Online CME: Web-based Resources
Since many of the best sites include more than one specialty, all physicians should browse Multiple Specialties in addition to checking out individual specialties. Primary Care should be of interest to most physicians as well. Note that Primary Care and some specialties are further divided into sites with multiple courses, and those with a single course. Maintaining any list of Web resources is a Sisyphean task; please contact me with corrections and comments.
Multiple Specialties
- BU Internet-based CME
Presented by: Boston University CME
Accrediting institution: Boston University
Release date: 1998-2000
Type: Mostly monographs; two audio slide shows
Content: Twenty-six text-based online courses primarily in Dermatology and General Medicine; a handful of courses also available in Cardiology, Pediatrics, and Radiology, and two audio slide shows on alopecia and cutaneous drug reactions. It is no longer associated with HealthGate. All courses on this well-maintained site are written by BU School of Medicine faculty.
Approved for: AMA
Hours:1-3 credit hours per course
Fee: $8 per 1 credit hour course, $15 per 2 credit course, $20 per 3 credit course
URL: http://www.bumc.bu.edu/www/busm/cme/modules/IBcme.htm
Site last visited: May 2001
- Cleveland Clinic Center for Continuing Education: Online CME
Presented by: Cleveland Clinic Foundation
Accrediting institution: Cleveland Clinic Foundation
Release date: Various
Type: Full-text articles, case presentations, and monographs
Content: Seemingly more complete and better organized than its partial presentations on HealthStream's cmecourses.com, described below. The Cleveland Clinic's Online CME is divided into 17 sections: Board simulations, Cardiovascular, Critical Care, Endocrinology, Gastroenterology, General Medical Topics, Geriatrics, Hematology, Infectious Diseases, Nephrology, Neurology/Neurosurgery, Oncology, Pediatrics, Psychiatry, Pulmonary, Rheumatology, and Women's Health. Most link immediately to HealthStream, but a few are free CME articles. For example, there is a free pharmaceutical company-supported courses in Gastroenterology, the 3 credit hour Diagnosis and Practical Management of GERD [see our GI section for course description), set to expire at the end of June 2001. Other courses are articles from Cleveland Clinic Journal of Medicine (CCJM) Online CME, which is described in our Primary Care section. In addition to the CCJM resource, the home page also links to a medical device company-sponsored monograph, Deep Brain Stimulation for Parkinson Disease, whose 1.5 hours of CME is freely available (see our Neurology/Psychiatry section for course description].
Approved for: AMA
Hours: 1 per course
Fee: Most are $25 per course (in conjunction with HealthStream); about a dozen are offered through Cleveland Clinic Journal of Medicine Online CME, whose CME is free (I'm told the new submission forms will no longer request $8 per course.)
URL: www.clevelandclinicmeded.com/online/topics.htm
Site last visited: May 2001
- CMeGateway
Presented by: Medical Education Initiative (MEC)
Accrediting institution: MEC
Release date: 2000-2001
Type: audio slide show (archived webcasts)
Content: On revisit, the site has five audio slide shows, on endometriosis, two on resistance to antibiotics, resistance to HIV therapy, and bipolar disorders. According to the home page, CMeGateway also jointly publishes some programs with Medscape CME Center in HIV/AIDS, oncology, hematology, cardiology, women's health, infectious diseases, psychiatry, gastroenterology, diabetes and endocrinology. MEC is a traditional and electronic CME provider and healthcare publisher for physicians, nurses, and pharmacists.
Approved for: AMA
Hours: 1-4 per course
Fee: No cost
URL: www.cmegateway.com/mec/default.asp
Site last visited: May 2001
- CMEweb
Presented by: American Health Consultants and Thomson Healthcare
Accrediting institution: American Health Consultants
Release date: Current within several months of newsletter publication
Type: Full-text articles
Content: The site houses 1300 credit hours in 21 specialties, all from the publisher's clinical newsletters. Monthly newsletters offering CME are Clinical Cardiology Alert, Clinical Oncology Alert, Critical Care Alert, Emergency Department Legal Letter, Emergency Medicine Reports, Infectious Disease Alert, Pediatric Emergency Medicine Reports, Primary Care Reports, Travel Medicine Advisor, Neurology Alert, Internal Medicine Alert, Pediatric & Adolescent Medicine Reports, OB/GYN Alert, Alternative Medicine Alert, Emergency Medicine Alert, and the new Trauma Reports. The online and hard copy tests are essentially the same. Newsletters vary with regard to content. Alerts, for example, consist of a few abstracts and commentaries on a recent clinical research article, or a short feature on a clinical topic, whereas Reports typically contain more substantial clinical reviews. Authors are usually academic physicians. Check out Sample Test first, because once you register you are automatically charged $15.
