Wednesday, July 30, 2008


Although I attend quite a few radiology meetings, the bulk of my continuing medical education (CME) comes from a much different source. Staid organizations such as the AMA call this "point-of-care" CME. Personally, I prefer the term: "WTF CME™". 

It works like this:
1. You read through a worklist of images (or hey, actually see a patient) and spot some finding you can't explain. As the image above suggests, you then ponder this finding and its significance.

(N.B.: If you are not au courant with the latest in internet abbreviations, let's just say that WTF stands for "What's that finding?")

2. If you work with other radiologists, you ask their opinion. They either know the answer, or utter a quizzical remark similar to yours.

3. If none of you know, you head for a website like Google or PubMed. Occasionally you get lucky and one of these sources resolves your question.

At this point, you may be wondering where the CME part comes in. Can it be that this sort of activity counts as a legitimate professional learning activity?

The answer is yes, indeed. The time you spend doing this counts as Category II CME (at least in my state). All you need to do is to keep track of it, which you can do on the back of an envelope. Alas, this scrap-of-paper logging method doesn't work too well for me -- most likely because I'm too lazy to tally up all of the scraps at the end of each year.

Fortunately, there is an easier way to keep track of this stuff -- colleagues at the University of Washington Department of Radiology have put together a handy, dandy web-based program called UDubMed that tracks all of one's PubMed searches. The interface is pretty much bare-bones, but the service is free and the basic features work just fine.

Once you set up a free UDubMed account, you log your searches thusly:
  1. type in your PubMed search term in the box labeled (oddly enough) "Search Terms"
  2. hit the search button
  3. UDubMed records your search terms in a database, flings your search terms off to PubMed, and then returns the result of this search
  4. repeat prn
Eventually (usually around license-renewal time), you realize that you need to rake together all of the CME you've amassed over the past few years. Like me, you may need to apply your rake to many piles of stuff. Raking the UDubMed pile, at least, will be pretty darned easy -- the report button will generate a list of the date, time and search terms of every search you've ever made. Printing out this list as a thick slab of paper should be just the thing to repel boarders during even the most anal CME audit.

Just to see how this might work for me personally, I did a brief one month experiment, in which I used UDubMed for all of the literature searches I did while reading out with my residents. By the end of the month, I'd done over 300 searches -- not too shabby.

That's a nice number, but how many CME hours can I get for that? There's the rub -- some searches are over in a minute, while others might lead to a series of articles that you then download and read for the next hour. Is there an easy way to keep track of this?

I was too lazy to count the actual search time, so I decided to greatly simplify my life by using an algorithm I learned years ago in the U. S. Air Force, known as the WAG (wild-assed guess) method. Using this, I assumed that each search ate up an average of 5 minutes of my life. This converted my 300+ searches into about 27 hours of CME.

I admit that I initially felt a bit guilty about setting the average search time so ridiculously high at 5 minutes. However, any guilt vanished when I found out how much time the American Medical Association was willing to give me per search for their Physician's Recognition Award (PRA): thirty (count 'em, 30) minutes! Using this even more wildly generous algorithm, my search time for the month swelled to 73 hours. Extrapolating to a whole year, this rate of searching would give me an outrageous 876 hours of Category II CME. Since I only need 50 hours per year -- Dude, I'm done!!

My sources at UDubMed tell me that this same system can be used to log searches for Category I CME credits, once they add a few simple, automated questions to their system and convince their CME department that This Is Actually A Good Idea -- No, Really. I hope they accomplish this really, really soon. Encouragement and feedback can be sent to them via this web form

In the meantime, I'll keep converting all of my many personal WTF moments into a truly ludicrous pile of Cat II CME.

1 comment:

i3i said...

I like your self-effacing light hearted take on this, but you are right! We get far less recognition for the CME we do without shouting about it. "CME is in our DNA!" as Umair Haque may say.