Golden Hoops - Considering the True Costs of MOC and CME

Nakit Jaroonsrirak/123RF.com

As medical students, we signed on to the life-long learning concept. Most of us have a keen sense of curiosity and enjoy self-directed exploration. Although there is an opportunity cost of time, the financial tally is underappreciated by those outside the medical realm.

Conferences abound in the business and personal development space in desirable locations. Apply any health-related descriptor, and the price easily doubles or triples. I have recently attended several marketing and personal development courses around the country for less than $700 for a three or four-day event, while a one-day continuing education conference can empty the wallet of a similar amount.

Plan Accordingly

Specialty boards, in my opinion, underestimate the cost of maintaining certification. While a dollar amount is often cited, the most expensive calculation is omitted - your time.

The following example is based on my specialty of Emergency Medicine and reflects the year of recertification.

Annual LLSA:

• Registration - $100
• Time cost - $250 x 2
• CME certificate - $30

Yearly CME:

• 25 hours
• Registration for courses and online CME - $3,250
• Time Cost - $250 x 25

Merit Badges:

• CPR - $25
• ACLS - $150
• PALS - $150
• NRP - $150
• ATLS - $275
• Time Cost: $250 x 20

Communication & Professionalism Requirements:

Board Review Course

• Registration - $1,000 +
• Travel - $750
• Hotel, meals, etc - $1,500
• Lost week of work - $7,500

Board Recertification Exam

• Registration – Approximately $2,600 every 10 years
• Travel
• Time Cost $250 x 8

I share this for several reasons. Some of the requirements add little to professional practice. Short of jumping through a hoop to receive a “stamp” of approval, little knowledge is gained, and competence is not guaranteed. Also, for the residents and newly minted physicians reading this, keeping your license and certification current is expensive. Factor this into the salary discussion when contemplating a position or move.

Fortunately, a simple solution exists, and many companies have stepped up, offering high-quality online CME that is educational, entertaining, and affordable. Annual meetings are generally excellent, packed full of top-notch presentations and great for networking and catching up with former colleagues. Understand, however, that most CME requirements can be met for a fraction of the cost.

Education is changing, and attitudes are shifting. College debt is in the trillions, and it’s not unheard of for professional students to owe $200,000 - 300,000 after completing medical or dental school. Plunging into the healing arts, many ignore the reality of paying back that debt. I am hopeful that undergraduate costs will decrease as the utility of specific graduation requirements are called into question. While I enjoy history and read extensively about historical leaders, the utility of my America in the 1800s sophomore class has done little for my ability to function in the chaotic trenches of an emergency department.

I hold out hope that education requirements for doctors will also adapt and consider the cost of continuous and life-long learning. Expensive doesn't mean better, and the data on the impact of CME requirements and practice competency are lagging. It seems that legislative imperatives and public opinion have found their way into state-mandated education for healthcare professionals. While there may be value, consideration of the real cost for those jumping through these hoops would be appreciated.