Free
AOA Communication  |   March 2010
AOA Continuing Medical Education
Author Notes
  • Ms Rodgers serves as the secretary for the American Osteopathic Association's Council on Continuing Medical Education. 
  • Address correspondence to Delores J. Rodgers, BS, Director, Division of Continuing Medical Education, Department of Education, American Osteopathic Association, 142 E Ontario St, Chicago, IL 60611-2864.E-mail: drodgers@osteopathic.org 
Article Information
AOA Communication   |   March 2010
AOA Continuing Medical Education
The Journal of the American Osteopathic Association, March 2010, Vol. 110, 168-182. doi:10.7556/jaoa.2010.110.3.168
The Journal of the American Osteopathic Association, March 2010, Vol. 110, 168-182. doi:10.7556/jaoa.2010.110.3.168
Abstract

The previous continuing medical education (CME) cycle began on January 1, 2007, and ended on December 31, 2009. All members of the American Osteopathic Association (AOA), other than those exempted, were required to participate in the CME program and to meet specified CME credit hour requirements for that CME cycle. The author provides an update on the new CME cycle, which began on January 1, 2010, and will end on December 31, 2012. The author also details minor changes to the requirements for Category 1 CME sponsors accredited by the AOA and describes new online CME opportunities. The current article also explains changes regarding the AOA's awarding and recording of specialty CME credit hours for AOA board-certified osteopathic physicians. In addition, the article includes information to assist osteopathic specialists and subspecialists in requesting AOA Category 1-A credit for courses accredited by the Accreditation Council for Continuing Medical Education.

