CME on a Napkin

It was the early 80’s; a group of us were sitting in my office at McMaster. I forget who all was there—a dean, an education researcher, our course coordinator, a couple of other docs and me. I do remember one participant very well: John Premi, professor of family medicine, a national and international leader in CME, though he never claimed the title. (He’s gone now but I hope he’s not reading this; he’d be midway between angry and embarrassed at the reference to “great.”)

We were talking about a problem in McMaster’s young but growing continuing education enterprise. We’d been successful in attracting many physicians from Ontario and even upstate New York to our courses and conferences, but not graduates of our new undergraduate program. McMaster, some may recall, was one of the first in the world to offer most of its undergraduate MD in small group, problem-based learning formats. As a result, the thought of sitting in a lecture for their continuing education—lecturers on a stage, a bunch of sleepy listeners in rows in front of them—just didn’t seem to pull our graduates’ chain.

I may not remember everyone who was there but I do remember it was lunchtime, the remains of the hospital kitchen’s chicken and egg salad sandwiches in front of us. John found a pen on my desk, reached over, wrote four letters on a napkin, and turned it upside down.

What was on the napkin?

“Our graduates aren’t used to sitting in lectures, are they?” John said. “And more important, not learning anatomy for anatomy’s sake, but to fix a broken wrist; or learning about lung physiology to help an asthmatic patient. Am I right?”? There were nods around the room.

”And we know that’s how we all learn best, solving a patient problem.” More nods as I grabbed the last chicken salad sandwich, and as he turned the napkin over. On it, he’d written BYOP, a slight twist on an old party invitation—not asking a guest to bring a bottle, but to bring a problem.

Talk about an ah-ha moment. In minutes, the discussion blossomed, from words and ideas, to possible actions—a few doctors to test ideas on, a trial small group learning experience, a larger research study, then in time, possibly, a program. Years later, the idea became the Foundation for Medical Practice. www.fmpe.org

It was the screen shot you see here, the unpronounceable PBSGL program, that triggered this trifecta of a memory: one of the CME greats, John Premi; the idea of small group learning for docs that spread into a national program; and a napkin.

Check out the foundation’s website for more about its programs and history—perhaps not unique, but very special.

#CPD #CME #medicaleducation #CPDhistory #McMaster #problem-basedlearning