Continuing Medical Education

The requirement for physicians to participate in Continuing Medical Education (CME) was established in order to create the most competent licensing population possible, thereby enhancing consumer protection. Under California law, physicians and surgeons must complete at least 50 hours of approved CME during each biennial renewal cycle.

Courses approved by the Licensing Program include:

  • Programs accredited by the Institute for Medical Quality/California Medical Association (IMQ/CMA), the American Medical Association (AMA), and the Accreditation Council for Continuing Medical Education (ACCME) that qualify for AMA PRA Category 1 Credit(s)™;
  • Programs which qualify for prescribed credit from the American Academy of Family Physicians (AAFP); and
  • Other programs offered by other organizations and institutions acceptable to the Division.

Courses approved by the Licensing Program for Category 1 CME include programs that are approved by the California Medical Association and the American Medical Association and programs that qualify for prescribed credit from the American Academy of Family Physicians.

Required CME on Pain Management and the Appropriate Treatment of the Terminally Ill

Most California-licensed physicians are required to take, as a one-time requirement, 12 hours of CME on pain management and the appropriate care and treatment of the terminally ill. Pathologists and radiologists are exempted from this requirement. The courses or programs must be presented by an organization accredited to provide CME by the ACCME, the AMA, the IMQ/CMA, or the AAFP. In addition to accrediting CME providers, AMA, IMQ/CMA, and AAFP may also present CME programs that will be accepted.

The 12 units may be divided in any way that is relevant to the physician's specialty and practice setting. Acceptable courses may address either topic individually or both topics together. For example, one physician might take three hours of "pain management education" and nine hours of "the appropriate care and treatment of the terminally ill;" a second physician might opt to take six hours of "pain management" and six hours of "the appropriate care and treatment of the terminally ill;" a third physician might opt to take one 12-hour course that includes both topics. The Medical Board will accept any combination of the two topics totaling 12 hours.

Physicians must complete the mandated hours by their second license renewal date or within four years, whichever comes first.

The 12 required hours would count toward the 50 hours of approved CME each physician is required to complete during each biennial renewal cycle.

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Required CME on Geriatrics for General Internists and Family Physicians

In order to ensure that physicians have the requisite knowledge and skills to competently treat California's older population, California law requires that general internists and family physicians who have a patient population of which over 25 percent are 65 years of age or older, are required to complete at least 20 percent of their mandatory CME in the field of geriatric medicine.

All other physicians are encouraged to take a course in geriatric medicine, including geriatric pharmacology, as part of their mandatory CME.

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Audit for CME Compliance

The Medical Board is required by law to conduct an annual audit of physicians who have certified that they have complied with Continuing Medical Education (CME) requirements by signing the CME certification statement on their license renewal notice. Under Section 1338 of Title 16, of the California Code of Regulations (CCR), it constitutes unprofessional conduct for any physician to misrepresent compliance with CME requirements.

In addition to fulfilling the CME requirements, you must maintain documentation of your CME for a minimum of four years. These records must include course title, dates of attendance, number of credit hours received, and sponsoring/accrediting agency. These records may be needed if your CME is audited by the Licensing Program.

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Requesting a CME Waiver

If you are unable to complete the minimum CME requirements due to health, military service, or undue hardship, you may request a CME waiver. If your application for a CME waiver is denied by the Board, you will be allowed to renew your license one time; however, you will be required to make up the deficient hours over your next renewal period and document to the Board 100 CME hours by the end of that renewal period.

If needed, you should request a waiver approximately three months prior to your license expiration. All requests are reviewed on an individual basis, and may be subject to verification of the physician's inability to comply.

For further information concerning CME and the renewal of your license, please contact the CME Coordinator at (916) 263-2645.

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Available CME Options

There are a number of educational activities that meet the content standards for CME credit. The following summary, provided by the IMQ (a subsidiary of the CMA), lists just some of the many educational activities that can qualify for CME credit. This information is provided to assist you in finding those options that best meet your needs and should not be considered exhaustive. You may contact the IMQ/CMA, the AMA, the ACCME, or the AAFP should you wish to obtain more specific information about other qualifying educational activities beyond those listed below. Please note that the credit limitations below are those of the American Medical Association (AMA) and not the Medical Board of California.

