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May 12, 2015

Reforming the Continuing Medical Education System

Author Affiliations
  • 1Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
JAMA. 2015;313(18):1813-1814. doi:10.1001/jama.2015.4138

In the modern era of medicine, the accelerating rate of change in medical knowledge represents an enormous challenge to the ability of physicians to offer patients the highest-quality care. A particularly striking example is the rate of introduction of new drugs. In the 1930s, the US Food and Drug Administration (FDA) approved an average of fewer than 2 new molecular entities annually, accelerating through the ensuing decades to an annual rate of more than 30 new drugs per year.1 For a physician who completed postgraduate training in 1985, more than half of all the critically important newly available pharmaceutical agents were introduced after they completed their training. Many therapies in common use a few years ago are now consider ineffective or harmful (eg, digoxin, niacin). Similarly, diagnostic methods such as medical imaging or laboratory testing and new surgical techniques have evolved at an extraordinarily rapid pace, rendering obsolete a considerable fraction of knowledge acquired during medical training.