The site has been updated to a clean, intuitive interface. Newsletters (inexplicably referred to as courses) can be browsed by specialty or topic, and there is a search engine that accepts keywords. In all cases, however, users must click on each newsletter for the particular titles. Site features include a list of CME regulations by state.
Approved for: AMA, AAFP (primary care), ACEP (emergency medicine), AAP (pediatrics), ACOG (OB/gyn)
Hours: 1.5 per newsletter
Fee: $15 per newsletter or Bulk Testing: $100 per 15 credits, $175 for 30 credits, $300 for 60 credits
URL: www.cmeweb.com
Site last visited: May 2001
- Conceptis Technologies
Presented by: Conceptis Technologies
Accrediting institution: Duke University, Institute of Continuting Healthcare Education
Release date: 2000-2001
Type: audio slide show (archived webcasts)
Content: Canada's Conceptis Technologies is a medical Web design and technology company. Their flagship product is Medical CyberSessions, a webcast technology for audio and synchronized graphics (usually slides). Typically, each presentation is divided into sections. Its interface is good but not very intuitive. One nice feature: the program advances automatically, but the user can also interrupt and move through the presentation by speaker or slide in any order, using drop-down menu bars. The technology is sophisticated but loading is somewhat slower than other resources. Toll-free phone number for tech support is very helpful. On the Medical CyberSessions site, the Calendar gives recent and coming events, though not all offer CME. Duke University uses Medical CyberSessions as the interface for their Cardiology Series 2000 and 2001, as noted within this list's Primary Care section.
In addition to Medical CyberSessions, CME can be found on theheart.org, their cardiology site. This site is described further under our Cardiology section and is another portal to access Duke's CME. Both Medical CyberSessions and theheart.org can be accessed off Conceptis' Products section. No other Conceptis product offers online CME at present, although they promise their first CME CyberSession on jointandbone.org, their rheumatology site, this summer.
Approved for: AMA
Hours: 1-2 per presentation
Fee: No cost
URL: www.conceptis.com
Site last visited: June 2001
- Cyberounds
Presented by: interMDnet Corporation
Accrediting institution: Albert Einstein College of Medicine
Release date: 1996 - present (current)
Type: Text or monographs with liberal use of instructive case presentations and interactivity
Content: Over 150 cyberounds are divided into Cardiovascular Medicine, Emergency Medicine, Endocrinology, Gastroenterology, Geriatrics, Health Law and Medical Ethics, Hematology/Oncology, Laboratory Medicine, Medical Genetics, Nephrology, Nutrition, Psychiatry/Neurosciences, Pulmonary, Rheumatology, Women's Health. Each section has a few to a dozen or more cyberounds, consisting of a conference (text or monograph, followed by CME questions) and a link to a moderated discussion section where readers can post and answer questions. Well credentialed authors create solid content, and the format is interesting -- some conferences are straight monographs, whereas others are filled with open-ended questions that the reader can ignore or answer by typing into a dialog box. On the next page, the correct answer is explained, then the conference continues. Unfortunately, the associated discussions are poorly attended and in some posted questions go unanswered. Content is appropriate for both generalists and specialists (though more so for the former), and the site employs a search engine, clearly lists authors and their credentials, and includes the dates of each resource. MD Consult subscribers and American Medical Women's Association can obtain CME credit from their first five Cyberounds gratis.
A new CME feature, Longevity, is a free Q&A on geriatric medicine, although the 4 credit hours will cost $40. It requires registration separate than that for Cyberounds.
Approved for: AMA, AOA
Hours: Maximum of 50 per year (AMA); 1 per round (AOA); 4 for Longevity
Fee: $125 annually (up to 50 hours); $40 for Longevity
URL: www.cyberounds.com
Site last visited: May 2001
- DocGuide Webcasts/CME
Presented by: P/S/L Group
Accrediting institution: various
Release date: various
Type: various
Content: Click on All Webcasts/CME from the home page's left navigation panel. This medical portal site has gathered almost 500 online CME resources from around the Web, presented in chronological order (as discovered by the site, unrelated to release date) or by channels, cataloging over a hundred disorders and specialties. The site says, "·Our editorial team identify relevant medical webcasts/CME on a daily basis, and then write a concise review, highlight salient information, and provide a direct link to the webcast/CME. Summaries are published including the titles of lectures, the background of speakers, information regarding accreditation, information for audio, text or video formats, with the possibility to download any needed plugins or players right from our summary page." The listing includes both free and fee-based courses. A good effort, although it does not capture all that's available on line, most noticeably from the largest sites, but also from smaller academic and medical association sites. Doctor's Guide is owned by P/S/L Consulting Group.
