for specialist.

iii. No carry forward of extra credit hour is permissible after one year.

1. Speaker at any conference /CME/ workshop/ training program will be given one hour per lecture given by him. If they attend the whole CME as a delegate, then they will be given the approved credit hour for the CME.

2. The doctors may attend the international CME Conference held overseas as delegates. On the production submission of the certificate of CME credit hour. CME credit hours will be given as per equivalence formula.

S.No. Particulars Specialty CME 1. General Practitioners/

Administration Any Clinical CME, BLS, ACLS

2. Pre-clinical Anatomy, Physiology, Bio-chemistry , Pharmacology etc

3. Para-clinical Pathology /Micro-Biology/ Community Health Sciences, Dental materials, dental pathology etc

4. Surgical Surgical and Allied discipline (medical/dental)

5. Medical Medicine and Allied discipline(medical/dental), paediatrics

6. Gynae/Obst. Gynae., Gen. Surg. Gen. Medicine, Anaesthesia, Gyane. Sub Specialty Radiology & Imaging

7. Multi-specialty CME BLS, ACLS, Any specialty or general practitioner

DISTRIBUTION OF CME CREDIT HOURS PER YEAR:

For GP’s 15 credit hours required

For Specialist 30 credit hours required

50 % of CME are required in the speciality of the respective doctor and rest of the 50 %

shall be accepted from other than respective specialities.

Only 25 % online CME shall be accepted of total CME.

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ORGANIZATIONS / ACADEMIC ACTIVITIES TO BE ACCREDITED FOR CME

ACCREDITATION

1 In the first phase PM&DC will accredit Universities, Degree Awarding Institutes (DAIs). Postgraduate Institutes, National Level Associations/Societies and National Level Programs will also be registered with PM&DC but they will conduct their CME activities under any Universities.

RESPONSIBILITIES OF ACCREDITED ORGANIZATIONS

1 To see that adequate standards are maintained and also ensure that no excessive fee can be charged from the delegates.

2 Delegate fee charges should be intimated to PM&DC along with application form granting for CME credit hours. Prior permission from PM&DC will have to be taken in case of excessive fee and explanation pertaining to the justification of high charges should be presented before PM&DC. In case any complaint regarding unreasonable delegate registration fee by the accredited organization, PM&DC will take strict action against that organization.

3 Yearly review (Performance Audit) will be done of such organizations by PM&DC. Accreditation can be given maximum for one year subject to renewal every year.

4 List along with registration number be submitted to the PM&DC upon completion of the Course/ Workshop/ Seminar, etc. duly attested by the Head of the Institute.

5 Association/Societies/organization which are registered with PM&DC for CME. They will give at least one month prior notice for CME activity and university will process with in one month.

6 The accredited organization will be held responsible for any irregularity while conducting CME programs as stand alone or wherever they are collaborating with other organization /institute.

MODALITIES FOR ACCREDITATION

1 All universities, Degree Awarding Institute (DAIs) and Postgraduate Institutes registered with PM&DC which are under Section 11 & 18 of PM&DC ordinance 1962 amended through an act No.XIX of 2012 shall be accredited for CME as per term & condition. These will have to pay the Prescribed fee @ 50,000/- for five years.

2 PM&DC will consider the request for registration of main centers of Associations/ Societies/ Organizations which are of National levels and registered as per law. The Regional Associations/ Societies/ Organization should be asked to apply to the main centers for conducting CME activities to be accredited by a University.

3 All medical/ dental colleges/ attached hospitals and District and Tehsil level hospital should be asked to apply to any recognized university accredited for CME by PM&DC.

4 National level Associations/ Societies and national level programmes fulfilling the criteria can apply through an application available on PM&DC website. After scrutiny and approval of application, PM&DC will inform the organization accordingly and thereafter the approved organization will have to pay the prescribed fee [Rs.50, 000] and then will be granted certificate of registration for maximum one year (initially). Application form is available on the website. i.e www.pmdc.org.pk

5 On receipt of application PM&DC can seek additional information or may inspect the applying organization before granting approval. There will be a fee prescribed for inspection of institute. For initial accreditation PM&DC can grant recognition on the basis of documentation only.

