Online CME becoming increasingly popular

David Gifford, MD, an internist subspecializing in rheumatology, gets most of his continuing medical education online.

He is a contract physician at Darnall Army Community Hospital in Fort Hood, Texas, working 20 hours a week. Attending medical conferences is too expensive, he said.

Going online or perusing a CD-ROM is inexpensive and can be done any time.

"The convenience really is the primary factor and my ability to select for relevance," Dr. Gifford said. "The simple reality is at a meeting I have to struggle to find things relevant to my practice. So much of it is basic science."

A growing number of physicians are discovering what Dr. Gifford has found. The Accreditation Council for Continuing Medical Education's latest annual report found that 9.57% of physicians who registered for CME activity in 2003 did so for an online course, up from 6% in 2002.

Long touted as the next big thing in CME, online courses have been slow to catch on. However, this year's data suggest they are finally gaining momentum.

"We're seeing the numbers go up significantly," said Steven Zatz, MD, executive vice president of professional information services and chief medical officer for WebMD, one of the largest CME providers on the Internet. "As more doctors have higher speed connections, it makes it more convenient."

Some 73% of physicians took some level of CME online in 2003, according to Manhattan Research, with 97% of all physicians using the Internet during that year. Forrester Research said 88% of physicians went online at least once a month in 2003, and 43% had a broadband connection at work.

Dr. Zatz would not speculate how much of the market online CME might eventually capture, but he was confident it will get much larger.

"Given the relatively modest growth in offline CME and rapid growth of online CME, we think there's lots of room for growth online," he said. "We don't see it replacing face-to-face human interaction, just like e-mail hasn't replaced all other forms of communications."

Widespread access to faster Internet service is not the only reason more physicians are getting their CME online. Providers are becoming more adept at giving physicians what they want. Online formats are becoming more interactive and engaging, according to Bernard Sklar, MD, who tracks online CME sites. However, it's the increase in short, to-the-point formats, CME providers said, that may be what's making the difference.

For example, Medscape sends out daily e-mails that physicians can read, then answer one or two questions correctly for 15 minutes of credit. Dr. Sklar said this makes it easy for time-strapped physicians.

"You haven't had to make a big decision or commitment to sitting at the computer for two hours, so why not take [the CME credit]?" he said.

Another version of CME on the fly, presented by the American College of Cardiology, has been a big hit with doctors, said Marcia Jackson, PhD, president of the Alliance for Continuing Medical Education and senior associate executive vice president for education at the college.

On the ACC site, physicians may earn CME credit hours incrementally as they answer clinical questions. The Web site keeps a tally of credits as they accumulate.

"The fact is, [physicians] have so little time," Dr. Jackson said. "If you can get CME in a short time and meet other needs [on the Web site] they'll go there."

She said Internet CME may be taking off also because of the increasing number of women physicians, who tend to have more family responsibilities than their male counterparts. Distance education for them could be one way to keep the balance between professional and personal duties.