Yes indeed, ’tis the month of bags filled with mail from little boys and girls asking for that special something. Sadly, we were unable to get good old Saint Nick to help out with CMEpalooza’s special mailbox — our Ask Us Anything feature — so it’s up to the two of us (with some help from a few of our own elves) to calm your nerves, ease those holiday blues, and soothe your soul.

I will admit that, after turning over our usually overflowing mailbag, not much is left over for future months, so please, if you have an issue (professional or personal) you want us to help with, click here to submit your question(s). We’ll do our jolly best to give our usual helpful advice. Surely you have some family holiday angst you need us to referee.

Dear Derek and Scott,

In medical education workplaces, younger professionals often want to be heard (as they should), but it can feel like those of us with experience are being treated like relics instead of active contributors.

I’m in many groups where we are genuinely excited to bring in fresh perspectives, but lately I keep hearing the same phrase, “We don’t want to hear from the same old voices.” Cute at first… until you realize they mean you.

It seems as though the only way they feel they have a voice is to silence others. And guess what? If they keep accelerating the timeline for when someone becomes ‘old,’ they’re going to phase themselves out faster than a trend on TikTok.

How do we strike the balance between honoring experience and embracing new voices? How do we help these newbies understand that experience isn’t a nuisance to be cleared out but the foundation they’ll be standing on when the next shiny new crowd rolls in?

Huzzah,

Respectfully Seasoned

SCOTT: This is one of those age-old issues that is common among companies of any type and size. The youngins come in and want to establish their foothold by coming up with all sorts of great ideas in an effort to be heard and seen. The old guard wants to protect their place in the pecking order and make sure that their experience and knowledge is acknowledged appropriately. It’s one of those push and pull issues that everyone then gripes about to their significant others/friends/family over the weekend.

It sounds like you have a role in a variety of different groups, probably both personally and professionally. Your feelings are hurt, and rightly so, when you are no longer seen as bringing value to the team in favor of these newer voices.

From my experience, it comes down to having the right leader in place who can deftly both incorporate the, as you note, valuable and necessary input from new voices as well as that from seasoned (OK, fine, older) professionals. I have been within organizations and groups where there was poor leadership in place and this devolved into a really toxic “us vs. them” situation full of back-biting and unrest. But I have also been part of circumstances where the leader — be it the CEO/President or group leader — was skilled at striking the right balance to keep everyone happy and engaged.

Being this kind of leader isn’t something that is easily taught or learned (and frankly, it’s not a personal area of strength). You have to be a good listener, a quick thinker, and a skilled diplomat. You recognize when feelings are hurt and bring aggrieved parties together to hash out solutions before things cascade out of control. You consider personalities and life circumstances. You figure out ways to find connections between people of all ages and perspectives. And sometimes, yes, you make the hard decision to cut loose people who simply don’t want to play together in the same sandbox.

DEREK: One of the interesting aspects of being part of an industry-wide community is the diverse array of settings and environments that community members work in. What feels like a pressing issue to Person A might be something that Person B has never experienced. That doesn’t diminish the impact of the issue on Person A but perhaps adds perspective to how pervasive the issue may be community wide.

Personally, the issue of newbies pushing out old heads is not one I’ve had much experience with. In fact, if anything, I’ve had more trouble with the reverse situation. As producers and planners of a twice-yearly conference, Scott and I are constantly juggling the balance of seasoned faculty vs new voices. Without a doubt, it is the new voices that we have much more difficulty finding.

Outside of CMEpalooza, the workplace issues I have seen and experienced related to sharing of perspectives and opinions have revolved more around personality types than age. It’s the same old story of the more extroverted individuals dominating the discussion while the introverts wait for a break in the conversation (that never comes) to share their thoughts. The extroverts are annoyed at the introverts for not participating, and the introverts are annoyed at the extroverts for not giving them time to speak.

That is not the issue you are asking about, but I think the method of resolution is similar. When these types of conflicts arise, we all can benefit from a healthy dose of self-reflection and self-awareness. If you are upset with the new guard trying to drown you out or with the extroverts for failing to read the questions you submitted to the Zoom chat, take a moment to think about if there is anything you could personally do to improve the situation. Compromise is the key. Scott is right to point out the value of a good leader in these situations. A good leader will lead their team through a self-reflection process and work with both sides on a compromise.

