For the Record
Members at Large
Trends in CME
In the late 1970s, U.S. state legislatures and specialty boards began making CME
a requirement for relicensure and recertification. The CME system has since become a cornerstone of continued professional development, so why change it?
Pressure for change. In 1999, the Institute of Medicine published To Err Is Human. This seminal report claimed that physicians are slow to integrate new knowledge into clinical practice. Some argue that this is because traditional forms of CME such as didactic presentations measured in terms of seat time aren't up to the job of persuading physicians to change their practice behavior.
Meanwhile, physicians have complained that CME providers could be more responsive to their learning needs. Some doctors say that the traditional CME formats don't meet everybody's learning preferences. Others have complained that they struggle to find enough time to stay up-to-date.
Whether new formats for CME will be more effective at changing physician behavior remains to be seen. One thing is certain; there is a strong movement to link CME with changes in physician behavior. This can be seen in the Accreditation Council for Continuing Medical Education requirement that exemplary CME programs demonstrate effectiveness in meeting educational needs as measured by practice application and/or health status improvement. And the American Board of Medical Specialties is also pressing for that causal relationship in its required components for Maintenance of Certification (MOC).
Future direction of CME. The Council of Medical Specialty Societies launched a Conjoint Committee on Continuing Medical Education as a forum for determining how the CME system should evolve. That committee has recommended that specialty-specific core curricula should be developed for CME, and that any recommendations for patient care should be evidence-based. It also urged that new ways be developed to evaluate how effective CME programs are in educating physicians and changing physician behavior. Two components of the ABMS MOC process are evidence of lifelong learning and assessment of performance in practice. All medical specialty societies are beginning to identify ways to link CME (lifelong learning) with performance in practice.
New ways to earn CME credits. There is likely to be a loosening of the by-the-hour basis under which physicians currently earn CME credits. Already CME providers are required to use the term credit but not necessarily base that on time spent in the activity. The AMA has made several important additions and modifications to its Physician's Recognition Award Category 1 Credit. Accredited CME providers can now designate credit for Internet searching and learning, test-item writing, manuscript review, and performance improvement activities. For instance, it is proposed that physicians should be able to earn credit for self-directed learning that is triggered by challenges that come up in actual practice.
Future of Academy CME. The Academy has already developed a core curriculum (the Practicing Ophthalmologists Curriculum) based on the knowledge base development effort of 10 panels of ophthalmologists. Future CME activities will be linked to this curriculum, organized around 10 practice emphasis areas. Members may expect to see more emphasis on self-directed CME, focusing on individuals assessments of their learning needs.
Further reading. The Conjoint Committee on CME report is available at www.cmss.org under the tab for Repositioning CME. The ABMS has an expanded discussion of assessment of performance in practice, as well as the overall approach to MOC, at www.abms.org. The Academy has information on the ABMS MOC process at www.aao.org/ame.
Brief History of the Academy's CME Program
The American Academy of Ophthalmology (the Academy) is the largest national membership association of ophthalmologists. More than 90 percent of practicing U.S. ophthalmologists are Academy members, and the Academy has more than 7,000 international members. The Academy evolved as part of the American Academy of Ophthalmology and Otolaryngology (AAOO), which was founded in 1896 primarily to provide continuing medical education to eye, ear, nose, and throat physicians. The American Academy of Ophthalmology was incorporated as an independent organization in 1979 when the AAOO was divided into two separate academies, one for ophthalmology and one for otolaryngology. The Academy carries on the heritage of the AAOO in providing continuing medical education to eye physicians.
Academy members are committed to responding compassionately to their patients individual needs and to advancing the highest standards of comprehensive eye care. To enable its members to meet these goals, the Academy provides a wide variety of programs, products, and services to ophthalmologists and the patients they serve. Among these programs is an extensive offering of continuing medical education (CME) activities.
The original continuing education effort of the AAOO was the Annual Meeting. The Annual Meeting is now a four-day event that includes an extensive scientific program, including 500 courses, 25 symposia in conjunction with ophthalmic subspecialty societies, 100 scientific papers, 500 scientific posters, two scientific exhibits, and a video program comprising 30 videos. Approximately 12,000 ophthalmologists attend the Annual Meeting each year. Subspecialty Day, created in 1994, immediately precedes the Annual Meeting and offers an intensive review of the latest advances in three to six ophthalmic subspecialties each year. Each subspecialty meeting is either one or two days in length, and is comprised of approximately 60 eight-minute presentations per day.
