1. Background

The status of the European Union of Medical Specialists (UEMS), is an organ constituted by the representatives of National and International medical associations with the purpose of representing the doctors of the European Union and coordinating and homogenising their Speciality training. "Medical Specialists" are defined as those who have chosen to confine their medical practice essentially to a certain field of medicine, resulting in a need for them to maintain a high level of competence in the selected specialisation, through continuous improvement of their knowledge.
Included in the definition of "Medical Specialist" there is, therefore, the concept of Continuing Medical Education (CME) ensuring high quality of both the scientific content of educational material and of clinical practice.
For this reason the contents of CME programmes, those educational, theoretical and practical activities designed to develop and increase the knowledge and skills of the physician, have to facilitate improvement in the professional practice of the specialist. A revolution in health care is occurring as a result of changes in the practice of medicine and in the nature of modern society. These include changing demographics and the pattern of disease; new technologies; changes in health care delivery; increasing consumerism; patient empowerment and autonomy; an emphasis on effectiveness and efficiency and changing professional roles

(1).Continuing medical education (CME) is of great value as a means of continued learning. Through educational programmes, CME facilitates optimal organisation, knowledge and practice of the specialist. Together with improved management of human resources (paramedical personnel, technical of laboratory etc ) and technical resources (informative and on-line tools), CME should ultimately translate into optimal care and service for the patient. A structured CME System at Regional and National level is required, but we must remember that we are facing globalisation of healthcare and free movement of specialists within Europe. In other words, CME  has become and International discipline. It's also important, especially in a subject that traverses many others, such as the Allergology, to maintain rigorous control of the quality of scientific information. In this rapidly evolving environment, there is a need for a Scientific body at European level that, in collaboration with the UEMS body devoted to guarantee the full reciprocity of credits in EU (EACCME; European Accreditation Council for CME), will guarantee the high scientific and educational quality of CME Programmes, which are free from the influence of the industry. 
In 1997 the first EAACIguidelines for CME were published.

Since then, a number of changes have taken place:
*  the creation of the European Accreditation  Council for CME (EACCME) by UEMS
*  the development of the EAACI CME Accreditation Council with the aim of scientific quality control and assistance for the development of a CME system at Regional, National an International level.
*  the EAACI partnership with an Agency devoted to the technical development of a system for CME in allergology throughout the Europe
These updated guidelines have been developed in order to explain these new developments in EAACI continuing medical education  and to provide more  detail of the ''Essentials'' for accreditation. They also guide CME providers and supporting companies in the regulation and management of commercial support, in addition to defining  the procedures for awarding credits related to CME activities.

2. Mission Statement

The EAACI CME Accreditation Council, created by the Executive Committee of the EAACI is the scientific and technical body of the EAACI devoted to the accreditation of CME activities in the field of allergology. The purpose of EAACI CME Accreditation Council co-sponsorship and voluntary accreditation of CME activities will be to guarantee high quality CME programmes, of scientific and educational excellence, which are free of influence from industry.

The role of the EAACI CME Accreditation Council include:

• Co-sponsoring Regional, National and International CME activities in Allergology where a National CME Authority responsible for programmes in allergology is already in existence.

• Accreditation of Congresses, educational projects and others allergological CME activities in Europe where no National CME Authority responsible for programmes in allergology exists.

• Monitoring CME activities relating to allergology in Europe and, in agreement with the EACCME, ensuring full reciprocity of credits with other specialties within the European Union.

• Guaranteeing the quality of the scientific content of CME in Allergology.

3. Eligible Providers and benefits to Programme Organisers

Applications may be submitted by:

* Medical institutions;

* Organisations involved in medical education;

* Medical service organisations;

* Professional Associations

* Patients’ Associations

- The EAACI CME Accreditation is validation of the high standard of the educational component of the event

- The EAACI CME Accreditation Council approval increases the likehood that CME activity will be accepted by all national health authorities

- An announcement of all EAACI CME Accreditation Council co-sponsored events will be made on the EAACI web site and in scientific journals.

- The EAACI CME Accreditation Council award credits and transmits them to the EACCME.