Approved for: AMA
Hours: various
Fee: various
URL: www.docguide.com
Site last visited: June 2001
- Duke OCME
Presented by: Duke Office of Continuing Medical Education
Accrediting institution: Duke University
Release date: 1999-2001
Type: audio slide show (Cardiology), monograph with slides (OB/Gyn)
Content: Use the menu in the main window to access Online CME. Content (not CME) is free. Two departments have resources for the public; all other offerings are limited to Duke and affiliated staff. The best are a dozen Cardiology webcast presentations, originally live and now archived, by academic physicians from thoughout the country. Random browsing of presentations found content to be authoritative and concise, with excellent speakers. There is a series from the year 2000, and a new series for this year. Both series use Conceptis' cme.cybersession.com site, and format. Its interface is good though less than intuitive. Each presentation is divided into sections. One nice feature: the program advances automatically, but the user can also interrupt and move through the presentation by speaker or slide in any order, using drop-down menu bars. The technology is sophisticated but loading is somewhat slower than other resources. Toll-free phone number for tech support is very helpful. Forums for questions and discussions are available for each cybersession but are, unfortunately, minimally attended.
Also, OB/Gyn offers monograph and slides to 1998 and 1999 Therapeutic Options for Menopausal Health.
Approved for: AMA
Hours: 1 per presentation (Cardiology); 2 (OB-Gyn)
Fee:$20 per Cardiology presentation; $25 ($20 for print version) for OB/Gyn
URL: www2.mc.duke.edu/docme/online.htm
Site last visited: June 2001
- eCornell Executive and Professional Education: Course Offerings
Presented by: eCornell
Accrediting institution: Weill Medical College
Release date: 2000
Type: not yet viewed (probably webcasts)
Content: eCornell has two online courses for CME credit: Orthopedic Conditions, a 3-part series from a conference last November, for pediatric practitioners; and Osteoporosis, a pharmaceutical companyösponsored symposium from last year's American College of Rheumatology annual meeting. The first part of registration allows entry into the site, but course content and CME are available only to those who pay. The technology uses QuickTime and Flash plug-ins, both freely available on line. This site has not yet been reviewed.
Approved for: AMA
Hours: 6 (Orthopedic); 2 (Osteoporosis)
Fee: $75 (Orthopedic); $49 (Osteoporosis)
URL: www.ecornell.com/courses.jsp
Site last visited: July 2001
- Frontiers in Biomedicine
Presented by: George Washington University Medical Center CEHP
Accrediting institution: George Washington University
Release date: April 1997-March 1999
Type: Slide show with audio (archives of live presentations)
Content: This excellent resource is a bit confusing, in that it separates all content from all CME quizzes and registration forms. Use the left navigation panel: Lecture Calendar accesses the 34 lecture presentations, and Continuing Education accesses the self-test questions and answer form that must be surface mailed to receive CME credit. Varied and interesting series of lectures by top experts in the field. Funded by an unrestricted educational grant from Glaxo Wellcome. On re-review, I was assured by GWU CEHP that the series is still current, although the material will be evaluated this summer for updates and expirations.
Approved for: AMA, ACPE
Hours: 1.5 per presentation
Fee: $25 per presentation
URL: 207.78.88.15/
Site last visited: June 2001
- GWU Web-based Programs
Presented by: George Washington University Medical Center CEHP
Accrediting institution: George Washington University
Release date: 1997-present
Type: audio slide shows
Content: GWU has been offering online CME since 1997. Click Web-based Programs on the left navigation panel for the various programs. There is the free GWGrandRounds.com in Medicine, Pediatrics, Psychiatry and Behavioral Sciences, and Surgery. There are also links to Frontiers in Biomedicine series, described above, and Frontiers in Clinical Genetics series, described under our Genetics section. All these programs have solid content, and the technology works without difficulty, though navigation on Frontiers series is confusing at first because all webcasts are listed separately from their CME quizzes.
Also available are two free presentations on atherosclerosis and MI, and an extensive Heme-Onc Board Review, the latter described under our Heme/Onc section.
Approved for: AMA
Hours: 1 per grand rounds; 1.5 per presentation; 60 (Heme-Onc Board Review)
Fee: no cost for grand rounds; $25 per Frontiers presentation; $850 Board Review ($550 per section)
URL: http://fact.gwumc.edu/cehp/webstudy.cfm
Site last visited: June 2001
- Healthcare Management University
Presented by: Milliman and Robertson
Accrediting institution: Annenberg Center and University of Washington
Release date: unknown
Type: medcast (Healthcare 2005), simulation software
Content: Click HMU Courses on the top of the screen to access downloadable and Internet streaming software. Healthcare 2005, a technically sophisticated medcast with both streaming video and slides, is HMU's first Internet course. "The goal of this course is to familiarize practicing and executive-level physicians with current and anticipated economic, market, and policy forces that will shape the future healthcare delivery and financing systems. Physicians best equipped to deal with emerging trends will be better able to provide optimal patient care." A demo of the medcast is available. A second course has been added, Healthcare Guidelines: Integration and Application.