6 All the registered organizations shall convene CME activities with university as being CME awarding institute.

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Purpose of accreditation for conducting CME program

1 CME programs meant for graduate doctors should have a brief session on relevant subjects i.e. community oriented preventive medicine, adequate exposure to recent advances, changing modalities of treatment, adequate exposure of consumer protection and medical insurance laws, record keeping, community oriented preventive medicine . Management and leader ship skill and medical audit etc.

2 The Institutes should have all the requisite and demonstrated ability to plan and implement CME programs to cover the targeted group (General practitioners, specialists, medical teachers, administrative and Vertical National Health Program officials, Teaching & Training skills officials) etc.

3 The Institutes should provide the detail schedule of each CME activity.

Methodology of CME activity.

1 Institutes should make arrangements for advance publicity to the targeted group of participants.

2 System of feedback evaluation through a standard feedback form filled by each delegate] duly signed by organizing secretary and observer should be maintained by the University.

3 The Institutes should undertake to publish handouts, bring out a brief report of each CME and also prepare a list of participants and delegates. The Attendance sheet [with PM&DC registration number] duly signed by organizing secretary and observer should be sent to PM&DC within one month of completion of the CME Program.

4 The certificate of each CME program will be considered relevant to enhance the knowledge of the medical/dental practitioners by way of latest medical advances, National Health Program, and the local needs of the Area.

5 Credit hours will be required by doctors. 15 credit hours for GP’s (MBBS, BDS) and 30 credit hours for specialist and basic sciences teaching faculty per annum.

6 The organization should evaluate CME to indicate the benefits accrued to participants by way of updating of knowledge, upgrading their ability and benefit to the patients.

7 PM&DC can appoint observer for each CME as and when needed.

Only for recognized institutions for CME

1 There will be arrangement for online submission of application for CME with facility for uploading the data. The certification will be made by the University.

2 It will be responsibility of the institutes arranging the CME to deposit requisite dues as decided by the University. Clearance of dues will only permit the institutes to convene CME.

3 Manual application will have to be made preferably three month in advance. Minimum 30 days in advance application will be required. University will have powers to waive this time limit in some specific circumstances.

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Physician’s Guidelines for CME

Frequently used terms:-

Organizations Activity directors who choose to delegate these activities for category 1 CME activity.

Physicians eligible to receive CME Category 1 Credit are individuals who have completed an

M.B.B.S/B.D.S, or equivalent medical degree.

To certify an activity for Category 1 Credit is the process by which it establishes that an activity meets

the standards and assigns a maximum number of credits as allowed.

Category 1 Credit is awarded (or issued) by Universities to physicians who full fill the eligibility criteria,

pays the registration fee and participate in their certified activities.

Continuing Medical Education activities particularly maintain and update the knowledge, skills, and

professional performance of the physician and built the relationships that a physician uses to provide

services.

The content of CME is the 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.

Ethical considerations for physicians and providers of CME.

PMDC expects CME organization/Registered CME institutes to present physicians with commercially

unbiased, independent and objective information in all of their activities and should meet the PMDC

Standards for their capacity building.

I. Educational Content at the institutes’ level:

What is activity director? A Professional faculty of concerned institution or group

conducting the CME, dully accredited by the

University/DAI’s/PG Institute. Activity director should

collaborate with their faculty and CME eligible doctor

whenever possible to ensure the content of the

educational activities they propose for PM&DC CME

Category 1 Credit.

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Purposing of activity for PM&DC Category I Credit.

To be designated for PM&DC Category I Credit, activity director / department must assure that their educational activities:

Confirm to the definition of CME

Present contents appropriate, in depth and scope for a physicians audience

It shall not for commercial or promotional nature.