  • Self-Study Programs (Enduring materials): Print, recorded audio-visual and internet or computer-based enduring educational material that requires completing and passing an assessment or test, is sponsored by an IMQ/CMA or ACCME accredited CME provider, and provides AMA PRA Category 1 Credit(s)™. (Note: Studying for tests is not eligible). Credits for a self-study course are calculated using the average or fixed amount of time required to complete it, rounded to the nearest quarter hour.
  • Courses (Live Activities): In-person educational activity offered for AMA PRA Category 1 Credit(s)™ from an IMQ/CMA or an ACCME accredited provider such as a hospital, medical specialty society, or medical school. Credit is granted based on the length of time a physician attends the course. Physician faculty may also be awarded AMA PRA Category 1 Credit(s)™ for their learning associated with preparation and teaching of an original presentation but this credit is awarded directly through the AMA. International courses must be offered by a CME-accredited organization.
  • Internet POC: A limit of twenty (20) AMA PRA Category 1 Credit(s)™ per year can be earned by completing the three phases of an Internet Point-of-Care (POC) learning activity (1. clinical question, 2. identify sources, 3. describe application to practice). This is a CME activ¬ity structured by an IMQ/CMA or an ACCME accredited provider in which a physician engages in self-directed, online learning on topics relevant to their clinical practice. Each structured Internet POC cycle can be designated for one-half (.5) AMA PRA Category 1 Credit(s)™.
  • Performance Improvement Continuing Medical Education (PI CME): An accredited CME provider structures a long-term, three stage process by which a physician or group of physicians learn about specific performance measures and assess current practice, implement interventions to improve performance related to those measures over a useful interval of time, and then reassess their practice using the same performance measures. PI CME can be designated for twenty (20) AMA PRA Category 1 Credit(s)™ when all stages are completed, or if only one or two stages are completed, physicians can receive five (5) AMA PRA Category 1 Credit(s)™ for each completed stage.
  • Manuscript review: A CME activity structured by an IMQ/CMA or an ACCME accredited provider in which a physician learns through the critical review of an assigned journal manuscript. Each accredited manuscript review, as deemed acceptable by and documented by the journal editor, can be designated for three (3) AMA PRA Category 1 Credit(s)™ with a limit of five (5) reviews—or fifteen (15) AMA PRA Category 1 Credit(s)™ per year.
  • Test item writing: Credit can be earned through contribution to the development of certain high stake examinations (National Board of Medical Examiners or American Board of Medical Specialty examinations) or peer reviewed self-assessment activities. Contributions can include research, drafting and defending potential questions. Accredited CME providers should designate each test writing activity for ten (10) AMA PRA Category 1 Credit(s)™.
  • Faculty Teaching: As of March 2013, faculty can earn AMA PRA Category 1 Credit(s)™ for the teaching of medical students, residents and fellows, as long as it meets all of the AMA core requirements for live activities and is certified by an institution that, in addition to being an accredited CME provider (or working in joint sponsorship with an accredited CME provider), is accredited by the LCME (to certify teaching medical students), the ACGME (to certify teaching residents/fellows) or both. Credit is awarded for a maximum of two (2) AMA PRA Category 1 Credit(s)™ per one (1) hour of interaction.

The following are educational activities for which AMA PRA Category 1 Credit(s)™ is awarded directly by the AMA (Physicians who complete learning for the activities listed below can claim AMA PRA Category 1 Credit(s)™ directly from the AMA.

  • Medically-Related Advanced Degree: A maximum of 25 AMA PRA Category 1 Credit(s)™ may be earned for obtaining a medically related advanced degree, such as a master's or Ph.D., degree in public health or in a clinical field related to medicine. (Note: this credit is not available if the academic program is certified as individual courses for AMA PRA Category 1 Credit(s)™).
  • Published Papers: A maximum limit of one (1) article or 10 AMA PRA Category 1 Credit(s)™ can be claimed per year for one (1) article by the lead author (first listed) of a peer-reviewed article published in a journal that is included in the MEDLINE bibliographic database.
  • Poster Presentations: A maximum limit of one (1) poster presentation or 5 AMA PRA Category 1 Credit(s)™ can be claimed per year for one (1) poster presentation that is included in the published abstracts for a conference designated for AMA PRA Category 1 Credit(s)™.