Also available is the collection of Anesoft's excellent clinical simulator software for downloading (or online ordering of CDs): ACLS, Anesthesia, Critical Care, Hemodynamics, and Sedation. See Course grid for the reasonably priced software.
Milliman and Robertson is a firm of actuaries and consultants serving the full spectrum of business, governmental and financial organizations. Their (in)famous health cost and hospital length of stay efficiency index reports can be accessed off their home page.
Approved for: AMA
Hours: 4 (Healthcare 2005), 5 (Guidelines). For Anesoft software see Course grid
Fee: See Course grid; note that price of Anesoft software does not include $30 CME free payable to University of Washington.
URL: www.cme-online.com:80/srvs/index.asp
Site last visited: May 2001
- Interactive Grand Rounds
Presented by: Medsite
Accrediting institution: A. Webb Roberts Center for Continuing Education of Baylor Health Care System, and UTMB at Gaviston
Release date: variable
Type: case presentation with interactivity
Content: This expanding list of now 31 cases covers Cardiology (arrhythmias, hypertension, dyslipidemias) Immunology (suppressive therapy in heart-lung and renal transplantation), Pediatric Infectious Disease, and Osteoporosis. All are nicely presented and well-referenced. While appropriate for primary care physicians, they are more thoughtful than the typical online fare. IGR is supported by unrestricted educational grants from multiple pharmaceutical companies. A press release advertising the addition of Medical Economics' journals Contemporary OB/Gyn, Contemporary Pediatrics, and Contemporary Urology in the near future.
Approved for: AMA
Hours: 1 per case
Fee: No cost
URL: igr.medsite.com/
Site last visited: May 2001
- The Interactive Patient
Presented by: Marshall University
Accrediting institution: Marshall University School of Medicine
Release date: 1995
Type: case presentation with interactivity
Content: Marshall University has earned a place in Web history, not to mention the eternal CME archives, by creating The Interactive Patient, the first pseudo-simulation program that did not automatically crash one's computer. By 1995 standards the interactivity is amazing. It's still online, and still asking $15 for one credit hour of CME ö submitted by mail, of course. (A second Marshall course, the text-based Online Health Informatics Course is described under our Medical Informatics section.)
Approved for: AMA
Hours: 1
Fee: $15
URL: medicus.marshall.edu/medicus.htm
Site last visited: June 2001
- Integrated Medical Curriculum
Presented by: Gold Standard Multimedia
Accrediting institution: Medical College of Georgia
Release date: Unknown
Type: Hypertext with graphics (Immun), patient presentations with interactivity (Dr's Dilemma)
Content: Two programs: Essentials of Immunology (described under Allergy & Immunology), and Doctor's Dilemma (described under Medical Ethics). Free registration required to access content. In navigation try alternate routes if not successful, as site is full of bad links.
Approved for: AMA, nurses
Hours: 15 (Dr's Dilemma) or 18 (Immun)
Fee: $99 per program
URL: http://ce.gsm.com/
Site last visited: September 2001
- Medconnect CME Center
Presented by: Medconnect
Accrediting institution: Academy of Medicine of New Jersey and other organizations
Release date: 1996-1998
Type: Largely case-based with interactivity and rare multimedia (audio)
Content: This site imposes free registration on all comers. Once registered, access to all Family Practice, Managed Care, and Emergency Medicine programs is through the CME Center page. Unfortunately, nothing has been updated in over two years. I don't know if anything other than the first two Family Practice essays, still offer current CME.
Approved for: AMA
Hours: 1-1.5 per program
Fee: $95 annual subscription for a maximum of 12 credit hours in Emergency Medicine and 1.5 hours in Managed Care.