4. The accreditation process

The EAACI CME Accreditation Council evaluates the eligibility for accreditation of allergological CME activities through the following procedure:

1. A CME provider submits the application form for accreditation (see appendix n°1) with full details of its educational activities to the secretary of the EAACI CME Accreditation Council.

2. The EAACI CME secretary submits the required documentation to the EAACI CME Accreditation Council members ( and , if appropriate, to the EAACI specialties consultants).

3. The EAACI CME Council members vote on the programme and the Chairman advise applicants of the acceptance of the programme or, if denied, the reasons for refusal and the terms and conditions regarding any reapplication. Aaccreditation authorises the CME providers to use the EAACI CME accreditation logo, the EAACI CME Accreditation statement ( “The < title of the CME activity organised by “ < name of institution >” is accreditted by the EAACI CME Accreditation Council ) “, and to atate the approved number of CME-credits in brochures, advertisements and in the programme of the CME activity.

4. The EAACI CME secretary performs the following procedures:

- applies for European recognition of credits by the EACCME. Full and detailed information concerning the activity with the programme, speakers, mechanisms for quality control, declaration of national endorsement (National Society), number of awarded CME credits, must be submitted to the EACCME . The EACCME subsequently awards the UEMS accreditation and the provider can print the symbol of the EACCME in the programmeme of the activity and on certificates of credit. The EACCME also communicates the data to the American Medical Association; eventually these data will be published in the JAMA.

- working closely with the organisers of the activity concerning:

• distribution and analysis of the programme evaluation forms (see Appendix 2).

• completion of a data base with the data of the participants

• evaluation of the procedure for the assessment of attendance and of the learning tools

• organisation of the on site survey visit

• completion of a report of the CME procedures as required by the EAACI CME Accreditation Council and by the UEMS.

5. Essentials for Accreditation, Standards for commercial support

The EAACI CME Accreditation Council recognises the “Essential for Accreditation”, and the “Standards for Commercial Support” approved and adopted by the board of the UEMS-UEA (Union of European Medical Specialists–Union of European Allergologists) at their meeting in Lisbon, Portugal on 1-2 Novembers 1996, published in Allergy 1997; 52: 490-503)

General information

The "Essentials" include five criteria which eligible providers should meet in order to demonstrate their qualification for accreditation by the EAACI CME Accreditration Council.

The term "need" implies some degree of necessity and obligation. The necessity arises from the physician's duty to maintain and improve his or her professional knowledge and skill. The obligation arises from external requirements of the EAACI CME Accreditation Council for the physician to obtain a renewed licence; essential in his or her daily professional activity, in the application for a new positions, and in patient recruitment.

The term "interest" implies an educational desire of potential applicants.

Essential no. 1. Task statement: the provider should have a written statement indicating the CME task, formally approved by its local governing body

Explanation

The task statement should:

- illustrate the goals of the CME programmeme in a concise manner

- document the processes used to identify CME needs

- indicate the characteristics of the potential applicants

- describe the activities and services provided.

Rationale

A written task statement formally approved by the local governing body guarantees CME quality. With the approved task statement, the CME organisation can easily request support (either teaching or financial support) from the local governing body in order to accomplish its goals.

A written task statement clarifies what is expected of the CME organisation and allows an immediate objective evaluation of its ability to accomplish the task. The task statement results from the identification of educational needs and interests of potential applicants.

Guidelines

The task statement describes the educational goals of the overall programmeme, including one or more CME activity, in terms of learning content, the physicians for whom the programmeme is designed, and the general educational tools and services which could be used to achieve the goals.

The crucial duty of the provider is to identify the educational needs and interests of potential applicants, through epidemiologic data, a patient care audit, survey interviews of potential applicants, research on current literature, or consensus of an expert panel in a particular field.

Essential no. 2. CME objectives: the provider should have targeted objectives for each CME activity proposed

Explanation

The CME objectives should:

- illustrate the educational needs and interests to which each CME activity is addressed

- indicate the potential applicants for whom each CME activity is designed

- describe the teaching content and expected learning outcomes in terms of theoretic knowledge and practical skills

- be disclosed to physicians by the provider.

Rationale

Clearly stated objectives allow potential applicants to select educational activities which meet their needs and interests. On the other hand, providers can target the educational activities to meet participants' needs and interests on the basis of participants' requests.