A physician must maintain a current, full, and unrestricted license to practice medicine in the United States, its territories, or Canada. Continuing medical education (CME)—often required for medical licensure—refers to a specific form of continuing education that helps medical professionals learn about new and developing areas in their fields of expertise to help them retain, develop, and enhance their knowledge, ability, and professional performance. Physicians' continued professional development in turn helps them serve patients and the community in a more effective and efficient manner. 
Activities for CME may consist of live events, written publications, online programs, and audio, video, or other electronic presentations. Content for CME activities is developed, reviewed, and delivered by faculty who are experts in their individual clinical areas. 
Within the United States, CME for physicians is regulated by the Accreditation Council on Continuing Medical Education (ACCME) and the Council on Continuing Medical Education (CCME) of the American Osteopathic Association (AOA). The CCME is committed to identifying and responding to the needs of osteopathic physicians (DOs) in order to facilitate ongoing improvement in the quality of patient care. 
The CCME encourages voluntary participation in CME by AOA nonmembers. However, all members of the AOA, other than those otherwise exempted (Figure 1), are required to participate in the AOA CME program and to meet specific CME credit-hour requirements for each 3-year CME cycle. In 2009, 71.4% of all AOA members had a CME requirement that had to be met by December 31, 2009. 
The present article provides an update of the AOA CME program for the new CME cycle, which began on January 1, 2010, and will end on December 31, 2012. Topic areas include recent changes in CME policies and the continuing challenges with the awarding and recording of CME credit hours for DOs who are specialty certified. 
More detailed information regarding CME guidelines for the previous 2007-2009 CME cycle and the current 2010-2012 CME cycle is available on DO-Online at http://www.do-online.org/index.cfm?PageID=cme_main. 
Credit Hours
Continuing medical education credit hours are granted by the AOA from any of four categories: 1-A, 1-B, 2-A, or 2-B (Figure 2). In general, CME credit from Category 1 is osteopathic (ie, AOA-accredited); Category 2 credit is nonosteopathic; type A credit is granted for formal, didactic courses; and type B credit is for less formal CME activities, such as hospital committee work or reading the scientific content in an osteopathic journal approved by the CCME (eg, JAOA—The Journal of the American Osteopathic Association) in conjunction with completing the respective CME quiz. 
Figure 1.
Members of the American Osteopathic Association (AOA) exempted from the AOA's continuing medical education (CME) credit-hour requirements. Lifetime members in active practice have a CME requirement. The AOA may grant exemptions, waivers, or reduction in credit hours only if due cause or inability to obtain hours is demonstrated to the Council on Continuing Medical Education (CCME).
Figure 1.
Members of the American Osteopathic Association (AOA) exempted from the AOA's continuing medical education (CME) credit-hour requirements. Lifetime members in active practice have a CME requirement. The AOA may grant exemptions, waivers, or reduction in credit hours only if due cause or inability to obtain hours is demonstrated to the Council on Continuing Medical Education (CCME).
Figure 2.
The four categories of continuing medical education (CME) credits granted by the American Osteopathic Association (AOA).
Figure 2.
The four categories of continuing medical education (CME) credits granted by the American Osteopathic Association (AOA).
At its February 2003 meeting, the AOA Board of Trustees (BOT) set the CME requirement for AOA membership at 120 credit hours, with a minimum of 30 hours dedicated to earning Category 1-A credits.1 The remaining 90 hours of the 120-hour requirement may be obtained by combining CME credits earned from any of the four credit categories (ie, 1-A, 1-B, 2-A, or 2-B). A maximum of 60 hours of Category 1-B credit for osteopathic preceptoring may be applied to the basic 120-hour requirement. In addition, the AOA, like the American Medical Association (AMA), awards a Certificate of Excellence to physicians who demonstrate exceptional commitments to CME.2,3 A more detailed description of how CME credit is categorized by the AOA is provided in Figure 3. 
As of December 2009, a total of 36,295 DOs have earned Category 1-A credit by attending formal education programs and osteopathic medical teaching sponsored by AOA Category 1 CME sponsors. A total of 24,160 DOs have participated in such activities as “hospital inspections/specialty board examinations,” “hospital committee meetings,” “osteopathic medical teaching/preceptorship,” “other osteopathic CME,” and “scientific papers/publication.”2 The Division of CME has recorded 10.6 million hours of Category 1-B credit for preceptoring by 24,878 DOs. 
The CCME considers exemptions, reductions, and waivers to its CME requirements on a case-by-case basis. However, no waiver for this 120-hour requirement will be granted unless due cause or inability to obtain hours are demonstrated to the CCME. 
For new AOA physician-members, CME requirements are reduced according to a proration schedule based on the date when the DO joined the AOA after the beginning of a new 3-year CME cycle. For those DOs who have specialty board certification through the AOA, of the total 120-hour requirement for CME credits, 50 hours of either Category 1 or Category 2 credit must be earned in CME activities related to the primary specialty field. However, the total CME requirement for DOs certified by the American Osteopathic Board of Family Physicians, the American Osteopathic Board of Anesthesiology, and the American Osteopathic Board of Neuromusculoskelectal Medicine is higher, at 150 hours per 3-year CME cycle.4 Failure to fulfill the AOA's CME requirement may result in loss of AOA specialty board certification. In recent years, the majority of the CCME's discussions and changes to the CME program have related to this component of member requirements, as further detailed on pages 176 and 177 of the present article. 
State Licensure and Renewal
Medical licenses are granted to those physicians meeting all state requirements at the discretion of the state board. All physicians—DOs and allopathic physicians (MDs)—must pass examinations to obtain state licenses to practice. 
Osteopathic physicians are licensed to practice medicine in the United States by licensing boards in each state. Requirements for licensure vary by state, but there are generally three methods by which a DO can become licensed, as follows5: 
  • Successful completion of a medical licensing examination administered by the state licensing board—A state board may prepare its own examination or administer an examination that has been prepared and purchased from a specialized agency. The US Medical Licensing Examination and the Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) are currently the most widely used tests.
  • Acceptance of the certificate issued by the National Board of Osteopathic Medical Examiners (NBOME)—This certificate is awarded after an applicant has satisfied the NBOME requirements, including successfully passing the COMLEX-USA.
  • Reciprocity or endorsement of a license previously received from another state—Typically, the license presented for reciprocity or endorsement must have been issued on the basis of a written examination.
Figure 3.
*The optional Category 1-A requirements listed in this figure are interchangeable. One may select 90 additional hours from any of the four continuing medical education (CME) credit types and in any combination, as long as the mandatory 30-hour requirement for Category 1 credit hours is met. †Osteopathic physicians who exceed the maximum limit of 15 credit hours of Category 1-A CME credit for faculty development programs can apply those excess credit hours to Category 1-B CME credit if the programs were provided by a Category 1 CME sponsor accredited by the American Osteopathic Association (AOA). ‡Content was previously assigned to Category 1-A. §The JAOA grants 2 hours of Category 1-B CME credit to osteopathic physicians who complete quizzes on the scientific content in the JAOA and its supplements. To apply for CME credit, AOA members who are registered users of DO-Online can take JAOA CME quizzes online (http://www.docmeonline.com). Alternatively, readers can complete the JAOA quiz and mail it with their AOA member number to the Division of CME. //Physicians who obtain 150 hours of CME credit in a 3-year CME cycle are recognized and awarded an AOA Certificate of Excellence in CME. Abbreviations: AAFP, American Academy of Family Physicians; ACCME, Accreditation Council for Continuing Medical Education; CCME, Council on Continuing Medical Education; COMLEX-USA Level 2-PE, Comprehensive Osteopathic Medical Licensing Examination-USA Level 2-Performance Evaluation; NBOME, National Board of Osteopathic Medical Examiners. Source: Continuing Medical Education Guide, 2010-2012: Guide for Osteopathic Physicians, December 2009.9
Figure 3.
*The optional Category 1-A requirements listed in this figure are interchangeable. One may select 90 additional hours from any of the four continuing medical education (CME) credit types and in any combination, as long as the mandatory 30-hour requirement for Category 1 credit hours is met. †Osteopathic physicians who exceed the maximum limit of 15 credit hours of Category 1-A CME credit for faculty development programs can apply those excess credit hours to Category 1-B CME credit if the programs were provided by a Category 1 CME sponsor accredited by the American Osteopathic Association (AOA). ‡Content was previously assigned to Category 1-A. §The JAOA grants 2 hours of Category 1-B CME credit to osteopathic physicians who complete quizzes on the scientific content in the JAOA and its supplements. To apply for CME credit, AOA members who are registered users of DO-Online can take JAOA CME quizzes online (http://www.docmeonline.com). Alternatively, readers can complete the JAOA quiz and mail it with their AOA member number to the Division of CME. //Physicians who obtain 150 hours of CME credit in a 3-year CME cycle are recognized and awarded an AOA Certificate of Excellence in CME. Abbreviations: AAFP, American Academy of Family Physicians; ACCME, Accreditation Council for Continuing Medical Education; CCME, Council on Continuing Medical Education; COMLEX-USA Level 2-PE, Comprehensive Osteopathic Medical Licensing Examination-USA Level 2-Performance Evaluation; NBOME, National Board of Osteopathic Medical Examiners. Source: Continuing Medical Education Guide, 2010-2012: Guide for Osteopathic Physicians, December 2009.9
A DO who satisfies the basic licensing requirements for a given state, however, is not guaranteed licensure. State licensing boards individually evaluate each applicant. For example, a state licensing board verifies personal and professional information provided by the applicant and appraises his or her moral character. 
Forty-five state licensing boards (including the District of Columbia) require CME for license renewal (Figure 4).6 Although the AOA CME program is on a 3-year CME cycle, state licensure boards have either a 2-year or 3-year CME cycle for their license renewal requirements. 
Some states also mandate CME content, such as knowledge of human immunodeficiency virus and AIDS, risk management, and end-of-life palliative care. In addition, many states require that a certain percentage of CME credit hours be in Category 1. 
Readers are encouraged to review the US Osteopathic Licensure Summary,6 which is available in the members-only section of DO-Online. State licensure requirements, categorized by profession, are also available on the CE Medicus Web site at http://www.cemedicus.com/common_state_requirements/index.htm. Physician-members who are interested in additional information about state licensing requirements are strongly encouraged to contact their individual state licensing boards, which are listed with Web links at http://www.osteopathic.org/index.cfm?PageID=ado_license. 
DO-Online's CME Center
DO-Online's “Spotlight on CME” Web site (see http://www.docmeonline.com) gives physician-members ready access to hundreds of hours of accredited online CME courses. With the help of this feature, AOA members can search through a catalog of online CME activities and quizzes, access and complete those activities and quizzes online, and receive a printable screen certificate immediately afterward. Credits for CME activities completed online are automatically applied to members' CME activity reports (CARs). 
Physician-members can view their current CARs at any time through DO-Online's “Spotlight on CME” Web site. In addition, CARs from previous CME cycles are archived online for at least 6 years after the end of a cycle (eg, reports for the 2007-2009 cycle will be archived on the site through 2015). However, only those DOs who are AOA members and registered DO-Online users can review their CARs online. Those members who have not created an account to view their CAR information may do so by contacting the AOA Department of Membership at (800) 621-1773, extension 8284. 
The AOA has always maintained member CARs as private documents. However, a physician-member can download his or her CAR or request that it be sent via e-mail to a third party. The AOA releases a member's CAR to outside agencies (eg, state licensing boards, hospitals, attorneys, government agencies) only on written request by the physician-member. Through DO-Online, the AOA continues to maintain the confidentiality of this information, but individual physician-members have the added convenience of forwarding this information electronically at their discretion. 
As previously noted in the JAOA,7,8 the AOA no longer routinely mails CARs to its physician-members. Members who do not have online access are asked to contact the AOA Division of CME to request an updated CAR, which can be sent by e-mail, fax, or mail. These requests can be submitted via phone ([800] 621-1773, extension 8262) or e-mail (cme@osteopathic.org), they can be faxed to (312) 202-8202, or they can be mailed to the AOA Division of CME, 142 E Ontario St, Chicago, IL 60611-2864. 
The CCME continues to believe that all CME activity should be audited. Therefore, physician-members are not allowed to manually enter or update their CME records online. Physician-members should continue to submit their update requests for CME credit directly to the AOA Division of CME using the contact information in the previous paragraph. 
Physician-members are encouraged to mail any other correspondence regarding their CARs to the Division of CME address previously mentioned. 
Recent Activities at the AOA
The CCME meets three times annually (ie, January, April, and November) to address members' concerns and routine business related to CME programming. A listing of the current members of the CCME may be found at http://www.do-online.org/pdf/CCMEList2009-2010.pdf. In addition, a standing subcommittee of the CCME—the Administrative Committee—meets in July, as needed, to perform any required duties of the CCME between regularly scheduled meetings, such as reviewing and taking final action on special consideration requests and reviewing policy items and basic documents before submission to the full committee. 
At its July 2009 meeting, the AOA BOT appointed Jeffrey S. Grove, DO, as the CCME's chairman. Dr Grove has served on the CCME for 5 years. He is a family physician based in Florida, is AOA–board certified in family practice with added certification in geriatric medicine, and is a fellow of the American College of Osteopathic Family Physicians. Dr Grove is also board certified by the American Board of Quality Assurance and Utilization Review Physicians. 
As previously described,7,8 the CCME has discussed at length various methods to assist subspecialists in obtaining AOA Category 1-A CME credit hours, which are not readily available within the osteopathic medical profession. A subcommittee was appointed by the late Morton Morris, DO, JD, previous CCME chairman, to examine proposals for recognizing allopathic CME programs for specialties and subspecialties in which CME credit hours are not available through osteopathic sponsors. The AOA BOT approved the CCME's Resolution B02 (A/2008—AOA Category 1-A CME Credit for Osteopathic Specialists/Subspecialists), which was intended to make the process of earning AOA Category 1-A credit easier for DO specialists and subspecialists. 