URL: www.healthatozcme-ce.com/index.html
Site last visited: June 2001
- MedCases
Presented by: MedCases
Accrediting institution: Jefferson Medical College
Release date: 2001 (current)
Type: case presentations with interactivity
Content: Two new electronic journals geared specifically to online CME in OB/Gyn and Pediatrics, with more on the way (Surgery, Internal Medicine, Cardiology, GI, Pulmonary, and Family Practice). Every other month, each journal provides four cases. These are not true patient encounter simulations as described on the site, since cases progress in a highly structured manner without variation regardless of one's choices, and there is no organ system manipulation -- all features characteristic of true simulations. But they are certainly thoughtfully-designed case presentations with lots of interactivity. One of the demo cases begins with a chief complaint, after which the user selects which portions of the history and physical exam to review, then selects from a list of potential diagnoses. Immediate feedback is provided with rationales, if desired, or the user can progress with limited or no feedback. Diagnostic tests are offered, a final diagnosis is made, and a treatment plan selected, again with optional evaluative feedback at every stage of the workup. A tabular toolbar allows easy navigation back and forth through the case. Final results compare one's score with the optimal score. The demo case is straightforward, the content appears accurate, and the interface is clean and intuitive. There are content bugs, such as a ROS without neurological or dermatological systems, and the case isn't sensitive to choices made during workup that may not be optimal but end up changing the treatment plan. A potentially good site, if it continues to develop and deepen and cuts back on the marketspeak.
Approved for: AMA
Hours: 2 per case (48 hours/year)
Fee: $175/year
URL: www.medcases.com
Site last visited: June 2001
- MedicalRounds
Presented by: MedicalRounds
Accrediting institution: variable (see individual presentations)
Release date: 2000-2001 (current)
Type: audio slide shows with occassional multimedia
Content: MedicalRounds categorizes and links to academic medical webcasts from several universities and medical societies. Over 500 presentations are divided according to medical or nursing specialty -- some of which offer CME, though unfortunately not all are labelled as such. As a Canadian site, its contributing sponsors are Canadian medical schools and hospitals, and Medical Rounds creates webcasts for them -- 84 at present count, though none of these offer Category 1 CME (yet).
Approved for: AMA (though some are only Category II)
Hours: variable (see individual presentations)
Fee: No cost
URL: http://www.medicalrounds.com/index.php3?page=inc/first
Site last visited: September 2001
- Medivision Virtual Online Training
Presented by: Medivision
Accrediting institution: Various medical schools and educational foundations
Release date: 1996-1998
Type: Webcasts (archived)
Content: At the home page, use the left navigation panel to link to Virtual Online Training. Once there,Course Listings identifies which courses offer CME for physicians and which are geared to EMTs, nurses, and pharmacists. Courses in AIDS/HIV, Cancer, Cardiology, Dermatology, Endocrinology/Diabetes, Gastroenterology, Infectious Disease, OB/GYN, Occupational Medicine, Psychiatry, and Urology are listed; on revisit, one new course in diabetes has been added. There is also a Healthcare Executive Program in Governance and Managed Care. The company must be emailed and fee paid before program can be viewed. There is no online demo. From its Web site, Medivision offers continuing educational programs to both physicians and non-physicians, and programs in occupational health.
Approved for: AMA
Hours: 1.5-2.5 per webcast
Fee: $28 per credit
URL: www.medivision-ol.com/index.htm
Site last visited: June 2001
- Medscape CME Center
Presented by: Medscape
Accrediting institution: Medical Education Collaborative (MEC)
Release date: Varies (current)
Type: Text-based articles, convention summaries, and case reports, some with graphics
Content: Medscape's educational offerings include CE for nurses and pharmacists in addition to hundreds of CME hours for physicians and physician assistants. Although directed at primary care practitioners, Medscape is listed here because some of its content is appropriate for specialists. Medscape's content is divided into Allergy and Clinical Immunology, Cardiology, Critical Care, Dermatology, Diabetes and Endocrinology, Gastroenterology, Hematology-Oncology, HIV/AIDS, Infectious Diseases, Molecular Medicine, Neurology, Orthopedics, Pediatrics, Psychiatry and Mental Health, Pulmonary Medicine, Rheumatology, Surgery, Transplantation, Urology, and Women's Health.
Kudos to Medscape for simplifying the organization of their CME offerings. When reviewed last year, this page was a mess of incomplete CME listings, including free Conference Summaries alongside fee-based content from Medscape's extensive collection of second-tier clinical review articles. Now, all CME is freely available, and easily accessible from one search engine at the bottom of the CME page. Users can bring up all Medscape CME written over the past 12 months, which recently numbered nearly 600 articles, conference summaries, treatment updates, clinical management modules, practice guidelines, and textbooks. The same engine allows keyword searches on only CME resources, and seems to work well. Advanced features allow a search to be refined by adding new terms and expanding/narrowing the age of the resources. It complements the site search engine, which brings up everything on the site, CME and non-CME. Be certain to use quotes around single search terms comprised of multiple words.
