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Ensuring and improving assistance is important to prevent additional suffering and reduce exacerbations requiring hospitalization, a particularly important aim given the high and rising incidence of advanced COPD. A number of other insightful findings reveal the significance of learning directly from the persons who live with chronic illnesses about their lives.

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The authors surveyed Canadian medical schools to identify gaps in current continuing professional development (CPD) with reference to social accountability and compared the results to best practices identified in a literature review. The literature review identified 15 relevant articles. Several themes on best practices emerged. In a fundamental social contract with society, physicians receive privileges in return for responding to social needs. CPD is part of this contract. To meet the terms of the contract, CPD must be credible, unbiased and respond to social needs. Physicians have a responsibility to maintain quality; CPD is one tool to do that. CPD should be measured against values of relevance, quality, cost effectiveness, and equity. The survey asked all 17 Canadian medical schools to report CPD initiatives that respond to societal needs. Eleven schools responded with descriptions of 28 such initiatives. Most initiatives focused on values of quality and relevance; fewer focused on cost effectiveness. Most often, initiatives addressed medical expertise and interprofessional collaboration, least often health advocacy. Faculty initiated most initiatives, rather than students, community or society. These findings lead to recommendations for future directions of CPD.