Resolution B02 applies to AOA DO-members in specialties and subspecialties that have fewer than 250 AOA or ABMS board-certified osteopathic physicians. These DOs may satisfy a portion of their AOA Category 1-A requirement using credits from programs in their specialties and subspecialties that are accredited by the Accreditation Council for Continuing Medical Education (ACCME). Specialists and subspecialists qualifying under the resolution were able to substitute 20 ACCME Category 1 credits for AOA Category 1-A credits during the 2007-2009 CME cycle; 15 such credits for the 2010-2012 cycle; and 10 such credits during the 2013-2015 cycle. These ACCME credits will count toward the 30 total hours of AOA Category 1-A credit that AOA members are required to earn during each CME cycle. 
Figure 4.
Osteopathic physicians should verify the material reported here with their state licensing boards as listed on http://www.osteopathic.org/index/.cfm?PageID=ado_license. The information provided in this figure is reported annually to the American Osteopathic Association (AOA) directly from each state licensing board and is compiled here for the convenience of AOA members. The exact wording provided by the state licensing boards is preserved in this figure where possible. The AOA takes no responsibility for changes to state guidelines made immediately before publication or for errors in reporting from state licensing boards. Material that is new since the publication of the JAOA`s 2008 Osteopathic Medical Education issue is indicated in boldface. *Connecticut and the District of Columbia previously had no continuing medical education (CME). †Florida limits the number of CME credit hours that osteopathic physicians can obtain from sources approved by the American Medical Association (AMA) to 13. Abbreviations: ABMS, American Board of Medical Specialties; ACCME, Accreditation Council for Continuing Medical Education; CCME, Council on Continuing Medical Education; HIV/AIDS, human immunodeficiency virus/acquired immunodeficiency syndrome; OSHA, US Department of Labor Occupational Safety and Health Administration. Source: US Osteopathic Licensure Summary, October 2009.6
Figure 4.
Osteopathic physicians should verify the material reported here with their state licensing boards as listed on http://www.osteopathic.org/index/.cfm?PageID=ado_license. The information provided in this figure is reported annually to the American Osteopathic Association (AOA) directly from each state licensing board and is compiled here for the convenience of AOA members. The exact wording provided by the state licensing boards is preserved in this figure where possible. The AOA takes no responsibility for changes to state guidelines made immediately before publication or for errors in reporting from state licensing boards. Material that is new since the publication of the JAOA`s 2008 Osteopathic Medical Education issue is indicated in boldface. *Connecticut and the District of Columbia previously had no continuing medical education (CME). †Florida limits the number of CME credit hours that osteopathic physicians can obtain from sources approved by the American Medical Association (AMA) to 13. Abbreviations: ABMS, American Board of Medical Specialties; ACCME, Accreditation Council for Continuing Medical Education; CCME, Council on Continuing Medical Education; HIV/AIDS, human immunodeficiency virus/acquired immunodeficiency syndrome; OSHA, US Department of Labor Occupational Safety and Health Administration. Source: US Osteopathic Licensure Summary, October 2009.6
Thus, the ACCME Category 1 credits will “sunset” during CME cycles in the following manner: 
  • 2007-2009—20 ACCME Category 1 credits; 10 AOA Category 1-A credits
  • 2010-2012—15 ACCME Category 1 credits; 15 AOA Category 1-A credits
  • 2013-2015—10 ACCME Category 1 credits; 20 AOA Category 1-A credits
  • 2016—0 ACCME Category 1 credits; 30 AOA Category 1-A credits
The CCME also encourages all AOA-accredited CME sponsors to develop interactive, online Category 1-A programs and other innovative approaches to help provide osteopathic specialists and subspecialists with relevant, high-quality Category 1-A CME. 
Furthermore, in November 2008, the CCME reaffirmed its policy regarding preceptoring physician-assistant students—namely, that no CME credit hours will be awarded for such preceptoring. Credit hours may be granted only for preceptoring osteopathic medical students. Additional information regarding preceptoring for specialty hours is described on the next page. 
In addition, the following activities do not qualify for AOA CME credits, as stated in the 2010-2012 CME cycle Guide for Osteopathic Physicians9: 
  • volunteer work
  • postgraduate studies toward advanced degrees (eg, Master of Science, Master of Public Health, Master of Business Administration, or other Doctorate)
  • medical facility tours
Faculty Development and Core Competencies
At its February 2010 meeting, the AOA Board of Trustees approved a resolution (B25 [M/2010]—Faculty Development/Core Competency Category 1-A CME Credit) to increase the maximum number of CME credit hours for faculty development from 10 to 15 hours per CME cycle. This guideline pertains to DOs who attend faculty development workshops that incorporate any or all of the seven core competencies sponsored by an AOA Category 1 CME Sponsor. 
Electronic Attestation Form
AOA policy requires that accredited AOA CME sponsors obtain a signed attestation sheet from each attendee indicating the number of hours actually attended for each sponsor's CME activity. At its February 2010 meeting, the AOA Board of Trustees approved a resolution (B26 [M/2010]—Onsite Monitoring for Continuing Medical Education Programs) that the term “signed” attestation of attendance and participation in AOA-approved Category 1 sponsored CME programs include the use of an electronic method of signature as long as there is evidence the physician attended the educational program. 
Scientific Exhibits
At its January 2010 meeting, the CCME clarified its existing policy relating to promotional materials that are displayed or distributed in the same room (ie, scientific exhibits) as formal education programs sponsored by an AOA Category 1 CME sponsor. As of March 1, 2010, the AOA Division of CME will no longer record CME credit for activity with exhibits, and all sponsors must cease and desist advertisement of awarding CME credit related to exhibits in accordance with the AOA guidelines for commercial support.10 Any AOA sponsor who has advertised CME credit associated with exhibits on their Web site or brochure before March 1 must notify the AOA Division of CME to request an exemption. 
Needs Assessment
At its midyear meeting in February 2009, the AOA BOT approved Resolution 38 (Needs Assessment, Pre-approval of CME Programs for AOA Category 1-A or Category 1-B Credit), effective July 1, 2009, that any AOA Category 1 CME sponsor that submits a formal request to the AOA Division of CME for approval of AOA Category 1-A or Category 1-B credit must provide a needs assessment. The following criteria relating to needs assessments are required on submissions to the CME Division from this point forward: 
  • The needs assessment must be conducted on an annual basis for each program.
  • A needs assessment must be included for each presentation.
  • The needs assessment must be timely and current for the field.
  • The needs assessment must be documented and at least one source must be evidence based.
A copy of a presentation on needs assessments in CME given at the 16th National CME Sponsors Conference by Diane Burkhart, PhD, director of the Department of Education, may be downloaded from the AOA CME Web site. If you have any questions, please contact Dr Burkhart at dburkhart@osteopathic.org. 
CME on the Internet
At its meeting in April 2009, the Council on CME reviewed a request addressing issues relating to (1) lifting the restriction of 9 hours for CME on the Internet; (2) revising the language from “real time, interactive simultaneous conferencing” to “Webcast with live faculty/participant interaction,” and (3) allowing the use of a hidden technical mechanism for transferring learning data (cookies). The CCME upheld its current policy and recommended no changes relating to items 1 and 2. However, the AOA BOT approved a resolution (B27 [M/2010]—Restrictions on Internet CME Programs) at its February 2010 meeting to remove the language “the use of hidden technical mechanism for transferring learning data (cookies) is prohibited.” The new language, which will be incorporated into the next version of AOA Accreditation Requirements for AOA Category 1 CME Sponsors, states that the CME sponsor must give full disclosure to the learner about its policy on privacy and confidentiality as they relate to CME activities on the Internet. 
Guidelines for AOA Specialty Board Certification
Medical specialty certification in the United States is a voluntary process.11 Although general AOA CME requirements help DOs maintain their medical competence and their ability to diagnose illness and treat patients, these requirements are not specialty specific. Board certification from the AOA demonstrates a DO's commitment to and expertise in a particular specialty or subspecialty of medicine. 
As previously noted,8 DOs who wish to maintain specialty board certification through the AOA are required to earn a minimum of 50 hours of AOA Category 1 or Category 2 CME credit in their specialty areas during each 3-year CME cycle. 
In February 2006, the AOA BOT approved the recommended guidelines for academic and professional activities that allow specialty-board–certified DOs to satisfy existing CME requirements (Resolution 45 [M/2006]—Specialty CME Reporting). These specialty-board “templates” were designed to provide physician-members with a variety of options for earning CME credit hours while also maintaining overall consistency among the specialties.7 Figure 5 provides a summary of areas of divergence among specialties for the current 2010-2012 CME cycle. The table for the 2007-2009 CME cycle is available at http://www.do-online.org/pdf/cmeTemplateRecordingSpecCreds0722.doc. 
For the activities noted in Figure 5 (ie, AOA specialty college seminars, ACCME courses, formal teaching, and standardized/basic life support), the maximum number of CME credit hours accepted per 3-year CME cycle must be designated at the beginning of each new CME cycle. All boards were surveyed in August 2009 for a recommendation for the 2010-2012 CME cycle. 
Twenty-five credit hours of preceptoring per CME cycle may apply to physician-members' specialty-board requirements for those boards that have designated specialty credit hours for preceptoring. In contrast, these hours will not be applied to member records for DOs in which the specialty boards indicated objections (Figure 6). For information regarding the use of preceptoring or other credits, physicians should contact their certifying boards. 
At its April 2008 meeting, the Council revisited the issue of recording AOA specialty credits for osteopathic entities during the 2007-2009 CME cycle. The chairman of the AOA Department of Educational Affairs instructed CCME staff to begin the recording process of specialty credit hours as of March 6, 2008. The interim rules for applying CME credit to the 50-hour specialty credit requirement are as follows for the 2007-2009 CME cycle: 
  • Continuing medical education credit from osteopathic specialty colleges applies to the specialty credit requirement on an unlimited, hour-by-hour basis.
  • Continuing medical education credit from osteopathic state societies and AOA CME sponsors other than specialty colleges applies to the specialty credit requirement on an hour-by-hour basis up to a maximum of 25 hours per cycle. Osteopathic state societies and AOA CME sponsors other than specialty colleges will continue to self-designate the number of hours that apply to each specialty, as they have in the past.
The CCME and BOS formed a task force to review and discuss a policy to assist state societies, osteopathic hospitals, colleges of osteopathic medicine, and osteopathic foundations in determining activities that will be eligible for specialty credit hours for the current 2010-2012 CME cycle. At its July 2009 meeting, the AOA Board of Trustees approved the following rules, which were proposed by AOA councils and bureaus, for applying CME to the 50-hour specialty credit requirement: 
  • Credit for specialty CME provided by AOA CME sponsors other than the relevant specialty affiliate may only be awarded by the certifying board with jurisdiction.
  • Each specialty certifying board will establish a CME Advisory Subcommittee, which will monitor compliance of CME programs based on the approved template and its defined criteria as needed.
  • Physicians may petition the specialty certifying board's CME Advisory Subcommittee on a case-by-case basis for exception to the policy. To request this process, contact the AOA Division of CME at (800) 621-1773, extension 8262.
Figure 5.
The maximum numbers of credit hours granted per cycle for the continuing medical education (CME) activities noted here were specified in the Bureau of Osteopathic Specialists' “template” responses, approved by the American Osteopathic Association (AOA) Board of Trustees in February 2006 (Resolution 45 [M/2006]—Specialty CME Reporting). *All activities must be related to the specialty for CME credit. Credit is awarded on an hour-by-hour basis for AOA specialty college seminars. For each other type of seminar, the number of maximum credit hours per cycle varies. For example, a maximum of 5 credit hours is allowed for human immunodeficiency virus/acquired immunodeficiency syndrome and risk management seminars; a maximum of 15 credit hours is allowed for test construction and publications seminars; and a maximum of 25 credit hours is allowed for AOA state society, foundation, and college of osteopathic medicine seminars. A maximum of 25 credit hours are granted for preceptoring only if a board indicated in its Council on Continuing Medical Education survey that it accepts such credit. Each board makes its own recommendation for maximum credit hours allowed for participating in the AOA Annual Convention and Scientific Seminar. †The full name of this board is the American Osteopathic Boards of Ophthalmology and Otolaryngology-Head and Neck Surgery. ‡Credit awarded on an hour-by hour basis. Abbreviation: ACCME, Accreditation Council for Continuing Medical Education; NA, not applicable.
Figure 5.
The maximum numbers of credit hours granted per cycle for the continuing medical education (CME) activities noted here were specified in the Bureau of Osteopathic Specialists' “template” responses, approved by the American Osteopathic Association (AOA) Board of Trustees in February 2006 (Resolution 45 [M/2006]—Specialty CME Reporting). *All activities must be related to the specialty for CME credit. Credit is awarded on an hour-by-hour basis for AOA specialty college seminars. For each other type of seminar, the number of maximum credit hours per cycle varies. For example, a maximum of 5 credit hours is allowed for human immunodeficiency virus/acquired immunodeficiency syndrome and risk management seminars; a maximum of 15 credit hours is allowed for test construction and publications seminars; and a maximum of 25 credit hours is allowed for AOA state society, foundation, and college of osteopathic medicine seminars. A maximum of 25 credit hours are granted for preceptoring only if a board indicated in its Council on Continuing Medical Education survey that it accepts such credit. Each board makes its own recommendation for maximum credit hours allowed for participating in the AOA Annual Convention and Scientific Seminar. †The full name of this board is the American Osteopathic Boards of Ophthalmology and Otolaryngology-Head and Neck Surgery. ‡Credit awarded on an hour-by hour basis. Abbreviation: ACCME, Accreditation Council for Continuing Medical Education; NA, not applicable.
Contact information for each CME Advisory Subcommittee and information on submitting a petition for an exception to the policy will be posted on the DO-Online Web site. 
In addition, AOA CME credit for certified physicians will be granted, per Resolution B13 (A/2009—Specialty Continuing Medical Education [CME] Policy), as follows: 
  • CME credit sponsored by osteopathic specialty affiliates in the declared specialty will be applied to the requirement on an unlimited hour-by-hour basis.
  • CME credit from sponsors other than the individual's declared specialty affiliate may be awarded by the certifying board with jurisdiction up to a maximum of 25 credit hours per cycle.
A certified physician must present the lectures for it to be considered for specialty credit. 
AOA-Accredited Category 1 CME Sponsors
There are currently 157 AOA-accredited Category 1 CME sponsors (Table 1). A list of these sponsors is maintained on DO-Online (see http://www.do-online.org/pdf/cme_sponsorslistDec09.pdf). 
Table 1
AOA-Accredited Category 1 CME Sponsors (N=157) *