Address demonstrated education needs.

Communicate a clearly identified educational objectives.

Use learning methodologies and formats appropriate to the activities educational objectives.

Use evaluation mechanism to assess an quality of an activity and relevance to its objectives. The evaluation form may be used or modified according to the nature of the activity as an assessment tool at the end of the activity to record the physicians feedback.

Maintain attendance to issue the actual credits of each Physician participants.

No CME Credit have shall be designated retrospectively to any activity.

II. PM&DC Category 1 Credit (How to assign them)

A. Live Activities

CME activities that CME institutes proposes or physicians must attend (in person or virtually) in order to

claim credit can be offered in a variety of formats that from national conferences and Live Internet

teleconferences to local workshops, seminars based on training session with already defined CME credit

hours (category-I) dully accredited by University.

Assigning credit for learner participation in live activities.

1. Sixty minutes of physician participation (i.e., formal interaction between faculty and the physician

audience) in a certified live activity equals one (1) PM&DC CME Category 1 Credit.

2. Simultaneous certified/approved sessions within a live activity can only be counted once.

3. If sections of a proposed activity do not fit the definition of CME then these sections must be

clearly identified in the activity proposal and excluded from the designated maximum amount of

credit.

Assigning credit for teaching at Category 1 live activities.

Universities may also award PM&DC Category 1 Credit to their faculty for teaching at the

certified live activities. This credit acknowledges the learning associated with the preparation

for an original presentation.

Presenter may be awarded one credit (Category 1) for each hour they present at a live activity

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certified for such credit.

Presenter may not claim simultaneous credit as physician learners for sessions at which they

present; however, they may claim participant credit for sessions they attend as learners for

the full learning activity.

Credit may only be claimed once for repeated presentations.

B. Enduring Materials

Enduring materials include printed, recorded, audio, video and/or online/electronic activities that may

be used over time at various locations, and that in themselves constitute a structured CME activity. To

be certified for PM&DC CME Category 1 Credit, enduring materials must:

1. Provide clear instructions to the learner on how to successfully complete the activity.

2. Provide access to appropriate bibliographic sources that allow for further study, and that

reinforce and clarify specific activity topics.

3. Provide for some type of learner interaction or self-assessment; examples include patient-

management case studies, a pre-test, a post-test, and/or application of new concepts.

Assigning credit for enduring materials Sixty minutes equals one PM&DC CME Category 1 Credit. To calculate the Designation

Statement’s credit maximum, University rounds to 0.5 or 1.0 or credit.

University may coordinate with the CME institutions to issue credit upon satisfying itself.

III. General information

A. Designation Statement:

The activity director/departments/ Organizations that

designates activity for PM&DC Category I

Credit must use the following language in both

enouncement and activity materials.

The University designates the educational activity for a

maximum [number of credits] PM&DC CME Category 1

Credit (s).

This standard language, along with the Designation

Statement, benefits both the institutes and physicians by

clearly communicating PM&DC CME Category 1 Credit.

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B. Activity announcements:

Activity announcements in both print and electronic

format should begin with the header CME in

collaboration with the department.

name of the department hosting

activity’s educational title;

facilitator’s name,

designation and affiliation (if required);

date of the activity;

timings;

venue;

target audience;

registration fees (if any);

contact/further inquiries, with advertising for

unrelated amenities playing a secondary role.

Any announcement, if it references the maximum

number of credits for which the institution has awarded

the activity, must clearly include the complete

Designation Statement exactly as it is stated above.

C. Recording credit:

The CME office of the awarding university would record

the actual number of PM&DC CME Category 1 Credits

awarded to each of the physician participants. These

records would be retained by CME office or department,

for each of their certified activities, for a minimum of

one year.

D. Credit certificates for physicians:

Submission of application form with attested copies of

CME certificates can also be submitted. Only physicians

may be awarded Category 1 Credit by institutes.

