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In 1932, Dr. Williard C. Rappleye, then dean of the College of Physicians & Surgeons, directed a study of continuing medical education for the Association of American Medical Colleges. In that report he stated: "1. The education sequence from premedical education to retirement from practice should be looked upon broadly as a single problem, not a succession of isolated and unrelated experiences. 2. The continuing education of physicians is synonymous with good medical practice, and provision should be made ultimately whereby every physician will be able to continue his education."

The College, therefore, has a long tradition of providing opportunities for practicing physicians and other health care providers to review and keep abreast of the latest developments in their specific fields.

The Continuing Medical Education Center (CME) has served to help practicing physicians maintain their medical knowledge in a variety of ways. The center organizes programs to inform and train our colleagues in medical/surgical knowledge developed here, e.g., laser treatment of ophthalmic disorders including, most recently, excimer laser surgery of the cornea, ultrasound of the fetus, and joint replacement. Specialists from around the world have taken part in national and international conferences designed to teach the state-of-the-art in a wide range of specialties. Review courses have been offered as preparation for Board exams and to provide an opportunity for practitioners to be brought up to date. These programs have been primarily targeted for specialists.

In the last 10 years a new need has arisen. Managed care health plans have placed restrictions on primary care physician referrals to specialists. To increase the level of knowledge and skill of these practitioners in a wide range of specialties, the CME Center started to organize annual courses, for a nominal fee, to primary care practitioners who live or work within a 75-mile radius of New York City. It has grown to the most comprehensive CME program in the metropolitan area for primary care doctors, with 5,000 physicians and 2,500 other health care professionals attending the courses for the past five years.

In order to not detract from practice time or weekend activities, we often offer the courses on Saturdays from 8:30 a.m. to 12:30 p.m., thanks to Mohamed Ali and the CME staff, who work that day to make the programs a success. Each year we offer six to eight such courses, which are run by our faculty. Eighty percent to 90 percent of the speakers are also drawn from our faculty.

We have designed the programs for the primary care physicians based on advances in medical practice and from particular expertise at Columbia-Presbyterian Medical Center derived from new talent that keeps enhancing the institution. For example, when the erectile dysfunction drug, Viagra, was approved we included a section on its use in a program about sexual dysfunction. Since the creation of the Naomi Berrie Diabetes Center in 1988, we have been able to provide unique courses to help the primary care practitioner manage the care of diabetics. In the upcoming year, we will be offering, for the first time, a sports medicine CME for primary care physicians, under the leadership of Dr. William Levine, assistant professor of orthopedic surgery.

Over the years courses have been offered by orthopedics, ophthalmology, cardiology, psychiatry, ENT, pediatrics, dermatology, gastroenterology and neurology. Topics have ranged from diabetes management to alternative and complementary medicine to pain management.

We work with each of the course directors to help design programs that would deal with problems of the specialty as they would present in the practitioner's office. For example, the neurology course addressed headache, dementia, seizures, stroke, numbness, weakness, movement disorders, multiple sclerosis, dizziness and syncope, and neurological emergencies.

Perhaps the best measure of our success is the large number of physicians who are "regulars," returning to our programs throughout the years.

We look forward to working with new faculty members interested in continuing to the meet the goals enunciated by Dean Rappleye in 1932.

Dr. Donald S. Kornfeld is director of continuing medical education and associate dean of the faculty of medicine.

Have a Point of View you would like to share on a topic relevant to the In Vivo audience? Contact the editors at invivo@columbia.edu.


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