Although the Annual Meeting remains the single most important continuing education activity for Academy members, the Basic and Clinical Science Course (BCSC) has become the foundation of the Academy's enduring materials. Thirteen BCSC books or sections provide comprehensive coverage of all ophthalmology and have become a required course of study for residents.
The BCSC began in 1939 as a home study course. Originally intended as an aid for young ophthalmologists in residency training, it consisted of prescribed reading followed by a written examination. During World War II the target audience expanded to include ophthalmologists in practice. In 1943 the Academy elected the first Secretary for Home Study Courses, a position that has evolved into Secretary for Ophthalmic Knowledge.
The BCSC has become the core ophthalmic CME material. It serves as the basis for the examination completed annually by every resident. Perhaps more importantly, ophthalmologists in practice now purchase more copies of the BCSC than residents and residency programs. All BCSC sections are reviewed for currency every year, and three sections are fully revised every four years, so that at least three new sections are available annually. A committee of five to eight ophthalmologists supervises development of each BCSC section, and a chairperson provides leadership to section chairs to ensure comprehensive coverage.
The Academy's CME program has evolved from the traditional fare of educational activities such as the Annual Meeting and the BCSC program to a much broader array of activities, including Regional Update Courses, videotape presentations of clinical skills, the Ophthalmology Monograph series (book-length treatments of highly specialized topics), CD-ROM presentations of update courses presented at the Annual Meeting, the Focal Points subscription series of clinical modules, a comprehensive self-assessment program, and an extensive offering of cases and courses in the online Education Resource Center (ERC). Some of these activities are no longer offered; others have been evolving for many years. A Senior Secretary for Clinical Education sits on the Academy's Board of Trustees and the Executive Committee and oversees the efforts of three Clinical Education secretariats as well as the editor of the Academy's medical journal, Ophthalmology.
The most recent shift in the Academy's CME effort occurred in 2002 when the American Board of Ophthalmology (ABO) began implementing the American Board of Medical Specialties (ABMS) Maintenance of Certification (MOC) program. (For more on this, see the Maintenance of Certification feature article in this month's issue of EyeNet Magazine.)
For the Record
Vote Online or by Post in This Year's Election
Calling all active voting members and fellows: Remember to cast a ballot for the next president-elect, senior secretary for Advocacy, chair of the Council, vice-chair of the Council and trustees-at-large, as well as the proposed amendments to the Academy's bylaws.
Voting lasts 30 days, from Monday, Oct. 17, at noon Central Standard Time to Tuesday, Nov. 16, at noon CST. You will have the option of voting via either the Internet or traditional mail ballot. If you vote both online and by mail, only the latter ballot will be counted.
Online voting: The easiest way to vote online is to visit the Academy's home page once voting has started and follow the well-marked link to the voting site.
Voting by mail: All members who are entitled to vote should receive a voting guide, which will include a mail ballot, shortly after the Annual Meeting.
The candidates and amendments: Visit www.aao.org/elections to read candidate biographies and view proposed amendments to the governance documents. At the Annual Meeting, candidate information will also be posted in the convention center Grand Concourse.
After the elections: In November, visit www.aao.org/elections to see the election results and find out how to nominate a candidate for the 2007 board.
Board Reappoints Public Trustee
The board of trustees has approved the reappointment of Humphrey J. F. Taylor to serve as public trustee for an additional three-year term commencing Jan. 1, 2006. Mr. Taylor has previously served as public trustee a position intended to bring an outside perspective to Board deliberations since 1994.
As chairman of The Harris Poll, he's had overall responsibility for more than 8,000 surveys in 80 countries for governments, corporations, universities and foundations.
For more on Mr. Taylor, go to www.aao.org/bot, where you also can find biographies of other board members.
Review the Candidates for 2005 Membership
The candidates for 2005 Academy membership are now listed online. These applicants have not yet been reviewed by the board of trustees. If you have reason to believe that any individual(s) should not be recommended by the board for election to membership, please submit the reason(s) with documentation (specific names, dates, places, etc.) in writing as soon as possible and no later than Oct. 7. Please send any documentation to: AAO, Member Services, Attention: Jill Hartle, P.O. Box 7424, San Francisco, CA 94120-7424.
Membership is a privilege and is conferred upon recommendation of the board and election thereto by a three-fourths (3/4) affirmative vote of the voting fellows and members present at the Annual Business Meeting, which takes place this year on Oct. 16 in Chicago.
To view the list of candidates, please visit the Academy's Member Center at www. aao.org/member.