Organization

No. (%)
Affiliates
□ Nonpractice (AOA) NA
□ Female2 (<1)
Colleges
□ Colleges of osteopathic medicine (AOA accredited)20 (12)
— Alumni groups NA
□ Specialty (AOA affliated)NA
Foundations (AOA affiliated) 8 (5)
Hospitals45 (28)
Military 1 (<1)
Philanthropic organizations (AOA affiliated)NA
Professional associations 1 (<1)
Societies
□ Divisional (AOA affliated) NA
□ Specialty27 (17)
□ State 53 (33)
 Abbreviations: AOA, American Osteopathic Association; NA, not applicable.
 *The number of continuing medical education (CME) sponsors in each category are accurate as of February 10, 2010. Percentages do not total 100 because of rounding.
 Applications for sponsorship are currently limited to the organizations indicated.
 The 53 state societies noted include all state societies, county societies, and state district societies (eg, Florida has a state osteopathic medical association, a county association, and seperate district societies: Broward County, District 7: and Southwest, District 11).
Table 1
AOA-Accredited Category 1 CME Sponsors (N=157) *

Organization

No. (%)
Affiliates
□ Nonpractice (AOA) NA
□ Female2 (<1)
Colleges
□ Colleges of osteopathic medicine (AOA accredited)20 (12)
— Alumni groups NA
□ Specialty (AOA affliated)NA
Foundations (AOA affiliated) 8 (5)
Hospitals45 (28)
Military 1 (<1)
Philanthropic organizations (AOA affiliated)NA
Professional associations 1 (<1)
Societies
□ Divisional (AOA affliated) NA
□ Specialty27 (17)
□ State 53 (33)
 Abbreviations: AOA, American Osteopathic Association; NA, not applicable.
 *The number of continuing medical education (CME) sponsors in each category are accurate as of February 10, 2010. Percentages do not total 100 because of rounding.
 Applications for sponsorship are currently limited to the organizations indicated.
 The 53 state societies noted include all state societies, county societies, and state district societies (eg, Florida has a state osteopathic medical association, a county association, and seperate district societies: Broward County, District 7: and Southwest, District 11).
×
The Council has instituted a policy effective July 1, 2009, regarding needs assessment for AOA Category 1-A or Category 1-B credit for pre-approval of CME (Resolution 38 [M/2009]—Needs Assessment, Pre-approval of CME Programs for AOA Category 1-A or Category 1-B Credit). Quality CME programs should focus on the determined needs of physicians as assessed by proven methods of needs assessment such as (1) medical audit, (2) pretest item analysis, (3) self assessment, and (4) questionnaire. Also effective July 1, 2009, all AOA Category 1 CME sponsors requesting pre-approval for a formal program (Category 1-A or Category 1-B credit) must provide written documentation of their needs assessment as tied to the program objectives at the time of the request for credit. 
When there has been no prior approval of a sponsor's CME program, the following language must be used: 

The [NAME OF SPONSOR] has requested that the AOA Council on Continuing Medical Education approve this program for [X] hours of AOA Category 1-A CME credit. Approval is currently pending.