Dear Derek and Scott,

Why do supporters issue RFPs at the end of the year if they’re only going to decline the applications citing a lack of funding?

Curiously,

Just Curious

DEREK: This is a little tricky to answer without additional context, but I’ll do the best I can.

“Lack of funds” does not mean “no funds.” Supporters do not issue RFPs without some budget dedicated to it. It’s possible that budget is small. It’s possible that budget is only enough for one grant. It’s possible that the application you submitted was really, really good — so good that it was ranked the second-best application received for the RFP., which, unfortunately, means there are not enough funds available to approve it. Thus, your application is declined for lack of funds.

Side note: You specifically mention RFPs at the end of the year, and I’m not quite sure what the relevance is here. Maybe I’m missing something. It is not uncommon for supporters to realize in Q4 that they have additional budget to use (there are a variety of reasons for this) and issue an RFP, but I don’t think that’s related to “lack of funds” rejections more than RFPs issued at other times of the year. Maybe Scott will correct me below.

SCOTT: I have a love-hate relationship with RFPs. They are good because they show that pharma company XYZ definitely has some money to spend in a specific therapeutic area on a specific topic and maybe even with a preferred format. They are bad because now everyone knows that pharma company XYZ definitely has some money to spend in a specific therapeutic area on a specific topic and there will be a mountain of grant submissions to compete with. I have anecdotally heard tales of supporters receiving upwards of 50 grants for one RFP (note from Derek: I can confirm this is accurate. I’ve received even more than that for one RFP.) Even if, for arguments sake, there are 3 “winning” grants, that means there are 47 losers. That’s a lot of organizations that get a decline email with a “lack of funding” rationale.

If you want to do some post-RFP research, it is usually possible to find a good number of the “winning” proposals, especially if they were tied to a specific conference. In earlier days, there was at least one pharma company that I am aware of that used to actually post the winning RFPs on their grant portal so everyone could see what was awarded and perhaps gain some insight into why that might have been the case. However, that hasn’t happened — at least that I am aware of — for many years.

I have a hard time believing that a pharma company would go through the time and effort to post an RFP and then not award any grant dollars to a “winning” proposal. I suppose it is possible if there are unforeseen circumstances, and funding that was initially earmarked for the RFP was pulled, but I would not think that is common. Yes, it can be frustrating to receive a cavalcade of “lack of funding” declines related to an RFP and there are most certainly dozens of other applicants grumbling right along with you, but that doesn’t mean that someone isn’t celebrating their “your funding application has been approved” email at the same time.

Dear Derek and Scott,

I think I already know the answer, but I’d appreciate your input.

Dr. B. Styles is an investor and on the Medical Advisory Board of his brother’s company, Styles Pharmaceuticals, which solely produces a CBD product for the treatment of insomnia. The CBD product has been clinically tested and registered with the FDA. Dr. Styles has disclosed this relationship to the CME provider in preparation for a presentation on pain management.

Although CBD has been clinically proven to aid in pain management, that’s not part of Styles Pharmaceuticals’ business line, nor does the company specifically promote CBD for pain management.

Does this relationship need to be mitigated? Should this relationship be disclosed to learners? Is there anything else we need to be worried about?

Back in the Saddle Again,

Disclosure Debbie

SCOTT: Just reading this question made me want to swallow a CBD gummy. So many variables, so many issues. And of course, since the question deals with the grey area of accreditation, I have no idea.

But this is where it pays to have friends, so I turned to the accreditation wizards behind our Fall 2025 “One Step Over the Line? What’s Right, What’s Wrong, and What Falls Into the Grey Area of Accredited CE” session to get their input. In a nutshell, here are their thoughts (if you aren’t an accreditation savant, you may want to pop a CBD gummy of your own right about now):

“Since the educational topic is pain management and Styles’ Pharmaceuticals’ business lines are related to insomnia — a completely different therapeutic area — Dr. B. Styles’ relationships are not relevant and do not require mitigation or disclosure under ACCME Standard 3 (see this Examples of Relevant Content document).