Content quality is typical Medscape, which many physicians complain is too light and/or commercial for professional use. I agree, although I have also located good professional content on Medscape. Overall, it compares favorably with non-academic online sites, some that charge for their content and/or CME. Interface is also typical Medscape -- intuitive, quick, and with banners and pharmaceutical sponsorships that are never far away. CME features include instant printable CME certificates for many courses, and a CME site tracker. I was surprised that I could not locate the links to access the post-CME quizzes needed to complete the CME process; it's the Table of Contents link at the top and bottom of the page that accesses the content source page, from which CME requirements for that article are linked.
Approved for: AMA
Hours: Varies widely, from 1 (most articles) to over 10 (some conferences)
Fee: No cost
URL: cmecenter.medscape.com/Home/CMEcenter/CMECenter.html
Site last visited: May 2001
- Medsite CME
Presented by: Medsite
Accrediting institution: Baylor School of Medicine
Release date: various (current)
Type: Interactive case presentation
Content: A series of new Medsite programs, Interactive Grand Rounds (IGR) in arrhythmias, dyslipidemias, hypertension, immunosupressive therapy, and pediatrics, is described under our Primary section. The page is also an entry point for cmecourses, described under our Primary section, but requires (free) registration at Medsite.
Approved for: AMA
Hours: 1 per course
Fee: No cost
URL: cme.medsite.com/
Site last visited: August 2001
- MeetingCast.com
Presented by: Rockpointe Broadcasting
Accrediting institution: various
Release date: 2000-2001 (current)
Type: audio slide show
Content: Click on Programs for CME webcasts on doctor-patient communications, preventing DVTs, post-MIs, adult growth hormone deficiency, androgens in women, pituitary disorders, atherosclerosis, arrhythmia management. Some webcasts on the list have outdated or no CME. Most if not all use Shockwave freeware, and are supported by pharmaceutical companies. Rockpointe Broadcasting is a Web technology firm specializing in meetings, educational programs, and features.
Approved for: AMA
Hours: various
Fee: No cost
URL: www.meetingcast.com Site last visited: September 2001
- MyChallenger Online
Presented by: Challenger Corporation
Accrediting institution: various academic and professional organizations
Release date: current
Type: Q&A format with graphics
Content: There are four comprehensive programs, in Emergency Medicine, Internal Medicine, Family Practice, and Pediatrics, and four atlases, in Drug Therapy, Dermatology, ECG, and Radiology. Each module follows a Q&A format similar to the company's CDs. Also like the CDs, the comprehensive programs share some identical material, so a physician taking all four Challenger's courses will not find as many unique opportunities for credit as it would initially appear. Duplicate CME credit is not available for the same material listed under different specialties. Challenger tells me that a revision is well underway, but pediatricians are cautioned that in the past much of the comprehensive (not atlas) material was written from an adult medicine perspective. There is an online demo covering Emergency Medicine's Eye, Ear, Nose and Throat, which presumably gives a good feel for the content and presentation. Interface and programming remain Challenger strengths, but the answers on the online demo are sometimes arguable and with unsatisfying explanations, and the frequently dated references are listed by topic only.
Portions of the Internal Medicine comprehensive program, and ECG and Radiology atlases, are also available online at Virtual Lecture Hall, for $7 a credit.
Approved for: AMA, ACEP, AAP, AAFP
Hours: Resource has over 890. See Promotion for available CME per module.
Fee: Three annual service plans, from $348 (includes 5 free hours) to $828 (includes 50 free hours).
URL: chall.lecturehall.com
Site last visited: May 2001
- MyPatient.com
Presented by: I.C. Axon
Accrediting institution: University of Virginia School of Medicine
Release date: unknown (current)
Type: patient cases with interactivity
Content: Marketing-savvy site, with a Guided Tour and lots of trademarked features. The patient case load is described as "extensive" and increasing monthly; see the site for thumbnail descriptions of patients divided by specialty. The demo allows the user to select one of ten cases (the other nine subsequently become inactive). The interface is terrific -- visually pleasant, with intelligent use of multiple frames and mouseovers. The case starts off with an interactive history, initial differential, physical exam, diagnostic tests, final diagnosis, and treatment plan. Feedback is limited to correct/incorrect, with short narrative explanations that help move the case along. Abnormal findings are described and illustrated with photos, radiographs, etc. The post-case CME exam is straightforward. Comparing the demo to other online patient cases, MyPatient may have less content depth. In my sample, I got the ego boost from doing well despite not being overly familiar with the condition, yet I didn't learn very much. MyPatient.com is jointly sponsored by Montreal-based I.C. Axon and the University of Virginia School of Medicine
Approved for: AMA
Hours: 1 per case
Fee: $480/year; three-month trial membership
URL: www.mypatient.com/mypatient/publicsite/index.asp
Site last visited: June 2001
- PDR.net Online Education
Presented by: PDR.net
Accrediting institution: American Health Consultants
Release date: 1999-2000
Type: full text articles, two webcasts
Content: On the PDR.net home page, click "CME/CE" for resources, online and non-electronic, for physicians and other healthcare professionals. For online CME for physicians, in addition to the free webcast symposium on emergency thrombolysis (described under our Emergency Medicine section), there are five new resources: a webcast symposium on transdermal HRT from Contemporary OB/GYN, and four articles on pneumococcal disease from Contemporary Pediatrics. Note that both of these monthly journals also offer free online CME as well, but they must be individually accessed off the PDR.net home page. Free registration is required.