In addition, the Medical Board allows the following:

  • Residency and Fellowship Programs: Residents and fellows are allowed six hours of CME for each month of postgraduate residency or clinical fellowship in a program accredited by the Accreditation Council for Graduate Medical Education.
  • Teaching or Presenting a CME Course: A maximum of one-third of the required CME hours may be satisfied by teaching or otherwise presenting a course or program that meets the requirements to offer CME.
  • Specialty Board Examination: A physician who takes and passes a certifying or recertifying examination administered by a recognized specialty board is granted 100 hours of CME credit for four consecutive years.

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Frequently Asked Questions Regarding CME

  • Can I receive CME credit for passing a specialty board examination?
    Yes, if you take and pass a certifying or recertifying examination administered by a recognized specialty board, you are granted credit for 100 CME hours for four consecutive years.
  • Does the American Medical Association's Physician Recognition Award (PRA) meet the CME requirement?
    To obtain a PRA, a physician must participate in 150 hours of CME, of which 60 hours are approved for AMA PRA Category 1 Credit(s)™. If more than 60 hours of CME are obtained to receive a PRA, a copy of the PRA application should be submitted to receive the appropriate amount of credit.
  • Can I receive credit for teaching or presenting a course that meets the CME requirements?
    Yes; a maximum of one-third of the required CME hours may be satisfied by teaching or presenting a course or program that meets the CME requirement.
  • How can I claim hours for which I have no documentation?
    The organization sponsoring the program must provide documentation that includes the participant's name, course title, dates of attendance and duration, the sponsoring organization and accrediting agency name, and hours received. If you are randomly selected for a CME audit and cannot provide documentation supporting your claim, you will “fail” the audit and will be required to make up any missing credit prior to the next licensure renewal cycle. Additionally, you may be charged with unprofessional conduct for misrepresenting compliance with the CME requirements during the license renewal process.
  • What if I cannot afford the cost involved in taking CME courses?
    There are many sources for earning CME credit that are available at low or no cost. Online CME offered by accredited providers is one source. Medical journals often offer CME credits related to one or more articles. Also, local hospitals may offer approved courses for CME credit to all physicians.
  • I have a California license, but I am currently in the military. Can I be exempt from CME?
    Perhaps. The law requires that every military physician comply with the CME requirement. However, reasons of war or being aboard a ship for extended periods of time (several years) which preclude a physician from participating in any CME may be considered. Requests to waive the CME requirement may be submitted to the Board.
  • I received a waiver for my last renewal period. How many hours do I need to complete by my next renewal?
    If a waiver is granted for a renewal period, 100 approved hours must be completed by the renewal period following the waived period.
  • Should I send CME documentation with my license renewal notice?
    No. If a physician is not being audited for CME completion, it is only necessary to sign the self-certification statement on the renewal application form and return it with the renewal payment. If the physician did not receive a renewal notice, he/she should contact the Board's Consumer Information Unit at 1-800-633-2322 to request a new notice.
  • If I am audited, do I have to show proof of completion of CME courses or programs?
    Yes. Documents that are acceptable include: Certificates of completion of CME activities, including in person or self-study programs. The documentation must show the name of the physician as the participant, the title and date(s) of the course or completion of the program, the number of approved CME hours or prescribed credit hours granted for completion, or a copy of the medical specialty board certificate (good for 100 hours of credit).
  • What happens if I am audited and cannot show proof or evidence of attendance of CME programs?
    The Licensing Program will allow a physician to renew his or her license one time following the audit to permit him or her to make up any deficient CME hours. However, the Board will not renew the license a second time until all the required hours have been documented. Furthermore, a physician may be charged with "unprofessional conduct" for misrepresenting compliance with the CME requirements during the license renewal process. (Title 16, California Code of Regulations, Section 1338.)

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Laws regarding CME

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Helpful Links

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