Nonetheless, we would advise Disclosure Debbie to have the presentation peer reviewed to confirm the following:

1. This presentation is not related to insomnia in any way. Even if it not included within his submitted slides, it may be worth reaching out to Dr. B Styles to ask if a discussion of insomnia is part of his planned oral remarks. Clearly, it doesn’t seem far fetched that CBD could be discussed….for instance, if someone has pain, that can lead to insomnia…
2. The presentation and its content meets the content validity expectations outlined in Standard 1 since Medical Marijuana and CBD are explicitly highlighted on the ACCME’s Website
3. The presentation discloses any new and emerging trends, as well as the evidence level supporting any claims or conclusions
4. The presentation meets content standards/requirements for all of your accrediting bodies (not just The Standards) since these may differ

But oh wise one, you said that the relationship wasn’t relevant to the content, why do I have to have it peer reviewed (essentially mitigating it)?? Well young padawan, if you are already having the content reviewed for content validity under Standard 1, you might as well have it reviewed for relevance too (and document it). This shows that you did your due diligence, especially if Styles Pharmaceuticals is a privately held company, which makes Dr. B Styles an ‘owner of an ineligible company’ and you are relying on the three exemptions under Standard 3.2 that permit him to be a presenting faculty member. Keep this documentation on hand for purposes of your self-study, PIP abstracts, audits, and the interview in case you need it.”

It may also be wise to assign a non-conflicted planner to monitor/moderate the session. This person can help ensure that Dr. Styles’ presentation and any follow-up discussions remain focused on the agreed-upon topics for the talk (ie, pain management). If the Q&A includes questions about sleep aspects of pain management, the planner can intervene to guide the conversation back to the approved topic, adding an extra layer of protection against any commercial bias.

Where our panelists differed is in their approach to Dr. Styles’ disclosure. Some felt it prudent to include his relationship and “over-disclose” to learners, letting them assess any potential conflict while others felt it was important only to disclose what their team had deemed relevant to the content. Like I said, grey areas.

Here are even some resources this crackerjack team suggested for you:

• Peer Review Form to validate content and relevance
• Compliance Check “When is a Financial Relationship Relevant?”
• Examples of related/unrelated content

I am sure that Derek has much, much more he’d like to add on this issue.

DEREK: [glances at nonexistent watch on his wrist]

Hoo boy, look at the time! I have so much I’d like to add here based on my accreditation experience as a CME Director 15 years ago, but with our word count approaching 2,500 words, I should probably wrap it up and save all that pent up wisdom for another AMA session. Too bad!

 

 

Two hundred and fifty years ago, Thomas Jefferson sat down in the small house he was renting a few blocks from Independence Hall in Philadelphia and wrote these prophetic words:

We hold these truths to be sacred and undeniable…

Yes, yes, I can hear you already. “Wait just a second. I may not have been the best student in Mr. Willis’ 11th grade American history class, but even I know that that isn’t how it goes in the Declaration of Independence. What kind of new-age flimflammery is this?”

And of course, you would be correct. The line in the Declaration of Independence is indeed, “We hold these truths to be self-evident…” But that doesn’t detract from the fact that good old Mr. Jefferson did not initially write it this way. It was only through the contributions of others who took an already good idea and polished it to make it something great that we have those special words which we all memorized in our youth.

Taking something good and making it great… that’s been precisely the recipe for CMEpalooza’s success, too. We had a good idea 13 years ago, but it’s only been with the support and participation of the CME community that CMEpalooza has turned into something great, an unquestioned highlight of the calendar twice a year.

As we gear up for CMEpalooza once again (sadly, we don’t have a cool anniversary like our country’s sesquicentennial to celebrate), we’re putting out a call to all of the CME providers, supporters, vendors, technology wizards, and other industry hangers-on to consider a CMEpalooza sponsorship in 2026. We have our dates set for CMEpalooza Spring and Fall – Wednesday, April 22, and Wednesday, October 21 – so now it’s up to you. Do you want to be a patriot and join the 35+ companies who support CMEpalooza annually, or do you want to be a Benedict Arnold (OK, maybe the traitor comparison is a little strong, but you get the point)?

We have the usual array of sponsorship opportunities available, as well as a couple other creative ways we’ve come up with to promote your company. We’ve thrown in a few new and improved goodies again this year as well. If there is anything particularly creative you have in mind, come talk to us, and we’ll figure out something fun (Derek says he’ll recite the Pledge of Allegiance before each Palooza for a nominal fee).