 
On an ongoing schedule, the CCME and AOA staff monitor sponsor compliance (ie, “spot monitoring”) with AOA policies and the CCME-approved uniform guidelines for accrediting agencies of CME.10 Once a sponsor has been selected for review, the AOA will request documentation of their CME activities and then use a checklist (Figure 7) to determine whether all requirements have been met or whether certain deficiencies exist. In addition, CCME and AOA staff investigate all written complaints or deviations from AOA policy using standard compliance-review procedures.10,12 
In the most recent reviews, all but one AOA CME sponsors were in full compliance with the accreditation program. The Council revoked accreditation from the one sponsor for failure to comply with submitting its document survey within its accreditation term. 
The AOA Division of CME continues to provide the following informative materials for AOA-accredited Category 1 CME sponsors on a yearly basis: 
  • Complete list of AOA CME courses submitted by AOA-accredited Category 1 CME sponsors on a quarterly basis to allow sponsors to verify that they have reported all their CME programs to the AOA.
  • AOA Speakers' Bureau Directory every 2 years as approved by the BOT to assist sponsors in obtaining speakers on unique topics.
  • List and mailing labels of DOs who have failed to submit their AOA CME credits to allow sponsors to contact those DOs and encourage them to fulfill their CME requirements.
  • Annual listing of AOA member identification numbers for use in reporting CME credits.
Figure 6.
List of the American Osteopathic Association specialty boards and osteopathic specialty colleges that allow or do not allow specialty continuing medical education (25 hours per CME cycle) for preceptoring according to survey responses as of December 28, 2009.
Figure 6.
List of the American Osteopathic Association specialty boards and osteopathic specialty colleges that allow or do not allow specialty continuing medical education (25 hours per CME cycle) for preceptoring according to survey responses as of December 28, 2009.
Online Calendar
Physician-members have opportunities to earn CME credit from many osteopathic medical organizations. A brief summary of programs sponsored or cosponsored by AOA-accredited CME sponsors is available on the DO-Online calendar, which is accessible through the Calendar link on the navigation bar at the top of the Web site (see http://www.do-online.org). 
Category 1 CME sponsors can directly enter their events in the online CME calendar through a secure online interface. All calendar items are reviewed by the American Osteopathic Information Association before being posted to the site. Sponsors may also e-mail their calendar items to meetings@osteopathic.org. 
Readers with questions or concerns related to calendar updating are encouraged to contact Mike Zarski at mzarski@osteotech.org or (800) 621-1773, extension 8148. 
National CME Sponsors Conference
The AOA's 16th Annual National CME Sponsors Conference was held from January 8, 2010, through January 10, 2010, at the Marriott Newport Beach Hotel in California in conjunction with the 20th Annual Osteopathic Medical Education Leadership Conference. The conference provided sponsors with up-to-date information regarding the latest requirements for maintaining their CME accreditation status. It was intended to help sponsors understand the rationale of CCME directives, clarify those directives as necessary, and explain the trends and evolution of the CME environment. The theme of this year's conference was “Collaborating With Change—Continuing CME Changes.” 
Figure 7.
The number of points awarded for the various items in the American Osteopathic Association (AOA) document on accreditation requirements for Category 1 continuing medical education (CME) sponsors. “Major” items receive 8 points, and “minor” items receive 4 points, for a maximum total score of 100. *Partial credit is awarded based on the proportion of the item that was completed, as follows: 25%=2 points, 50%=4 points, 90%=8 points. †Four extra points may be awarded if outcomes questionnaire documents are submitted within 90 days after completion of program. ‡Partial credit is awarded based on the proportion of the item that was completed, as follows: 50%=2 points, 75%=4 points, 90%=8 points. §If the total score is 90 points or more, a 3-year accreditation is awarded; if 80-89 points, a 2-year accreditation is awarded; if 70-79 points, a 1-year accreditation is awarded; if 60-69 points, a 1-year accreditation is awarded and the sponsor is required to attend the next CME Sponsors Conference; if less than 60 points, accreditation is withdrawn.
Figure 7.
The number of points awarded for the various items in the American Osteopathic Association (AOA) document on accreditation requirements for Category 1 continuing medical education (CME) sponsors. “Major” items receive 8 points, and “minor” items receive 4 points, for a maximum total score of 100. *Partial credit is awarded based on the proportion of the item that was completed, as follows: 25%=2 points, 50%=4 points, 90%=8 points. †Four extra points may be awarded if outcomes questionnaire documents are submitted within 90 days after completion of program. ‡Partial credit is awarded based on the proportion of the item that was completed, as follows: 50%=2 points, 75%=4 points, 90%=8 points. §If the total score is 90 points or more, a 3-year accreditation is awarded; if 80-89 points, a 2-year accreditation is awarded; if 70-79 points, a 1-year accreditation is awarded; if 60-69 points, a 1-year accreditation is awarded and the sponsor is required to attend the next CME Sponsors Conference; if less than 60 points, accreditation is withdrawn.
A total of 81 individual registrants, including speakers, attended this year's National CME Sponsors Conference. The keynote address was delivered by Vicky Gordon, PhD, the chief executive officer of The Gordon Group. Dr. Gordon's presentation, titled “Exceptional Times Require Exceptional Leaders,” identified the new challenges facing leaders of osteopathic medical colleges and hospitals, such as understanding the key leadership competencies required to be an exceptional leader in the 21st century and using feedback to make sure a powerful leadership example is set. 
Conference topics and guest speakers covered a wide range of issues related to CME, such as needs assessments, specialty credit hours, integrating core competencies, and healthcare reform. Detailed information on the program agenda and presentations can be downloaded at https://www.do-online.org/index.cfm?PageID=cme_sponsmain. 
Social networking (ie, breakout) sessions at the annual conference allowed participants to voice their concerns or praise regarding various topics. For example, state societies voiced their concerns and observations regarding grants (eg, applying for grants should be done as soon as possible, having an education foundation may improve results in seeking grants). 
Specialty colleges recommitted to careful review of small specialty colleges' CME programming that might not have an even split of DOs and MDs. In addition, specialty colleges clarified the assignment of specialty credits based on the specialty of the presenter vs the specialty of the target audience. In essence, the boards are the final arbiter for eligibility of credits and the CCME is the administrator. They also emphasized the mandate for a “Planning Committee” rather than staff to determine assignment of specialty credits. 
Hospitals discussed the appropriateness of offering Category 1-A vs. Category 1-B for hospital committee activities, while COMs emphasized the need for timely communication of any changes as well as a need to revise the current definition of “enduring CME.” 
The AOA's 17th Annual National CME Sponsors Conference will be held in January 2011 in Las Vegas, Nevada. Additional information will be posted on DO-Online as it becomes available. 
CME Program Trends and Statistics
The AOA CME program continues to develop annually, as does the proportion of physician-members who have CME requirements from their state or specialty boards (Table 2). As of March 2010, the number of AOA members with state-mandated or specialty-board–mandated CME requirements was 29,137. As of May 31, 2009, AOA membership totaled 40,793. Therefore, approximately 71.4% of AOA members now have a mandated CME requirement. 
Table 2
AOA Members With a CME Requirement


AOA Members, No.
3-Year Cycle
CME Requirement*
Dropped from Membership
1973 to 1976NANA
1977 to 1979 10,373 239
1980 to 198212,050159
1983 to 1985 11,881 298
1986 to 198812,90143
1989 to 1991 16,093 159
1992 to 199416,040146
1995 to 1997 19,315 214
1998 to 200021,383219
2001 to 2003 23,770 259
2004 to 200625,964296
2007 to 2009 30,332 NA
2010 to 2012NANA
 Abbreviation: NA, not available.
 *The number of American Osteopathic Association (AOA) physician-members who have a continuing medical education (CME) requirement are those whose state or specialty boards mandate a CME requirement for relicensure.
 Numbers are not reported for the 1973-1976 CME cycle because the program was in its testing phase during those years.
 Number reported for the 2007-2009 cycle is current as of February 26, 2009.
Table 2
AOA Members With a CME Requirement


AOA Members, No.
3-Year Cycle
CME Requirement*
Dropped from Membership
1973 to 1976NANA
1977 to 1979 10,373 239
1980 to 198212,050159
1983 to 1985 11,881 298
1986 to 198812,90143
1989 to 1991 16,093 159
1992 to 199416,040146
1995 to 1997 19,315 214
1998 to 200021,383219
2001 to 2003 23,770 259
2004 to 200625,964296
2007 to 2009 30,332 NA
2010 to 2012NANA
 Abbreviation: NA, not available.
 *The number of American Osteopathic Association (AOA) physician-members who have a continuing medical education (CME) requirement are those whose state or specialty boards mandate a CME requirement for relicensure.
 Numbers are not reported for the 1973-1976 CME cycle because the program was in its testing phase during those years.
 Number reported for the 2007-2009 cycle is current as of February 26, 2009.
×
The type of CME credit recorded by the AOA has changed over time (Table 3). While earned Category 1-A credit has fluctuated, earned Category 1-B credit has experienced dramatic growth—increasing from 5.7 million hours in the 1995-1997 CME cycle to at least 10.3 million hours in the 2007-2009 CME cycle. 
Table 3
Total Number of CME Credit Hours Recorded (in Millions) by the AOA for Each 3-Year CME Cycle


CME Credit Category

3-Year Cycle
1-A
1-B
2*
Total
1973 to 19761.30.11.12.5
1977 to 1979 1.4 0.8 0.5 2.7
1980 to 19821.51.30.63.4
1983 to 1985 1.5 1.4 0.8 3.7
1986 to 19881.83.01.15.9
1989 to 1991 2.2 3.7 1.3 7.2
1992 to 19942.34.11.27.6
1995 to 1997 2.5 5.7 1.6 9.8
1998 to 20003.07.31.712.0
2001 to 2003 2.9 8.6 1.6 13.1
2004 to 20062.69.22.113.9
2007 to 2009 2.7 10.7 1.8 15.2
2010 to 2012NANANANA
 Abbreviations: AOA, American Osteopathic Association; NA, not available.
 *Numbers reported for continuing medical education (CME) credit Category 2 include all Category 2-A and Category 2-B credit hours recorded.
 Credit hours reported for the 2007-2009 CME cycle are current as of March 16, 2010.
Table 3
Total Number of CME Credit Hours Recorded (in Millions) by the AOA for Each 3-Year CME Cycle


