End of CPD: Myth or Reality in the Continuing Education Landscape for Healthcare Professionals?
The question of the "end of CPD" (Continuing Professional Development) is causing a stir in the healthcare sector following the IGAS report. Although CPD has been in place since 2009, its effectiveness and suitability for the needs of healthcare professionals are regularly called into question. The introduction of the Complementary Professional Development (CP) program, initially intended for medical professions but later extended to seven regulated professions, has raised questions about the sustainability of CPD in its current form. This article aims to explore in depth the factors driving the debate over “the end of CPD,” drawing on information from official reports and reflections on the future of continuing education in the French healthcare sector.
The current CPD system: a system at a crossroads and its weaknesses
Continuing Professional Development (CPD) was established with the aim of maintaining knowledge and improving the professional skills of the twenty-eight healthcare professions defined by the Public Health Code. Managed since 2016 by the National Agency for Continuing Professional Development (ANDPC), a Public Interest Group (GIP) comprising the State and the national health insurance system, the Continuing Professional Development (CPD) program aims to fund the training of self-employed professionals and employees of healthcare facilities, representing approximately 453,800 people.
However, despite its ambitious goals, the CPD program has faced significant criticism and has not fully achieved its objectives. A key finding is the low number of practitioners who have fulfilled their CPD requirements. During the 2020–2022 period, only 5% of professionals subject to this requirement complied. This alarming figure underscores the challenges faced by the program.
Several factors account for these disappointing results. The National Agency for Continuing Professional Development (DPC) has been criticized for interpreting the regulations too narrowly, recognizing only activities that fall under the priority guidelines. These guidelines, although established under Article L.4021-2 of the Public Health Code, often fail to meet the needs expressed by professionals. Furthermore, the authority granted to the Agency to interpret these priority guidelines is deemed inconsistent with Article R.4021-4 of the Public Health Code, which assigns responsibility for drafting such guidelines to the State for public health matters and to the National Professional Councils (CNP) for the specific needs of each profession.
The high number of priority guidelines—which the Court of Auditors considers excessive (238 for the 2020–2022 three-year period and 205 for 2023–2025)—also contributes to the system’s complexity and lack of clarity. Many guidelines have received little or no support from professionals. Furthermore, the evaluation of CPD activities by independent scientific committees (ICS), although required by Article R.4021-13 of the Public Health Code, covers only a small proportion of proposed activities due to the workload of some ICS. This situation results in limited prior quality control of the activities. Paradoxically, the share of activities published by healthcare facilities and universities—which are potentially better aligned with skills needs—is decreasing in favor of commercial organizations, which may be better equipped to meet the Agency’s administrative criteria. Finally, salaried staff are virtually absent from CPD, particularly in healthcare facilities, which are sometimes even unaware of the legal requirement. Difficulties in reaching agreements between the ANDPC and the National Association for Continuing Education of Hospital Staff (ANFH) as well as the OPCO Santé contribute to this low penetration. Some professions also face an insufficient supply of Continuing Professional Development (CPD), particularly in terms of professional practice assessment (PPA), that meets their specific needs.
The Emergence of Periodic Certification (PC): A New Paradigm?
IGAS Recommendations: Toward the Elimination of Continuing Professional Development (CPD) for Certain Professions?
Against the backdrop of challenges surrounding CPD and the implementation of PPD, the Minister of Health commissioned a new study from the General Inspectorate of Social Affairs (IGAS) in November 2023. The study was designed to examine the future of the ANDPC (National Agency for Continuing Professional Development) and the relationship between CPD and PPD.
The IGAS report, published in December 2024, makes several key recommendations regarding the future of mechanisms for maintaining and improving skills. One of the top recommendations is the elimination of the CPD requirement for regulated professions. The task force believes that the scope of periodic certification (maintaining skills and improving practices) encompasses the scope of Continuing Professional Development (CPD) for these professions.
However, the report recommends maintaining the CPD requirement for professions without a professional regulatory body. The task force notes that the current scope of CPD activities available to these professions is too narrow to allow them to fulfill their obligation. It therefore proposes maintaining a CPD requirement by adapting its content, in particular by removing the current system of priority areas, which are considered too numerous and far removed from the needs of professionals. The National Professional Councils (CNPs) would be invited to develop CPD frameworks tailored to their needs. Furthermore, it is deemed necessary to broaden the scope of Continuing Professional Development (CPD) for these professions.
To ensure overall consistency, the report recommends aligning the durations of periodic certification cycles, continuing professional development (CPD), and accreditation for high-risk specialties to a six-year period.
With regard to funding, the mission estimates that the amount allocated in 2023 for continuing professional development, continuing professional education (CPD), and skills development for regulated professions (approximately €438 million) could be reallocated to CPD. Analysis of the average costs of CPD activities and draft frameworks suggests that existing funding could cover between 3 and 4 of the 8 mandatory paid activities over six years for regulated professions. Including non-paid activities would allow us to complete all 8 required actions.