CLICK HERE TO ACCESS THE 2026 SPONSORSHIP PROSPECTUS

While the rest of the CME world decompresses after another banner year of CMEpalooza, here at Palooza HQ, we simply couldn’t ignore our mailbag that was overwhelming with cries for help. And so we’re back with another installment of our Ask Us Anything feature.

We’d love to keep this going through the end of 2025 and beyond, but our advice is only as good as those who seek it. So if you have an issue (professional or personal) you want us to help with, click here to submit your question(s). While we may not have a professional degree that would be of use, we promise we’ll try our best to be helpful.

Dear Derek and Scott,

I’ve been hearing a lot about pharmaceutical and medical device companies offering “educational grants,” but I can’t shake the feeling there’s more to it than just goodwill. What’s the real reason they provide these grants? What actionable takeaways/insights are they hoping to get? How do they use those and why are they important? For example: How is understanding, “Time is a barrier to change” an actionable takeaway?

Giddily,

Curious but Cynical in Cleveland

DEREK: I struggled with how to respond to this question, but decided on honesty as the best policy. There’s no need to shake the feeling that there’s more to educational grants than just goodwill. There is. I don’t think there’s anyone who has worked in this industry for a decent period of time who would disagree. But that does not mean that there is something nefarious afoot.

This is how I explain my job to my mom: I work for a company that creates a product that helps people with a certain disease. One of the strategies for informing people about that product is through independent medical education (IME) programs. IME programs cost money to produce, so we provide grants in areas of our interest to defray those costs. We support IME because we believe that the product we produce is helpful in treating patients and will be included as part of the educational materials. When managed appropriately, everyone benefits.

So, no, supporters do not give educational grants strictly out of goodwill. I suppose we can argue about the altruistic value of this approach, but I don’t see the point of that. I have worked for two different supporters and can honestly say that both of them, without a doubt, have the patient at the heart of their mission. I’m sure the same can be said for most supporters. The real reason we provide these grants is because we think they will ultimately improve patient care. There is room for cynicism here, some of it undoubtedly warranted, but that has not been my overall experience over the past 25 years of working in IME.

SCOTT: Unlike Derek, I have never worked on the supporter side of things so I can’t speak with any sort of authority as the altruistic nature of the pharma supporter. I will concur with our advice seeker that, from an external perspective, our whole enterprise may appear a bit suspect, which is probably why we are occasionally in the crosshairs of policy makers who wonder exactly how and why our industry works.

We all know that pharma companies will only support education in therapeutic areas that they have a product to treat (or a product in development to treat), and often have a set of internal goals/educational needs that will shape the grant proposals they will support. Yes, this means that there may be a flood of education on disease state X while there is nothing on disease state Y. We see this all the time – a long-ignored therapeutic area where nothing new has emerged for a decade or more all of the sudden has a rush of new therapeutics approved and the educational floodgates open. This may seem odd – let’s face it, patients didn’t sudden stop going to their doctor with disease state Y – but it’s the way our world works. And truth be told, many clinicians that I have spoken to are most interested in education that at least touch on new drugs so that they can determine whether they are (or are not) something they should/will consider for their patients.

As to the second part of your question related to “what do the pharma companies get out of supporting grants,” I could point you to a whole slew of previous CMEpalooza sessions where our panelists talk specifically how the data they receive from providers is used internally to shape future corporate strategy. Again, I don’t work in pharma and never have, so I can only share anecdotal data from others, but it does appear that at least some of our educational outcomes do more than fall into a black hole never to be seen again.

Dear Scott and Derek,

We have outstanding grant applications in a few supporter portals and cannot reach anyone at the companies for status updates. Emails to their general mailbox, direct messages to relevant employees on LinkedIn, AND calls to the main corporate office have yielded no results. Shy of taking a road trip to their headquarters and camping out in the lobby, how else can we connect with someone who can give us a yes or no answer?

Gently,

Awaiting Answers

SCOTT: This is a pet peeve of mine as well. I recently was working on a grant proposal in response to an RFP that read, “If you have any questions about this RFP, please direct them to Person XYZ at personxyz@pharmacompany.com.” I usually don’t bother knowing that any response to a question will usually be vague and unhelpful, but I had a question that was fairly germane to our proposed budget and would have been good to know. I sent a series of emails to Person XYZ (it was someone I knew from professional circles a bit, so I felt somewhat confident that I wouldn’t get ghosted) but never got any sort of response. So we eventually had to take our best guess and wing it. You’ll be stunned to know that our proposal was not the winning one.

