For the second year in a row, members of the AMA House of Delegates sent back policy proposals tightening the organization’s rules regarding continuing medical education.

The proposal, by the AMA’s Council on Ethical and Judicial Affairs (CEJA), deemed acceptance of commercial support for CME from drug and device manufacturers “ethically permissible,” though not preferable, provided that a laundry list of conditions were met. That, in itself, was a sharp departure from CEJA’s call, a year earlier, for an end to commercial sponsorship. That proposal met with vociferous opposition from all three primary voting blocks within the House of Delegates—primary care physicians, state societies and specialty societies—and was referred back to CEJA.

“I think the ambiguous language killed it,” said Rockpointe Medical Education president Thomas Sullivan of this year’s legislation. “There was suspicion of CEJA from last year, when they tried to kill us all by banning commercial support, that this was a back door way of doing the same thing. Delegates were very vocal. I think this is the last time we’ll see this for a few years.”

Dr. Daniel Carlat, a critic of commercial support, blogged: “Apparently even this watered down version of medical ethics is unacceptable to the AMA, because defining industry-free CME as ‘preferable’ might slow down the flow of industry cash, so they rejected it, referring it back to CEJA for more extreme dilutions.”