Approved for: AMA
Hours: 2 for symposium, 1 for articles
Fee: no cost for symposium; no cost to journal subscribers, otherwise $20 per article
URL: www.pdr.net
Site last visited: May 2001
- POL CME
Presented by: Physicians' Online
Accrediting institution: University of Washington (Rheumatology), Medical Directions (VLH)
Release date: all current: 1999 (Rheumatology), various (VLH)
Type: Text-based instruction with graphics
Content: POL maintains two links. The first is to a three-part pharmaceutical company-supported program for rheumatologists: The Emerging Role of Protein A Immunoadsorption in Rheumatoid Arthritis. POL also links to Virtual Lecture Hall (VLH), an external site which is described below. There is no advantage to using POL to access VLH.
But VLH offers POL users a hidden CME treat: Clinical IQ, where VLH's eCore - The Core Content Review of Primary Care provides 2 questions a week to POL users. Over time, CME can be retrieved; each group of 10 questions is worth 1 AAFP CME credit, and costs $8. Clinical IQ also archives questions, so users can also obtain CME at one sitting. POL users can access Clinical IQ off the left navigation panel on POL's home page.
Approved for: AMA
Hours: 2.5 (Rheumatology); 1-23 per course (VLH)
Fee: No cost (Rheumatology), see VLH
URL: www.pol.net
Site last visited: May 2001
- Stanford SKOLAR MD
Presented by: Skolar
Accrediting institution: Stanford University
Release date: 1999-2001 (current)
Type: clinical reference search
Content: Skolar MD is a subscription-based clinical reference that, like MD Consult described above, uses a single search engine to access information from multiple databases. The AMA has a pilot project to test whether self-directed, self-initiated online learning experiences can meet the criteria of eligibility for category 1 credit. At present, the only project participant is Skolar MD. The site describes the interactivity and feedback required so that clinical searches and reading can be considered for CME credit. "Physicians can earn Category-I CME credits while conducting SKOLAR, M.D. searches relevant to patient care, in-depth study or research. Using Stanford SKOLAR, M.D. to answer real-time in-context clinical questions has been approved by the AMA as the pilot program to introduce this novel approach to obtaining CME. After using SKOLAR, M.D. to research a topic, you may elect to apply for CME by answering a few simple questions regarding the study session's relevance to your clinical decisions and practice and also identifying the most helpful sources used. Your application is automatically forwarded for approval by Stanford SKOLAR physicians."
Approved for: AMA
Hours: variable
Fee: $240/year
URL: md.skolar.com
Site last visited: June 2001
- Virtual Hospital Online CME Courses
Presented by: U Iowa's Virtual Hospital
Accrediting institution: University of Iowa
Release date: 1996-2001 (current)
Type:Case presentations or text, mostly outlines, with embedded graphics
Content: Most of these courses are pulmonary or critical care: Adult Critical Care Core Curriculum (fulminant meningococcemia, autoPEEP, and neuromuscular complications of critical illness), Adult Pulmonary Core Curriculum (17 courses in airway, pleural, vascular and malignant diseases, infections, environmental disorders, and clinical problems), ATS Radiology for Chest Physicians (3 groups of case presentations), Interpretation of PFTs (spirometry), and Lung Cancer Topics. Also on line is a course in CLIA for the Physician's Office Lab (described under our Administration section), and Laser Safety (described under our Therapeutics/Treatments section). Content is freely available and quizzes can be submitted electronically, but payment is made and certificates are sent using surface mail. On revisit, there is no new content, but old content is periodically revised.
Approved for: AMA
Hours: 1
Fee: $15 per credit hour
URL: www.vh.org/Providers/CME/
Site last visited: June 2001
- Virtual Lecture Hall (VLH)
Presented by: Medical Directions, Inc.