Institution would provide the certificates only at the

conclusion of the educational activity strictly on the

condition of provision of the attendance and the

evaluations by the activity director, so that those

physicians can accurately awarded their credit for

participating. CME department would require a

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minimum of 14 working days for the processing and

preparation of the certificates.

PM&DC Category 1 Credit certificates for physicians should read as under: The CME department of the university which has given

affiliation to the respective CME activity will certify that;

name of physician has participated in the

educational activity

titled [title of activity]

location

date

awarded number of credits

PM&DC Category 1 Credit. Credit certificate for activities

not conduct in specified sitting such as enduring material

or Journal CME, do not need to include the location.

E. PMDC/University Monitoring:

The activity brochures and announcement in any form

on a regular basis for compliance with PM&DC Category

I Credit system should be monitored.

F.WITHDRAWAL OF PRIVILEGE TO DESIGNATE CREDIT:

If an activity fails to comply with the standards and

requirements for PM&DC Category I Credit University

reserves the right to withdraw designated activities for

PM&DC Category I Credit.

G. Registration fee:

Physicians who pay the registration fee for PM&DC

Category I Credit designated activities are only eligible to

participate and awarded the PM&DC Category I Credit .

IV. CME Category 2 Credit activities :

Definition:- PM&DC CME Category 2 Credit is defined as all

educational activities not designated for Category 1

that: comply with the PMDC Standards for license to

practice (i.e., are non-promotional in nature); and a

physician finds to be a worthwhile learning experience

related to his/her practice.

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Physicians may claim PM&DC Category 2 Credit for such

learning activities from parent institution: teaching

residents, medical students or other health

professionals; unstructured online searching and

learning; reading authoritative medical literature; or

participating in live activities.

Other examples include: 1. consultation with peers and medical experts;

2. Small group discussions;

3. Self-assessment activities;

4. Medical writing;

5. Preceptor ships;

6. Research;

In each case, the physician individually determines the

educational value of those PM&DC CME Category 2

activities in which he or she participates.

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Application for obtaining Accreditation by PM&DC

To

Registrar, PM&DC

Islamabad

Subject: ISSUE OF CERTIFICATE OF ACCREDITATION

Sir,

Our organization regularly conducts CME/workshops/ seminars for updating knowledge of

doctors and we have demonstrated ability to plan and above programs to cover the targeted

doctors. Brief details of our organization are as below.

Name of the Organization / / / /:__________________________________________________

Address: _____________________________________________________________________

Any other? (Detail about the organization)

I request to issue certificate of accreditation to our organization / / /. We hereby agree to

follow the rules prescribed by PM&DC to conduct CME.

Thanking you

Regards

Signature /stamp of office bearer

Name: _______________________

Note! - Application to be sent on official letter head

- A bank draft of Rs. 50,000 will be payable to PM&DC

- Recognition will be granted upon letter of approval received by PM&DC

- For recognition all Performa organized need to be produced certificate of registration from

office of the Registration Societies.

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To, The Registrar, Pakistan Medical and Dental Council, Islamabad.

SUBJECT: PROVISION OF INFORMATION BEFORE START OF THE CME PROGRAMS Sir,

It gives us great pleasure to inform you that we are going to start the CME/workshops/ seminars

for updating the knowledge of the doctors as per detail given below:-

* Name of the organization:________________________________________________.

* Registration No of the organization allotted by PM&DC:_________________________.

* Postal Address of the organization: __________________________________________.

* Number of Faculty Members/Tutors: _____________________________(List attached).

* Number of participants doctors: _________________________________(List attached).

* Duration of the Program: From __________________To____________________.

* Nature of Programs offered (Kindly Tick) CME _______ ________or both__________.

* Programs specified for (Kindly Tick) GPs/Admin____________ Specialists____________.

* Please specify specialty ____________________________________________________.

* Total number of credit hours offered: ________________________ (program attached).

With best Regards

Name/ Signature/ Stamp of the Organization

Name: ______________________