ACC to Eliminate Outside Industry Supported CME Symposium at Future Meetings or Maybe Not?

We think this week, that the American College of Cardiology (ACC) is forming a new business unit to produce promotional meetings and CME symposium, which at the same time could potentially ban participation by other CME providers including associations, universities and medical education companies. 

In their announcement, they are calling for the elimination of the current model for CME-certified Educational Satellite Symposia (ESS) at all future annual scientific sessions of the College. The leaders of the ACC believe that “a more in-depth, independently planned certified Continuing Medical Education (CME) activity will benefit members and meeting attendees.” 

According to their press release, the decision was the result of a three-year evaluation by ACC’s Education Oversight Committee and was prompted in part by ongoing concerns about real and/or perceived bias in interactions with industry, specifically related to non-independence of certified satellite symposia.   A recent study was published addressing the ACC’s guideline committee and potential conflicts of interest (COIs) and did not address CME programs. 

Joseph Green, Ph.D., chief learning officer of the ACC noted that, “this decision will allow the Planning Committee for the Annual Scientific Session/i2 Summit the time and resources to more fully develop educationally meaningful and independent clinical content.”  Beginning with the 61st Annual Scientific Session/i2 Summit (ACC.12), ACC will implement two new opportunities for program enhancements: 

  1. Integration of topics for a limited number of ACC-developed CME-/CE-certified ‘in-depth focused sessions’ into the overall ACC/i2 Scientific Session planning framework.  These in-depth focused sessions will be planned and developed by the Annual Scientific Session planning committees as enhanced options to the structured sessions.  
  2. Non-certified satellite symposia that may be industry-sponsored will be managed through ACC’s Business Development Division, with guidelines and policies that are consistent with FDA, OIG, and other regulatory entities that have oversight of non-certified education.

Rick Nishimura, M.D., F.A.C.C., co-chair of the 2012 ACC’s Annual Scientific Session, noted that, “this move is important because it will allow for transparency in the two separate approaches and meet the educational needs of our members.” 

Patrick O’Gara, M.D., F.A.C.C., also a co-chair of the 2012 ACC meeting that takes place in Chicago, asserted that, “the new model is best suited to maintain the ACC’s preeminent standing in the areas of continuing professional development, life-long learning, and complete transparency in relationships with industry.” 

Throughout this three-year process, which included input from all ESS stakeholders, ACC concluded that any change in the model for CME-certified education events must: 

  • Support ACC’s ongoing leadership in the development and implementation of evidence-based, independent medical education.
  • Be devoid of any real or perceived bias in the programming and content development of CME-certified programs
  • Provide Annual Scientific Session planners, attendees and corporate supporters with enhanced options for programming to address attendees’ educational gaps and general interests in a more comprehensive manner
  • Allow greater flexibility and transparency in the design and delivery of education sessions, including small group interactions, simulations and cases 


While details, guidelines, and processes related to the new models are yet to be developed in full, this announcement by ACC may be troubling for many CME stakeholders.  For several years, CME providers have continued to improve their standards in creating highly objective and scientific CME that is producing real outcomes for clinicians. 

Is the ACC’s decision to eliminate access by outside CME providers who accept commercial support ignoring the recent developments, policies, and guidelines created by the FDA, HHS OIG, and the ACCME?    Is it also ignoring the strong commitment that AdvaMed and PhRMA have made in their Code of Ethics and other policies, which ensure objectivity and the highest level of integrity in funding CME?

ACC’s concern that programs be “devoid of any real or perceived bias in the programming and content development” ignores three recent studies that produced substantial data, which demonstrate a lack of commercial bias in industry-sponsored CME (Cleveland ClinicMedscape, and UCSF). 

Has extensive thought been given by the ACC to the fact that if you take away this education from the meeting, how can you prove that it will not lead to less informed physicians?

Have they looked at what the patient harm would be from changing their symposium?Where is the risk analysis that shows that if ACC took away this kind of CME, it wouldn’t harm physician training and patients?

What may also problematic about ACC’s proposal is that it creates more obstacles to some of the goals it seeks to achieve.  For example, if ACC hopes to create greater flexibility in the design and delivery of education by including small group interactions, this will cost significant amounts of money.  Putting together the content, ensuring objectivity and evidence-based data, compliance, and setting up the program demand a tremendous amount of resources.    It is unclear where ACC has thought through where those “resources” will come from. 

When you break it down, the ACC is a really a club, and club members can set all the rules they want for their meetings.   It is unclear from re-reading their press release what they are actually doing and if this is the ACC accrediting satellite activities or eliminating them.

How is ACC going to reconcile working on expanded CME offerings for more in depth study, with organizing promotional CME supported by industry? Is ACC somehow exempt from the rules the rest of us must follow?

Perhaps in the next few years when their leadership changes we will see a shift back towards a more level position.  At that time, maybe ACC members can go back to learning about breakthroughs at breakfast and dinner symposium.

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