APPLICATION FORM - CERTIFICATION OF CONTINUING MEDICAL EDUCATION (CME) ACTIVITY

For Pharmaceutical & Other Organizations

CME Application Timeline – Important Notice:

Organizations applying for CME accreditation are required to submit complete applications at least eight (8) weeks prior to the scheduled event. The Medical Council of Jamaica (MCJ) mandates that CME applications be submitted no later than one (1) month in advance of the event for credits to be reviewed, approved, and confirmed ahead of the meeting. Please note that CME certificates will not be issued or distributed unless formal confirmation of approved credits has been received from the MCJ. Late submissions may result in delayed or non-approval of CME credits. Early submission is strongly advised to ensure timely processing and certificate issuance.

DEFINITIONS TO NOTE: AFFILIATES AND NON-AFFILIATES

*Affiliate and Non-Affiliate Classification

The Association of General Practitioners of Jamaica (AGPJ) classifies organizations into Affiliates and Non-Affiliates to distinguish the nature of our collaborations:

Affiliates: These include medical organizations aligned with the practice of medicine, such as national and regional family medicine associations, healthcare institutions, and academic entities dedicated to advancing family medicine and primary care.

Non-Affiliates: These include pharmaceutical companies, healthcare product manufacturers, and other organizations that support healthcare delivery but are not directly aligned with medical practice. Organizations not related to medicine or healthcare, such as corporate sponsors, are also classified as non-affiliates.

PROCESS REQUEST THROUGH:

AGPJ (Association of General Practitioners of Jamaica)

SECTION 1: ORGANIZATION DETAILS (Type of Organization:)

Pharmaceutical Company Medical / Healthcare Organization Academic Institution Other

Affiliate Status:

Affiliate Non-Affiliate Unsure

Contact Person:

Email:

Telephone:

SECTION 2: CME ACTIVITY DETAILS

Title of CME Activity:

Proposed Date(s):

Format:

Face-to-Face Virtual Hybrid Online / On-Demand

Venue (if applicable):

Target Audience:

SECTION 3: PROGRAMME INFORMATION

Brief Rationale:

Total Educational Time:

≤ 4 hours > 4 hours

CME Credits Requesting:

SECTION 4: FACULTY / PRESENTERS

Number of Presenter(s):

Local or International:

Bio/CV attached COI attached

SECTION 5: MANDATORY REQUIRED DOCUMENTATION

SECTION 6: EDUCATIONAL DESIGN

Educational Methodology:

PowerPoint Lecture Clinical Case Studies Workshop Pre-Test Other

Method of Programme Evaluation:

Post-Test Q&A Session Breakout Sessions Poll Questions Other

SECTION 7: ACCREDITATION BODY

MCJ ONLY MCJ & CCFP Regional AAFP (additional cost as advised by AAFP) CCFP Regional only

SECTION 8: ACCREDITATION FEES

NOTE: Distribution and emailing of CME Certificates by AGPJ is MANDATORY.

Jamaica Only Accreditation:

Non-Affiliate / Pharmaceutical – US$489.00 per day Affiliate Medical / Academic – US$389.00 per day

Jamaica & Regional Accreditation:

Non-Affiliate / Pharmaceutical – US$589.00 per day Affiliate Medical / Academic – US$489.00 per day

Regional Only Accreditation:

Non-Affiliate / Pharmaceutical – US$489.00 per day Affiliate Medical / Academic – US$389.00 per day

SECTION 9: MEDICAL COUNCIL OF JAMAICA (MCJ) FEES

MCJ Application Fee (payable separately):

J$7,500.00 per day (≤ 4 hours) J$15,000.00 per day (> 4 hours)

SECTION 10: OPTIONAL EVENT PROMOTION

No promotion required

No promotion required 1 Complimentary Email Blast – US$00.00 1 Additional Email Blasts – US$80.00

SECTION 11: PROCESS ACKNOWLEDGMENTS (MANDATORY)

CME certificates will be distributed by AGPJ. One Complimentary email and WhatsApp blast. Invoice/estimate will be issued after submission. Mandatory follow-up email will be sent to AGPJ Secretariat. MCJ approval required before CME credits issued.

SECTION 12: MISCELLANEOUS

Promotion or Design Support: (tick all that is applicable)

None Required Flyer Design IT Support

SECTION 13: DECLARATION (tick all that apply)

I confirm that the content is scientific, evidence-based and non-promotional. I understand that CME approval is subject to MCJ/CCFP-NCCME review. I acknowledge that timelines and fees apply.