Table 2 CME for GPs in the Netherlands

Role of primary care within the health system

Patients are assigned to a GP of their choice via lists. GPs often work in general practice centres where they, together with other health professionals, care for the complete spectrum of diseases varying from all kinds of acute conditions to chronic diseases. These centres are usually run by the GPs themselves. Referrals to specialists are made in the case of unforeseen courses of disease or for diagnostic or treatment difficulties [19].

Legal regulations

GPs are centrally registered on a national list. Only registered doctors can practise their profession. Recertification takes place every 5 years. This requires, among other things, proof of CME participation. These must comprise 40 CME credits per year, i.e., 200 CME credits in 5 years. In addition, doctors can also obtain continuing education credits through teaching and coaching in the clinical field as well as through publications or their own dissertation [1, 20].

Published aims

The goals of general practice training are formulated rather superficially and focus on the fact that GPs should generally continue their education to be aware of the current state of research. This inevitably leaves a lot of room for different interpretations.

Actual content

There is no CME curriculum that prescribes subject areas. All GPs are free to choose their own topics for CME training. At the same time, thematic interests are often queried at the end of events, so that they have an influence on future offers [1].

Operationalisation

CME training can be offered by practically any institution/person. Accreditation is carried out by means of the Gemeenschappelijke Accreditatie Internet Applicatie (GAIA) and considers, among other things, the topic, learning objectives, content, and teaching material. General practice training is usually offered and conducted by GPs. If necessary, locally active experts, such as specialists or pharmacists, are invited.

Funding and sponsorship

As training is usually offered within networks of doctors, there are no or only extremely low costs. For about 20 years there is a decrease in the influence of pharmaceutical companies on (general) practitioner training. Today, there are no more training courses that are linked to pharmaceutical companies in terms of content or organisation. This is regularly and strictly controlled.

Evaluation

Training is evaluated by the participants. A standardised template is used for this purpose. This short evaluation is then given to local employees of the Gemeenschappelijke Accreditatie Internet Applicatie (GAIA). Based on the evaluation, they confirm the successful implementation of the training. An evaluation that would verify the learning success of the participants or lead to an increase in the quality of care does not take place [21,22,23].