Accrediting institution: various
Release date: various (current)
Type: Case-based, monograph, and Q&A, some with graphics
Content: See Course Descriptions for links to VLH's offerings. Content appears geared to primary care physicians, and is presently of three types: case-based teaching programs (on management of domestic violence, recurrent dysurias, acne, ovarian cancer, NSC lung cancer, primary dysmenorrhea, breast cancer, mental health in primary care, Virtual Dermatology from the University of Indiana, and the University of Colorado Oncology Rounds); a program in Melanoma; and quizzes for Family Medicine Board review and portions of Challenger's Internal Medicine, ECG, and Radiology programs (the latter also available on MyChallenger). There is a also a free course for physician executives (and wannabes). Access to content is free to registered users.
Special features include a customized home page, notification of changes in CME requirements for selected specialties and states, pause and resume functions, and a one-click payment option. On revisit, the site is well-maintained and has added a number of new courses as noted above. VLH's interface remains easy to navigate. Comments and ratings from physician and non-physicians who completed the courses are displayed, and are more honest than one might expect. VHL is a solid, thoughtful resource.
Approved for: AMA, AAFP (some programs)
Hours: Variable, from 0.5-4.5 (case-based programs) to 6 (melanoma program) to 15-23.9 (quizzes)
Fee: $7-$9 an hour
URL: www.vlh.com
Site last visited: May 2001
- WebMD Practice: CME
Presented by: WebMD
Accrediting institution: Various
Release date: various (current)
Type: Short articles (JIT), audio slide shows (CCPC), case studies (SAMSAQ)
Content: A spanking new interface with more space and importance given over to online CME. After a fairly intrusive but free registration process, physicians can access a number of CME resources:
- Just-In-Time CME, short articles written by WebMD and tied to specific medical news;
- links to HealthStream's Core Curriculum in Adult Primary Care and Cleveland Clinic's Internal Medicine Review Board, both part of cmecourses.com and described under our Primary section;
- the newly titled (and newly acquired) WebMD Scientific American's well-regarded monthly Self-Assessment Quiz CME program, also described under our Primary section;
- Master of Pediatrics Special Presentations, 9 modules of 2-3 presentations comprised of slide shows with audio and transcripts. There is a demo online which shows solid content and good technology, though audio and graphics are less than crisp.
Site automatically logs completed CME under its Log Book feature, including offsite references if accessed through WebMD. New online CME is promised, such as self-assessment tools to complement ACS Surgery: Principles and Practice, another recently acquired textbook.
Their marketing superlatives aside, some of the content really is quite good, though SAM probably remains their best deal at present. WebMD appears to be medicine's online Pacman, buying up content and forming strategic partnerships. We don't yet know whether WebMD, physicians, or both will come out winners.
Approved for: AMA
Hours: 0.25 per segment (JIT), 1 per presentation (CCPC), 10 per monthly quiz (SAM) , 1-2 per module (Peds)
Fee: free (JIT); $12.50 per presentation (CCPC), $30/year (SAM), $10-12 per presentation (Peds)
URL: https://professional.webmd.com/object.orb (this is a secure server)
Site last visited: June 2001
- World Medical Leaders CME Lectures
Presented by: World Medical Leaders
Accrediting institution: Health Science Center for Continuing Medical Education
Release date: 2000-2001 (current)
Type: slide show with audio and video, transcripts
Content: Eighteen primary care-oriented original presentations, each comprised of several lectures, on erectile dysfunction, upper and lower respiratory tract infections, emergency rheumatology, GERD, asthma, atherosclerotic heart disease, psychosis, diabetes, infertility, and gynecology in primary care. World Medical Leaders is listed under Multispecialties because there is also an extensive series from the 2000 ACC Symposium; the deBakey lecture on cardiovascular surgery does not offer CME. Based on the previews, the video quality alongside the audio slide show is remarkable. Transcripts are available, with or without slides. I have not viewed the content, but the site promotes itself as very concerned with creating top quality presentations and its impressive faculty is prominently desplayed on line. Site maintains a members-only reference library, and discussion forum. No overt mention of pharmaceutical company support, but there is a members-only Drug Sample Center on site -- presumably not for physicians to enchance their online CME experience.
Approved for: AMA
Hours: 1 per lecture (1-8 lectures per presentation)
Fee: $300/year, free three-month trial
URL: www.wml.com/video_lib/symposia.jsp?CurrentMenuContext=CMELecture
Site last visited: June 2001
This section is under development. Until then:
- access an annotated list of 128 CME software products using CRI's Online Directory of Medical Software search engine. Check the CME box (add other search filters if desired), then click Search.
- UT Southwestern Electronic Media offers six CDs at 19.95 each. CME varies from 2-7.5 credit hours per program.
- Unitech Communications, a subsidiary of the Cleveland Clinic Foundation, lists a handful of free and commercial educational CDs among its drop-down menu offerings.
- access information and reviews on Boards Review Software, most of which includes CME credit.
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