Views on recertification

The Aug. 17 issue of CMAJ contains 2 articles illustrating contradictory approaches to continuing medical education: one emphasizing independent thinking, the other arguing for more conformity.

Alexandra Barratt and associates,1 in their series on teaching tips for evidence-based medicine, encourage us to be professionals and think things out for ourselves; the first article in the series presents the foundation for calculating risk in a meaningful way.

A news article in the same issue2quotes Dr. Sunil Patel (then president of the CMA) as saying that “It makes sense that in a rapidly evolving world, … standards have to be maintained ... .” The logical extension of this thinking is that individualized decision-making is to be discouraged and a standardized approach to problems encouraged.

Rather than running with the pack, our medical associations must remind the public, government and the legal profession that the practice of medicine, even in 2004, is not a manufacturing enterprise. It is highly individualized with very few absolutes, despite the impression that might be given by the proliferation of guidelines.

Having an educated and well-informed public and medical profession entails more than knowing about the latest trends. Instead, it means we must all have the tools to better determine what is really significant in this cascade of so-called “new” information. Maybe we should put less emphasis on re-educating and changing behaviour and more emphasis on nurturing the skills of thinking.

Tom Vandor Ormstown Medical Center Ormstown, Que.