1. Online CME in India.
Fast tracking the closure of a gap in provision
of continuous medical education
Emma Van Hoecke1, Shailaja Nair2
1
Founder CMEpedia, Tretjakovlaan 6, 1064 PR Amsterdam, The Netherlands; emma@cmepedia.net; twitter :@EmmaHoecke ,
2
Founder CMEpedia
CONTEXT
The Twelfth Five-Year Plan(1) (2012–2017)
of the Government of India, as well as the
draft National Health Policy 2015(2), in-
tends to expand continuing medical educa-
tion (CME) programmes through the use of
information technology.
PROBLEM
• Emerging demands of CME on Indian
medical professionals
• Demand for live presence at CME events
• Shortage in availability of online CME
modules in India.
ASSESSMENT OF THE
PROBLEM AND ANALY-
SIS OF ITS CAUSES
Indian physicians require a minimum of 30
CME credits every 5 years (6 credits ev-
ery year) to renew their licence to practice.
Physicians need to be physically present at
a live event to gain these credits. The aver-
age travel time to attend a live event based
on the weighted average of urban and ru-
ral travel time is 2.85 hours. The study time
required to gain one CME credit is 4 hours
(therefore total time spent for 1 credit is
2.85 + 4 hours). In order to expose each of
the 0.9 million physicians in India to 1 cred-
it hour of CME, there will be a loss of ap-
proximately 6.1 million clinical hours. (Ta-
ble 1)
This translates to each physician requiring
41.1 hours per year (Table 2)
to earn his/her 6 annual credits through
live events. In a workforce of 891,6743
(around 0.9 million) physicians, this leads
to a minimum loss of 36 million clinical
hours per year (891,674 x 41.1).
In addition, the state medical councils send
one or two experts as observers to each
event. A minimum number of 2.6 million
conference days of CME events are required
per year (Table 3). Excluding an average
travel time of 3 hours per day, it requires
over 5000 person-days of experts’ time (Ta-
ble 3)
Solution
If CMEs in India could be conducted sole-
ly online, the yearly burden on physicians
would be reduced to 6 hours per year, which
would mean that 35.1 clinical hours
would remain available for clinical
work (Table 2) every 5 years per physi-
cian. If all medical professionals are taken
into consideration, a total of 36 million
clinical hours will be freed up.
INTERVENTION
We have developed www.CMEpedia.net, an
online database for CME content that has
already been accredited by regulatory bod-
ies in developed countries. This database
sells CME modules at an affordable price or
distributes them for free. Acquired credits
are managed in an online portfolio, which
can be viewed by medical bodies in case of
(re)registration.
STUDY DESIGN
We quantified the potential time that would
be saved by allowing Indian medical profes-
sionals to acquire their CME credits online.
STRATEGY FOR
CHANGE
In November 2014, CMEpedia launched a
static internet site to announce this con-
cept, which became functional in Septem-
ber 2015.
At present, CMEpedia is inviting interna-
tional CME providers to distribute content
through their database.
CMEpedia adheres to strict standards re-
garding equivalence frameworks of accredi-
tation, advertisement policies and uses dis-
claimers of the interests of authors.
The concept of CMEpedia was announced
at the WPA (Word Psychiatric Association)
Regional Congress in Cochin in September
2015, as well as during the 5th International
Patient Safety Congress on 16 October 2015
in Bengaluru, Karnataka, India. The social

2. media is also being used to create aware-
ness.
We submitted the concept of using CME-
pedia for public consultation of the Nation-
al Health Policy in February 2015. We in-
tend to approach the Minister of Health, the
National Academy of Medical Sciences and
the National Knowledge Network to seek
support for our initiative. We are also con-
tacting the medical bodies of the different
states in India.
MEASUREMENT OF IM-
PROVEMENT
CMEpedia is augumenting its content. In
the future, an accurate measurement of im-
provement will be an integral part of the
CMEpedia site. The content providers, as
well as institutions, employers and medical
bodies, will be able to track the use of CME
modules.
IMPACT ASSESSMENT
The impact of this initiative will become ev-
ident in the coming months, when more
content is uploaded.
LESSONS LEARNED
• Replacing live presence at CME
events by online CME modules can
save Indian doctors 36 million clini-
cal hours per year.
• CME in India will be fast tracked
by adopting internationally accredit-
ed CME modules.
MESSAGE TO OTHERS
www.cmepedia.net welcomes the delivery
of content by authors and distribution of
modules to other countries. CMEpedia will
allow authors to charge for each country
differently according to WorldPenn stan-
dards (6).
CONFLICTS OF INTER-
EST
Both authors are founders of
www.cmepedia.net. They have not received
any funding.
References
1. The Twelfth Five-Year Plan.
http://planningcommission.gov.in/plans/
planrel/12thplan/pdf/12fyp_vol3.pdf-
p.24, paragraph 20.94; p. 25, paragraph
20.98; p. 28 box 20.5 (accessed on 09
March 2015).
2. The draft National Health
Policy 2015.mohfw.nic.in/showfile.php?
lid=3014(accessed on 09 March 2015).
3. Human resources in health sector.
Data from the National Health Profile
2013. http://cbhidghs.nic.in/writereadda-
ta/(accessed 09 March 2015).
4. MCI circular for allotment of CME
credits through live events.
http://
www.karnatakamedicalcouncil.com/
News.aspx, under MCI guidelines for Cred-
it Hours MCI Circular No: MCI-Aca-
demics/2013/30661 (accessed 09 March
2015).
5. One India. With only 33% government
doctors in rural India, ‘health for all’ is a
tough task.
http://www.oneindia.com/feature/with-
only-33-govt-doctors-rural-india-health-
all-is-toug-1485567.html (accessed on 09
March 2015).
6. Feenstra, Robert C., Robert Inklaar
and Marcel P. Timmer (2013), "The Next
Generation of the Penn World Table"
at www.ggdc.net/pwt (accessed on 15
September 2015)