Note the Academy's New Phone Number
The Academy has a new toll-free number. The number has been changed to 866-561-8558 (similar to the Academy's traditional number, 415-561-8500, which is also still available). When you call the Academy, you are presented with three options:
1. Dial your party's extension. If you don't know what it is, you can dial for a directory.
2. Member Services. The Member Services staff will continue to answer all of your membership questions.
3. Annual Meeting. Customer Service staff members will answer general questions regarding the 2005 Annual Meeting. After the Annual Meeting this option will change, directing you to Customer Service staff who can answer questions regarding Continuing Medical Education credits or your CME transcripts.
If you do not select any of these options, your call goes to a centralized Service Center. The Service Center handles all other calls, including operator transfers and product orders.
Spread the Word on EyeCare America: Be a Champion Volunteer
In order to serve those in need, EyeCare America relies on television, radio and the print media to publicize its programs for children, seniors and patients with glaucoma or diabetes.
In addition to volunteering to see EyeCare America patients, many of the programs volunteer ophthalmologists are using ECA templates to send letters and press releases to their hometown newspapers. Those volunteers who get the word out to their communities are designated as ECA champion volunteers. (At this year's Annual Meeting, the ECA will be giving a gift of appreciation to each champion volunteer who stops by its exhibit at Booth #2157.)
To find out more about how to become a "champion volunteer" call ECA toll-free at 1-877-887-6327.
Launch a Career in Geriatrics Research
The Dennis W. Jahnigen Career Development Scholars Award program helps individuals to initiate and sustain a career in research and education in the geriatrics aspects of their discipline. Each award provides two-year support of $75,000 per year for salary, fringe benefits and/or the costs of doing research. The supporting foundations require that your institution provide a minimum match of $25,000 per year. Up to 11 awards will be given in 2006.
To apply for the next round of grants, you must submit your application by Dec. 6.
For an application form and to review selection and eligibility guidelines go to www.americangeriatrics.org/hartford/jahnigen.shtml.
If Eye Care Is in Your Genes, Please Contact the Academy
Academy Seniors (formerly the Senior Ophthalmologist Interest Group) believes that ophthalmology has a familial heritage that surpasses other specialties in medicine.
In June of 1999, Thomas A. Weingeist, MD, PhD, past president of the American Academy of Ophthalmology (2002), published an editorial in EyeNet mirroring this belief. His article discussed the relevancy and archival importance of identifying national and international, third- and fourth-generation Academy ophthalmologists.
Academy Seniors has adopted this legacy project and will compile the information for the Academy archives and Museum. The Museum will also create an exhibit for display at the 2006 Joint Meeting.
Please help Academy Seniors to record this historical data by forwarding the names of second-, third- or fourth-generation ophthalmologists. You can submit the family name(s); brief family history; birth dates; ages; schools attended; duration, location and type of practice; as well as any other interesting facts that might be applicable.
To submit your information, please send it to the attention of Brigid Saulny by mail at American Academy of Ophthalmology, 655 Beach Street, San Francisco, CA 94109 or by e-mail to firstname.lastname@example.org.
What's New with the FDA, VA and the Politics of Children's Eye Care
If your reattending the Academy's Annual Meeting in Chicago, plan time in your schedule for these free sessions:
A Guide to Ophthalmic Device and Drug Evaluation. Experts, including FDA officials, will present a step-by-step discussion of the FDA's application and review process for ophthalmic drugs and devices. The latest legislative and regulatory developments in drug approval will also be covered. (Sunday, Oct. 16, from 12:45 to 1:45 p.m. in Room N427a.)
What's New at the VA: Exciting Opportunities for Ophthalmologists. A panel of ophthalmologists who are practicing in the Veterans Health Administration will discuss new market-driven physician pay levels, research opportunities and more. (Monday, Oct. 17, from 12:45 to 2:15 p.m. in Room S102d.)
Politics and Money in Children's Eye Care. Examine how politics and money are driving the delivery of children's eye care. Highlights include a review of the recent push by organized optometry and eyeglass frame manufacturers at both the federal and state levels for mandatory comprehensive pre-K vision exams and new research findings that support screening. (Monday, Oct. 17, from 12:45 to 1:45 p.m. in Room N427a.)
Members at Large
State Society Leaders Are On the Road in N.J.
The seven-month On the Road program has provided an excellent opportunity
to meet our members and potential members face-to-face and to relay how the New Jersey Academy of Ophthalmology continues to be an excellent resource for information and ophthalmology's voice in the state noted John D. Dugan Jr., MD, NJAO president.