To ensure financial sustainability, the report emphasizes the need to review the rules governing the financing of CPD activities, in particular by harmonizing accounting rules and limiting the unit cost of fee-based activities. The report also recommends implementing an individual six-year financial entitlement for each healthcare professional to fund fee-based activities. Finally, the mission emphasizes the need to implement a post-evaluation for Continuing Professional Development (CPD) and for Professional Certification (PC), with the definition of sufficiently precise ethical and scientific standards. Implications and Consequences of a Potential End to CPD: The elimination of the CPD requirement for regulated professions, if implemented, would have significant implications for the professionals concerned and for the landscape of continuing education. For regulated professions, periodic certification would become the central mechanism for maintaining and improving skills. They would have to complete the four modules of PC and undertake a minimum of eight activities over six years. Greater importance would be placed on the recognition of unpaid activities, such as participation in multidisciplinary meetings, the preparation of structured reports, or the monitoring of quality and safety indicators. The individual "Ma Certif Pro Santé" account would play a key role in tracking completed activities, whether paid or unpaid. Professional bodies would see their role strengthened in monitoring and enforcing the mandatory Continuing Professional Development (CPD) requirement. For professions without a professional body, CPD would be maintained but adapted. The elimination of priority guidelines and the increased involvement of National Professional Councils (CNPs) in defining standards should allow for a better response to their specific needs. A broadening of the scope of CPD is planned, as well as the development of continuing professional development (CPD) offerings. The establishment of a common label for the various CPD funders is also desired.
At the funding level, the reallocation of funds earmarked for CPD from professional bodies to the CP would require rigorous management and harmonization of funding rules. The concept of an individual financial entitlement could affect access to funding for fee-based activities.
The transformation of the ANDPC is also a potential outcome. The IGAS report considers three scenarios: its transformation into a public institution, the transfer of its resources and responsibilities to a department under the Minister of Health, or the transfer of responsibilities to the HAS. The scenario favored by the mission is the transfer of responsibilities to the HAS (French National Authority for Health). Finally, it is crucial to emphasize that removing the mandatory CPD (Continuing Professional Development) requirement for regulated professions would require a legislative measure. The recommendations of the IGAS (General Inspectorate of Social Affairs) report must therefore be taken into account by public authorities for any potential regulatory changes. The future of continuing education: integration or coexistence of CPD and CP (Continuing Professional Development)? The future of continuing education for healthcare professionals appears to be moving toward a profound reconfiguration of existing systems. The coexistence of Continuing Professional Development (CPD) and Professional Certification (PC), with distinct objectives and methods depending on the profession, could serve as a transitional phase before further integration. The IGAS report highlights the need for a new, unified organizational structure for PCD and CPD. Transferring the responsibilities of the ANDPC (National Agency for Continuing Professional Development) to the HAS (French National Authority for Health) is presented as the preferred scenario. The HAS would then play a leading role in defining guidelines, evaluating standards and actions, in conjunction with the CNPs (National Professional Councils). A specialized HAS commission, incorporating the current CNCP (National Council for Professional Certification), could be created to oversee PCD and CPD. Streamlining the systems is a priority, with the elimination of mandatory CPD for regulated professions and its continuation, in an adapted form, for others. The harmonization of training cycle durations and funding rules is also essential. The individual "Ma Certif Pro Santé" account is intended to become a central tool for managing continuing professional development (CPD) activities and potentially continuing professional development (CPD). Its development must take into account strategic changes and the recommendations of the IGAS (General Inspectorate of Social Affairs) mission. The DGOS (General Directorate of Healthcare Provision) is identified as the strategic leader of this transformation, in conjunction with the ANS (Digital Health Agency) as the operational leader. A new set of specifications for individual accounts will need to be established.
Widespread and consistent communication with healthcare professionals is essential to support these changes and ensure a clear understanding of the new systems.
Finally, it is crucial to conduct an impact assessment of these systems on clinical practices and patient health, given the significant amount of public funds allocated to continuing education.
Conclusion: Navigating the Future of Continuing Education for Healthcare Professionals
The end of CPD does not necessarily mean the complete disappearance of the concept of continuing professional development, but rather a significant evolution of the continuing education landscape for healthcare professionals in France. The emergence of periodic certification for regulated professions, combined with the observed limitations of the current Continuing Professional Development (CPD) system, paves the way for a reconfiguration of the existing systems. The recommendations of the IGAS (General Inspectorate of Social Affairs) in favor of eliminating the CPD requirement for regulated professions and adapting it for other professions represent a potential break with the current system. The expanded role of National Professional Councils (CNPs) and professional bodies, the recognition of unpaid activities, and the implementation of an individual account are key elements of this transformation. While the end of Continuing Professional Development (CPD) as we know it appears to be approaching for some professions, it reflects a desire to create a more coherent system, better adapted to the needs of professionals, and potentially more effective in terms of improving practices and the quality of care. The future of continuing education will likely involve a gradual integration of CPD and Continuing Professional Development (CPD), potentially under unified governance by the French National Authority for Health (HAS). The coming years will be crucial for implementing these changes and defining the future of continuing education for healthcare professionals.