CME Credit Category

3-Year Cycle
1-A
1-B
2*
Total
1973 to 19761.30.11.12.5
1977 to 1979 1.4 0.8 0.5 2.7
1980 to 19821.51.30.63.4
1983 to 1985 1.5 1.4 0.8 3.7
1986 to 19881.83.01.15.9
1989 to 1991 2.2 3.7 1.3 7.2
1992 to 19942.34.11.27.6
1995 to 1997 2.5 5.7 1.6 9.8
1998 to 20003.07.31.712.0
2001 to 2003 2.9 8.6 1.6 13.1
2004 to 20062.69.22.113.9
2007 to 2009 2.7 10.7 1.8 15.2
2010 to 2012NANANANA
 Abbreviations: AOA, American Osteopathic Association; NA, not available.
 *Numbers reported for continuing medical education (CME) credit Category 2 include all Category 2-A and Category 2-B credit hours recorded.
 Credit hours reported for the 2007-2009 CME cycle are current as of March 16, 2010.
×
The number of DOs whose AOA memberships were dropped as a result of failure to complete the CME requirement has fluctuated between a high of 298 members in the 1983-1985 CME cycle and a low of 43 members in the 1986-1988 CME cycle (Table 2). Association members are given a 17-month grace period to fulfill requirements from the previous CME cycle. A total of 296 members were dropped from membership on May 31, 2008, for not meeting the 2004-2006 CME requirement. Data for the 2007-2009 CME cycle will not be available until May 31, 2011. 
Similarly, the total number of CME credit hours recorded by the AOA has increased considerably during each successive 3-year CME cycle (Table 3). This growth is a reflection of the increasing number of AOA members who have state-mandated or specialty-board–mandated CME requirements and of the steadily increasing average number of CME credit hours recorded per member. 
PhRMA Code on Interactions With Healthcare Professionals
As previously indicated, the Pharmaceutical Research and Manufacturers of America (PhRMA) unveiled revised industry guidelines in July 2008 restricting pharmaceutical company sales representatives from providing gifts (eg, food, pens, coffee mugs, trips to resorts) to physicians.13 The revised rules are intended to end a problem that has bedeviled pharmaceutical marketers for years—the negative image of the drug company representative, armed with pizza and restaurant gift certificates, inviting a prescribing physician out for a golf game. Critics have bemoaned such gifts as bribes that sway physicians away from the best interests of their patients. 
The 36-page document containing the revised PhRMA guidelines13 has 15 main rules, which went into effect in January 2009. The most important changes to the previous guidelines are the following: (1) a complete ban on giving free meals to physicians when the meals have no educational value, and (2) a complete ban on taking physicians to entertainment or recreational events, such as golf and baseball games. Sales representatives are allowed to provide occasional, modest meals to physicians, but only in the settings of physician offices or hospitals and in conjunction with educational presentations. 
The complete new PhRMA code can be viewed at http://www.phrma.org/files/attachments/PhRMA%20Marketing%20Code%202008.pdf. This and other regulatory organizations and government agencies that provide information to physicians regarding guidelines and regulations related to the commercial support of CME are listed in Figure 8. 
CEJA Report on Industry Funding of CME
The AMA Committee on Ethics and Judicial Affairs (CEJA) proposed a report last year that would prohibit commercial support for CME. The report, “Financial Relationships with Industry in Continuing Medical Education,” was developed by CEJA to provide “an ethical framework to guide professional practice with respect to financial relationships in the context of [CME].” It was referred back to CEJA, which held a round table discussion last January. A new report was reviewed at the America Medical Association House of Delegates in October 2009, but the revise report was again referred back to CEJA. This is the third time it has been sent back for more work by the AMA House of Delegates. 
Comment
Continuing medical education consists of educational activities that serve to maintain, develop, or increase the knowledge, skills, and professional abilities of physicians. These qualties help physicians provide quality services to patients. The content of CME is that body of knowledge and skills generally recognized and accepted by the profession as within the basic medical sciences, the discipline of clinical medicine, and the provision of healthcare to the public. 
Figure 8.
Regulatory organizations and government agencies that provide information to physicians regarding guidelines and regulations related to the commercial support of continuing medical education (CME).
Figure 8.
Regulatory organizations and government agencies that provide information to physicians regarding guidelines and regulations related to the commercial support of continuing medical education (CME).
The CCME continues to be committed to an agenda of progress in AOA CME policies, including maintaining the high standards for which the AOA is known. The Council also continues to study the changing environment of osteopathic medicine, particularly as it relates to osteopathic specialty board certification, and to adjust the AOA CME program to respond to the ever-evolving needs of the public, physician-members, and the AOA. 
 Editor's Note: Although most articles in The JOURNAL's annual osteopathic medical education theme issue focus on recent changes to programming and updates to demographic data within the profession, the current article—though it also provides such summative information—is intended as an accessible and fairly comprehensive point of reference for the 71.4% of American Osteopathic Association members who have continuing medical education requirements.
 