From March through September, NJAO leaders, supported by an educational grant from Alcon, scheduled a series of five meetings across the state. They invited both members and nonmembers alike to hear from NJAO leaders and to provide their input on the organization's agenda and programs.
NJAO leaders presented topics including the history of the NJAO, conflicts and compromises, while also plugging the importance of New Jersey's Ophthalmology PAC and the Academy's Surgical Scope Fund. This has allowed us not only to highlight NJAO accomplishments, but also to discuss the crucial work ahead, said Ralph C. Lanciano Jr., DO, NJAO councilor. Through this program, members could network with leadership and also had the opportunity to provide their input on NJAO programs and services. We wanted to meet with current members and reach out to nonmembers to strongly encourage them to join and unify with their colleagues to support their state ophthalmological society.
Hitting the road along with Drs. Dugan and Lanciano to participate in these series of meetings were several NJAO board members, including six NJAO past presidents and NJAO executive director Bev Lynch.
The Academy's Secretariat for State Affairs commends the NJAO and its leadership for this innovative approach to membership retention and recruitment, said Academy Secretary for State Affairs Cynthia A. Bradford, MD. It is a great way for leadership to show that it values its members input and to share information about the state society. This will likely be emulated by other state societies across the country.
The Secretariat for State Affairs selected the NJAO as a 2005 Star Award recipient. Four other societies also received the Star Award for outstanding programs:
- Arkansas Ophthalmological Society Sight Savers Program: A program to screen individuals for glaucoma and create awareness in the community of the prevalence and effects of glaucoma; targeted Arkansans who don't have easy access to eye care.
- Connecticut Society of Eye Physicians Health Plan Relations: An advocacy effort aimed at changing Aetna's policy against paying OCT and GDx claims.
- Massachusetts Society of Eye Physicians and Surgeons Pre-School Vision Screening Initiative and Implementation: An advocacy effort that led to passage of a law requiring preschool vision screening.
- Washington Academy of Eye Physicians and Surgeons Increase WAEPS PAC Contributions: As part of an effort to increase PAC contributions by members, the society created a recognition program for PAC contributors. It also revamped its dues billing statement so that PAC contributions could appear on the invoice.
These state societies will be formally recognized during the October 17 Presidents' Breakfast and Recognition Awards held in conjunction with the Academy's Annual Meeting.
Marshall M. Parks, MD, the main founder of pediatric ophthalmology, died July 27, 2005. He was 87. Dr. Parks had a distinguished career as a physician, writer, lecturer, professor and leader. He defined the diagnosis and treatment of strabismus and amblyopia, described monofixation syndrome, explained the benefits of early strabismus surgery, wrote about the management of infantile cataracts and invented surgical techniques.
Dr. Parks completed St. Louis University School of Medicine in 1943. His medical prowess earned him an internship at the U.S. Naval Hospital in San Diego, where he trained until he served as a medical officer aboard destroyers in the Pacific theater during World War II. Afterward, he completed his ophthalmology residency at the U.S. Naval Hospital, Great Lake, Ill.
Dr. Parks introduced the practice of pediatric ophthalmology before ophthalmic subspecialties existed. In 1946, Dr. Parks encountered dozens of children with vision problems and decided to expand the pediatric ophthalmology program with his mentor, Frank D. Costenbader, MD, at Children's Hospital in Washington, D.C.
Dr. Parks achieved the posts of attending physician at Children's National Medical Center and the Washington Hospital Center, clinical professor at George Washington University Medical Center and instructor at Georgetown University Medical Center. In Dallas, he was instructor at Children's Medical Center and the University of Texas Southwestern Medical Center, all while simultaneously working as a consultant surgeon. He also served for 40 years as consultant at Bethesda Naval Medical Center and Walter Reed Army Medical Center.
The founder of the Costenbader Society, Dr. Parks trained more than 160 of the world's leading pediatric ophthalmologists. Over 15 societies honored him with prestigious awards, including the American Academy of Ophthalmology's Laureate Recognition (2004) and Life Achievement (1998) awards.
Among his many leadership positions, Dr. Parks was the first president of the American Association for Pediatric Ophthalmology and Strabismus and president and chairman of the board for the Children's Eye Foundation. He was president of the American Academy of Ophthalmology (1982), and director and chairman of the board of The Foundation of the American Academy of Ophthalmology.
Memorial contributions may be made in his name to the Children's Eye Foundation, 655 Beach St., San Francisco, CA 94109.