Now, your question is a bit different. I am guessing that you have submissions that have been languishing in supporter portals far longer than the 45-60 day review window that is usually promised on supporter websites, and you are hoping for some sort of status update on your proposal. This is another common frustration of providers, especially when a proposal has a live element to it that is tied to a specific event or congress.

I can’t say with any certainly why you are getting the cold shoulder from various supporters, but I have a few guesses based on conversations that I have had in the past:

1. The supporter has been unable to get his/her grant committee together for this therapeutic area and therefore does not know when your proposal is going to be reviewed. So instead of giving you a “We don’t know” answer, they simply are not responding to you.
2. The supporter currently has no budget in this therapeutic area but likes your proposal enough that they are holding onto it in case they do get some sort of incremental funding down the line. But since they have no idea if this is going to happen or not, they simply are not responding to you.
3. The supporter is overwhelmed with grant requests and is way behind on reviews. Your turn will come eventually, but since they have no idea when “eventually” may arrive, they simply are not responding to you.
4. They think you are being a pest and have better things to do. So they simply are not responding to you.

I don’t have any great advice for you beyond, “Be patient.” Eventually – maybe in a few weeks, maybe in a few months – you will hear something. If your proposal is tied to a specific meeting and that meeting has now passed, your proposal won’t be funded (this happens not infrequently). If it is not date specific, there is still a chance, though I will say from experience, the longer a grant languishes, the less chance it will be funded. That said, I did recently have a proposal that sat with a provider for 7 months before it was funded out of the blue. We never found out what had happened that caused it to sit for so long.

DEREK: [Long sigh]

Look…on a macro level, most people…[thinks about it]…yes, most people are terrible at correspondence. As someone who has a propensity to overcommunicate, this drives me nuts. It’s not that hard to send out a quick email with an update or respond to a text with a thumbs up or whatever.

On a micro level, I won’t try to defend the inconsistent communication from the supporter side. We should be better.

Scott has put together a good list of reasons above that I’d like to respond to. Again, I do this based on my own experience and don’t speak for others blah, blah, blah, you get the point.

1. Absolutely. This is probably my #1 reason for not responding. It’s not always specifically a grant committee issue, but something has gone wonky that I wasn’t expecting (budget delay, disagreement on strategy, etc.) I usually try to give an initial update if there is a delay, but if the delay continues, I am probably not going to constantly respond to your emails with additional updates, especially if I have no new information. Unfortunately, the answer to “how much longer” is frequently “I don’t know.” And sometimes, I get tired of saying that.
2. Rarely. Or I should say, rarely would I do this and not let you know. If the supporter you applied to is primarily RFP-based, then it’s unlikely that this is the reason. If you submitted an unsolicited proposal, then I suppose it’s possible.
3. Sure, I suppose. Probably not.
4. Yes. This definitely happens. (side note: please don’t DM me on LinkedIn.)

Dear Derek and Scott,

What should I do if I forget to include an important attachment with a grant submission? Ask the supporter to reopen the application? Shrug it off since it would likely have been declined anyway?

Grumpily,

(Lack of) Attention to Detail

DEREK: Yes, just contact the supporter and ask them to reopen the application or upload the attachment for you. We all forget stuff — none of us is perfect. One year at the Alliance conference, I forgot and left my bag behind at three separate meetings in one day. Who am I to judge someone for forgetting an upload?

SCOTT: OK, but then what if your supporter is one of those people we talked about in the previous question, and they decide to ignore your email? What then? Huh huh huh? (I can tell you what Derek’s response would be without even asking him — “Stop bothering me.”)

I have probably submitted more than 1,000 grant requests over the course of my career and maneuvered through many, many weird grant portals. I used to spend far too much time making sure every “I” was crossed and every “T” was dotted (Strike that. Reverse it.) before I hit the submit button, and there were still times when I either forgot something or realized that I didn’t put everything into every field that I wanted to. It happens.

Certainly, emailing either the general grant mailbox would be the best first step. Hopefully you’ll get a response. And if not, well, there are many grants in the sea of CME.