Rodgers DJ. AOA continuing medical education. J Am Osteopath Assoc. 2003;103(11):531-538. http://www.jaoa.org/cgi/reprint/103/11/531. Accessed March 9, 2010.
Division of Continuing Medical Education. Continuing Medical Education Guide, 2007-2009: Guide for Osteopathic Physicians, December 2006. Chicago, Ill: American Osteopathic Association; 2006. http://www.do-online.osteotech.org/pdf/cme_guidemain07-09.pdf. Accessed March 9, 2010.
Apply for your American Medical Association Physician's Recognition Award page. American Medical Association Web site. http://www.ama-assn.org/ama1/pub/upload/mm/455/praapplication.pdf. Accessed March 9, 2010.
Verification & maintenance of certification. American Osteopathic Board of Family Physicians Web site; 2000. http://www.aobfp.org/verification-cert/index.html. Accessed March 9, 2010.
Physician licensing overview. American Osteopathic Association. http://www.osteopathic.org/index.cfm?PageID=ado_license. Accessed March 9, 2010.
Division of State and Socioeconomic Affairs. US Osteopathic Licensure Summary, October 2009. Chicago, Ill: American Osteopathic Association; 2009.
Rodgers DJ. Osteopathic continuing medical education. J Am Osteopath Assoc. 2007;107(2):67-81. http://www.jaoa.org/cgi/content/full/107/2/67. Accessed March 9, 2010.
Rodgers DJ. AOA continuing medical education. J Am Osteopath Assoc. 2009;109(3):160-179. http://www.jaoa.org/cgi/content/full/109/3/160. Accessed March 9, 2010.
Continuing Medical Education 2010-2012: Guide for Osteopathic Physicians. Chicago, IL: American Osteopathic Association; December 2009. http://www.osteopathic.org/pdf/CME_Guide2010-2012.pdf. Accessed March 9, 2010.
Division of Continuing Medical Education. Accreditation Requirements: Category 1 CME Sponsors. Chicago, Ill: American Osteopathic Association; 2007. http://do-online.org/pdf/acc_cmespo.pdf. Accessed March 9, 2010.
Ayres RE, Scheinthal S, Ramirez AF, Bell EC. Osteopathic certification evolving into a continuous certification model. J Am Osteopath Assoc. 2008;108(3):159-165. http://www.jaoa.org/cgi/content/full/108/3/159. Accessed March 9, 2010.
Rodgers DJ. AOA continuing medical education [published correction appears in J Am Osteopath Assoc. 2004;104(12):514]. J Am Osteopath Assoc. 2004;104(11):493-502. http://www.jaoa.org/cgi/content/full/104/11/493. Accessed March 9, 2010.
Pharmaceutical Research and Manufacturers of America. Code on Interactions With Healthcare Professionals. Washington, DC: Pharmaceutical Research and Manufacturers of America; July 2008. http://www.phrma.org/files/attachments/PhRMA%20Marketing%20Code%202008.pdf. Accessed March 9, 2010.
Figure 1.
Members of the American Osteopathic Association (AOA) exempted from the AOA's continuing medical education (CME) credit-hour requirements. Lifetime members in active practice have a CME requirement. The AOA may grant exemptions, waivers, or reduction in credit hours only if due cause or inability to obtain hours is demonstrated to the Council on Continuing Medical Education (CCME).
Figure 1.
Members of the American Osteopathic Association (AOA) exempted from the AOA's continuing medical education (CME) credit-hour requirements. Lifetime members in active practice have a CME requirement. The AOA may grant exemptions, waivers, or reduction in credit hours only if due cause or inability to obtain hours is demonstrated to the Council on Continuing Medical Education (CCME).
Figure 2.
The four categories of continuing medical education (CME) credits granted by the American Osteopathic Association (AOA).
Figure 2.
The four categories of continuing medical education (CME) credits granted by the American Osteopathic Association (AOA).
Figure 3.
*The optional Category 1-A requirements listed in this figure are interchangeable. One may select 90 additional hours from any of the four continuing medical education (CME) credit types and in any combination, as long as the mandatory 30-hour requirement for Category 1 credit hours is met. †Osteopathic physicians who exceed the maximum limit of 15 credit hours of Category 1-A CME credit for faculty development programs can apply those excess credit hours to Category 1-B CME credit if the programs were provided by a Category 1 CME sponsor accredited by the American Osteopathic Association (AOA). ‡Content was previously assigned to Category 1-A. §The JAOA grants 2 hours of Category 1-B CME credit to osteopathic physicians who complete quizzes on the scientific content in the JAOA and its supplements. To apply for CME credit, AOA members who are registered users of DO-Online can take JAOA CME quizzes online (http://www.docmeonline.com). Alternatively, readers can complete the JAOA quiz and mail it with their AOA member number to the Division of CME. //Physicians who obtain 150 hours of CME credit in a 3-year CME cycle are recognized and awarded an AOA Certificate of Excellence in CME. Abbreviations: AAFP, American Academy of Family Physicians; ACCME, Accreditation Council for Continuing Medical Education; CCME, Council on Continuing Medical Education; COMLEX-USA Level 2-PE, Comprehensive Osteopathic Medical Licensing Examination-USA Level 2-Performance Evaluation; NBOME, National Board of Osteopathic Medical Examiners. Source: Continuing Medical Education Guide, 2010-2012: Guide for Osteopathic Physicians, December 2009.9
Figure 3.
*The optional Category 1-A requirements listed in this figure are interchangeable. One may select 90 additional hours from any of the four continuing medical education (CME) credit types and in any combination, as long as the mandatory 30-hour requirement for Category 1 credit hours is met. †Osteopathic physicians who exceed the maximum limit of 15 credit hours of Category 1-A CME credit for faculty development programs can apply those excess credit hours to Category 1-B CME credit if the programs were provided by a Category 1 CME sponsor accredited by the American Osteopathic Association (AOA). ‡Content was previously assigned to Category 1-A. §The JAOA grants 2 hours of Category 1-B CME credit to osteopathic physicians who complete quizzes on the scientific content in the JAOA and its supplements. To apply for CME credit, AOA members who are registered users of DO-Online can take JAOA CME quizzes online (http://www.docmeonline.com). Alternatively, readers can complete the JAOA quiz and mail it with their AOA member number to the Division of CME. //Physicians who obtain 150 hours of CME credit in a 3-year CME cycle are recognized and awarded an AOA Certificate of Excellence in CME. Abbreviations: AAFP, American Academy of Family Physicians; ACCME, Accreditation Council for Continuing Medical Education; CCME, Council on Continuing Medical Education; COMLEX-USA Level 2-PE, Comprehensive Osteopathic Medical Licensing Examination-USA Level 2-Performance Evaluation; NBOME, National Board of Osteopathic Medical Examiners. Source: Continuing Medical Education Guide, 2010-2012: Guide for Osteopathic Physicians, December 2009.9
Figure 4.
Osteopathic physicians should verify the material reported here with their state licensing boards as listed on http://www.osteopathic.org/index/.cfm?PageID=ado_license. The information provided in this figure is reported annually to the American Osteopathic Association (AOA) directly from each state licensing board and is compiled here for the convenience of AOA members. The exact wording provided by the state licensing boards is preserved in this figure where possible. The AOA takes no responsibility for changes to state guidelines made immediately before publication or for errors in reporting from state licensing boards. Material that is new since the publication of the JAOA`s 2008 Osteopathic Medical Education issue is indicated in boldface. *Connecticut and the District of Columbia previously had no continuing medical education (CME). †Florida limits the number of CME credit hours that osteopathic physicians can obtain from sources approved by the American Medical Association (AMA) to 13. Abbreviations: ABMS, American Board of Medical Specialties; ACCME, Accreditation Council for Continuing Medical Education; CCME, Council on Continuing Medical Education; HIV/AIDS, human immunodeficiency virus/acquired immunodeficiency syndrome; OSHA, US Department of Labor Occupational Safety and Health Administration. Source: US Osteopathic Licensure Summary, October 2009.6
Figure 4.
Osteopathic physicians should verify the material reported here with their state licensing boards as listed on http://www.osteopathic.org/index/.cfm?PageID=ado_license. The information provided in this figure is reported annually to the American Osteopathic Association (AOA) directly from each state licensing board and is compiled here for the convenience of AOA members. The exact wording provided by the state licensing boards is preserved in this figure where possible. The AOA takes no responsibility for changes to state guidelines made immediately before publication or for errors in reporting from state licensing boards. Material that is new since the publication of the JAOA`s 2008 Osteopathic Medical Education issue is indicated in boldface. *Connecticut and the District of Columbia previously had no continuing medical education (CME). †Florida limits the number of CME credit hours that osteopathic physicians can obtain from sources approved by the American Medical Association (AMA) to 13. Abbreviations: ABMS, American Board of Medical Specialties; ACCME, Accreditation Council for Continuing Medical Education; CCME, Council on Continuing Medical Education; HIV/AIDS, human immunodeficiency virus/acquired immunodeficiency syndrome; OSHA, US Department of Labor Occupational Safety and Health Administration. Source: US Osteopathic Licensure Summary, October 2009.6
Figure 5.
The maximum numbers of credit hours granted per cycle for the continuing medical education (CME) activities noted here were specified in the Bureau of Osteopathic Specialists' “template” responses, approved by the American Osteopathic Association (AOA) Board of Trustees in February 2006 (Resolution 45 [M/2006]—Specialty CME Reporting). *All activities must be related to the specialty for CME credit. Credit is awarded on an hour-by-hour basis for AOA specialty college seminars. For each other type of seminar, the number of maximum credit hours per cycle varies. For example, a maximum of 5 credit hours is allowed for human immunodeficiency virus/acquired immunodeficiency syndrome and risk management seminars; a maximum of 15 credit hours is allowed for test construction and publications seminars; and a maximum of 25 credit hours is allowed for AOA state society, foundation, and college of osteopathic medicine seminars. A maximum of 25 credit hours are granted for preceptoring only if a board indicated in its Council on Continuing Medical Education survey that it accepts such credit. Each board makes its own recommendation for maximum credit hours allowed for participating in the AOA Annual Convention and Scientific Seminar. †The full name of this board is the American Osteopathic Boards of Ophthalmology and Otolaryngology-Head and Neck Surgery. ‡Credit awarded on an hour-by hour basis. Abbreviation: ACCME, Accreditation Council for Continuing Medical Education; NA, not applicable.
Figure 5.
The maximum numbers of credit hours granted per cycle for the continuing medical education (CME) activities noted here were specified in the Bureau of Osteopathic Specialists' “template” responses, approved by the American Osteopathic Association (AOA) Board of Trustees in February 2006 (Resolution 45 [M/2006]—Specialty CME Reporting). *All activities must be related to the specialty for CME credit. Credit is awarded on an hour-by-hour basis for AOA specialty college seminars. For each other type of seminar, the number of maximum credit hours per cycle varies. For example, a maximum of 5 credit hours is allowed for human immunodeficiency virus/acquired immunodeficiency syndrome and risk management seminars; a maximum of 15 credit hours is allowed for test construction and publications seminars; and a maximum of 25 credit hours is allowed for AOA state society, foundation, and college of osteopathic medicine seminars. A maximum of 25 credit hours are granted for preceptoring only if a board indicated in its Council on Continuing Medical Education survey that it accepts such credit. Each board makes its own recommendation for maximum credit hours allowed for participating in the AOA Annual Convention and Scientific Seminar. †The full name of this board is the American Osteopathic Boards of Ophthalmology and Otolaryngology-Head and Neck Surgery. ‡Credit awarded on an hour-by hour basis. Abbreviation: ACCME, Accreditation Council for Continuing Medical Education; NA, not applicable.
Figure 6.
List of the American Osteopathic Association specialty boards and osteopathic specialty colleges that allow or do not allow specialty continuing medical education (25 hours per CME cycle) for preceptoring according to survey responses as of December 28, 2009.
Figure 6.
List of the American Osteopathic Association specialty boards and osteopathic specialty colleges that allow or do not allow specialty continuing medical education (25 hours per CME cycle) for preceptoring according to survey responses as of December 28, 2009.
Figure 7.
The number of points awarded for the various items in the American Osteopathic Association (AOA) document on accreditation requirements for Category 1 continuing medical education (CME) sponsors. “Major” items receive 8 points, and “minor” items receive 4 points, for a maximum total score of 100. *Partial credit is awarded based on the proportion of the item that was completed, as follows: 25%=2 points, 50%=4 points, 90%=8 points. †Four extra points may be awarded if outcomes questionnaire documents are submitted within 90 days after completion of program. ‡Partial credit is awarded based on the proportion of the item that was completed, as follows: 50%=2 points, 75%=4 points, 90%=8 points. §If the total score is 90 points or more, a 3-year accreditation is awarded; if 80-89 points, a 2-year accreditation is awarded; if 70-79 points, a 1-year accreditation is awarded; if 60-69 points, a 1-year accreditation is awarded and the sponsor is required to attend the next CME Sponsors Conference; if less than 60 points, accreditation is withdrawn.
Figure 7.
The number of points awarded for the various items in the American Osteopathic Association (AOA) document on accreditation requirements for Category 1 continuing medical education (CME) sponsors. “Major” items receive 8 points, and “minor” items receive 4 points, for a maximum total score of 100. *Partial credit is awarded based on the proportion of the item that was completed, as follows: 25%=2 points, 50%=4 points, 90%=8 points. †Four extra points may be awarded if outcomes questionnaire documents are submitted within 90 days after completion of program. ‡Partial credit is awarded based on the proportion of the item that was completed, as follows: 50%=2 points, 75%=4 points, 90%=8 points. §If the total score is 90 points or more, a 3-year accreditation is awarded; if 80-89 points, a 2-year accreditation is awarded; if 70-79 points, a 1-year accreditation is awarded; if 60-69 points, a 1-year accreditation is awarded and the sponsor is required to attend the next CME Sponsors Conference; if less than 60 points, accreditation is withdrawn.
Figure 8.
Regulatory organizations and government agencies that provide information to physicians regarding guidelines and regulations related to the commercial support of continuing medical education (CME).
Figure 8.
Regulatory organizations and government agencies that provide information to physicians regarding guidelines and regulations related to the commercial support of continuing medical education (CME).
Table 1
AOA-Accredited Category 1 CME Sponsors (N=157) *

Organization

No. (%)
Affiliates
□ Nonpractice (AOA) NA
□ Female2 (<1)
Colleges
□ Colleges of osteopathic medicine (AOA accredited)20 (12)
— Alumni groups NA
□ Specialty (AOA affliated)NA
Foundations (AOA affiliated) 8 (5)
Hospitals45 (28)
Military 1 (<1)
Philanthropic organizations (AOA affiliated)NA
Professional associations 1 (<1)
Societies
□ Divisional (AOA affliated) NA
□ Specialty27 (17)
□ State 53 (33)
 Abbreviations: AOA, American Osteopathic Association; NA, not applicable.
 *The number of continuing medical education (CME) sponsors in each category are accurate as of February 10, 2010. Percentages do not total 100 because of rounding.
 Applications for sponsorship are currently limited to the organizations indicated.
 The 53 state societies noted include all state societies, county societies, and state district societies (eg, Florida has a state osteopathic medical association, a county association, and seperate district societies: Broward County, District 7: and Southwest, District 11).
Table 1
AOA-Accredited Category 1 CME Sponsors (N=157) *

Organization

No. (%)
Affiliates
□ Nonpractice (AOA) NA
□ Female2 (<1)
Colleges
□ Colleges of osteopathic medicine (AOA accredited)20 (12)
— Alumni groups NA
□ Specialty (AOA affliated)NA
Foundations (AOA affiliated) 8 (5)
Hospitals45 (28)
Military 1 (<1)
Philanthropic organizations (AOA affiliated)NA
Professional associations 1 (<1)
Societies
□ Divisional (AOA affliated) NA
□ Specialty27 (17)
□ State 53 (33)
 Abbreviations: AOA, American Osteopathic Association; NA, not applicable.
 *The number of continuing medical education (CME) sponsors in each category are accurate as of February 10, 2010. Percentages do not total 100 because of rounding.
 Applications for sponsorship are currently limited to the organizations indicated.
 The 53 state societies noted include all state societies, county societies, and state district societies (eg, Florida has a state osteopathic medical association, a county association, and seperate district societies: Broward County, District 7: and Southwest, District 11).
×
Table 2
AOA Members With a CME Requirement


AOA Members, No.
3-Year Cycle
CME Requirement*
Dropped from Membership
1973 to 1976NANA
1977 to 1979 10,373 239
1980 to 198212,050159
1983 to 1985 11,881 298
1986 to 198812,90143
1989 to 1991 16,093 159
1992 to 199416,040146
1995 to 1997 19,315 214
1998 to 200021,383219
2001 to 2003 23,770 259
2004 to 200625,964296
2007 to 2009 30,332 NA
2010 to 2012NANA
 Abbreviation: NA, not available.
 *The number of American Osteopathic Association (AOA) physician-members who have a continuing medical education (CME) requirement are those whose state or specialty boards mandate a CME requirement for relicensure.
 Numbers are not reported for the 1973-1976 CME cycle because the program was in its testing phase during those years.
 Number reported for the 2007-2009 cycle is current as of February 26, 2009.
Table 2
AOA Members With a CME Requirement


AOA Members, No.
3-Year Cycle
CME Requirement*
Dropped from Membership
1973 to 1976NANA
1977 to 1979 10,373 239
1980 to 198212,050159
1983 to 1985 11,881 298
1986 to 198812,90143
1989 to 1991 16,093 159
1992 to 199416,040146
1995 to 1997 19,315 214
1998 to 200021,383219
2001 to 2003 23,770 259
2004 to 200625,964296
2007 to 2009 30,332 NA
2010 to 2012NANA
 Abbreviation: NA, not available.
 *The number of American Osteopathic Association (AOA) physician-members who have a continuing medical education (CME) requirement are those whose state or specialty boards mandate a CME requirement for relicensure.
 Numbers are not reported for the 1973-1976 CME cycle because the program was in its testing phase during those years.
 Number reported for the 2007-2009 cycle is current as of February 26, 2009.
×
Table 3
Total Number of CME Credit Hours Recorded (in Millions) by the AOA for Each 3-Year CME Cycle


CME Credit Category

3-Year Cycle
1-A
1-B
2*
Total
1973 to 19761.30.11.12.5
1977 to 1979 1.4 0.8 0.5 2.7
1980 to 19821.51.30.63.4
1983 to 1985 1.5 1.4 0.8 3.7
1986 to 19881.83.01.15.9
1989 to 1991 2.2 3.7 1.3 7.2
1992 to 19942.34.11.27.6
1995 to 1997 2.5 5.7 1.6 9.8
1998 to 20003.07.31.712.0
2001 to 2003 2.9 8.6 1.6 13.1
2004 to 20062.69.22.113.9
2007 to 2009 2.7 10.7 1.8 15.2
2010 to 2012NANANANA
 Abbreviations: AOA, American Osteopathic Association; NA, not available.
 *Numbers reported for continuing medical education (CME) credit Category 2 include all Category 2-A and Category 2-B credit hours recorded.
 Credit hours reported for the 2007-2009 CME cycle are current as of March 16, 2010.
Table 3
Total Number of CME Credit Hours Recorded (in Millions) by the AOA for Each 3-Year CME Cycle


CME Credit Category

3-Year Cycle
1-A
1-B
2*
Total
1973 to 19761.30.11.12.5
1977 to 1979 1.4 0.8 0.5 2.7
1980 to 19821.51.30.63.4
1983 to 1985 1.5 1.4 0.8 3.7
1986 to 19881.83.01.15.9
1989 to 1991 2.2 3.7 1.3 7.2
1992 to 19942.34.11.27.6
1995 to 1997 2.5 5.7 1.6 9.8
1998 to 20003.07.31.712.0
2001 to 2003 2.9 8.6 1.6 13.1
2004 to 20062.69.22.113.9
2007 to 2009 2.7 10.7 1.8 15.2
2010 to 2012NANANANA
 Abbreviations: AOA, American Osteopathic Association; NA, not available.
 *Numbers reported for continuing medical education (CME) credit Category 2 include all Category 2-A and Category 2-B credit hours recorded.
 Credit hours reported for the 2007-2009 CME cycle are current as of March 16, 2010.
×