Free
AOA Communication  |   April 2012
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   |   April 2012
AOA Continuing Medical Education
The Journal of the American Osteopathic Association, April 2012, Vol. 112, 211-224. doi:10.7556/jaoa.2012.112.4.211
The Journal of the American Osteopathic Association, April 2012, Vol. 112, 211-224. doi:10.7556/jaoa.2012.112.4.211
Abstract

The author provides an update on the current continuing medical education (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 American Osteopathic Association (AOA) and describes new online CME opportunities to be used as a pilot program. The current article includes an update on the final action approved by the AOA Board of Trustees regarding the Education Policy and Procedure Review Committee III recommendation relating to the AOA CME program. In addition, the article contains an update to assist osteopathic specialists and subspecialists in requesting AOA Category 1-A credit for American Medical Association Physician Recognition Award Category 1 courses.

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 members 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 (ie, DOs) in order to facilitate ongoing improvement in the quality of patient care. 
The CCME encourages voluntary participation in CME by AOA nonmember DOs. However, all members of the AOA, other than those otherwise exempted (Figure), are required to participate in the AOA CME program and to meet specific CME credit-hour requirements for each 3-year CME cycle. 
Figure.
Members of the American Osteopathic Association (AOA) exempted from the AOA's continuing medical education (CME) credit 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.
Members of the American Osteopathic Association (AOA) exempted from the AOA's continuing medical education (CME) credit 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).
In the present article, I provide an update on the AOA CME program for the new CME cycle, which will begin on January 1, 2013, and will end on December 31, 2015. Topic areas include recent changes in CME policies and the continuing challenges with awarding and recording CME credits for osteopathic physicians who hold specialty board certification. More detailed information regarding CME guidelines for the current CME cycle is provided in Continuing Medical Education 2010-2012: Guide for Osteopathic Physicians.1 
Credits
Continuing medical education credits are granted by the AOA from any of the 4 following categories: 1-A, 1-B, 2-A, or 2-B (Table 1). In general, CME credit from Category 1 is for osteopathic (ie, AOA-accredited) activities; Category 2 credit is for nonosteopathic activities; type A credit is 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. 
Table 1.
Categories of Continuing Medical Education Credits Granted by the American Osteopathic Association
Type
Category A – Formal B – Less Formal
1 – Osteopathic 1-A 1-B
2 – Nonosteopathic 2-A 2-B
Table 1.
Categories of Continuing Medical Education Credits Granted by the American Osteopathic Association
Type
Category A – Formal B – Less Formal
1 – Osteopathic 1-A 1-B
2 – Nonosteopathic 2-A 2-B
×
At its February 2003 meeting, the AOA Board of Trustees (BOT) set the CME requirement for AOA membership at 120 credits, with a minimum of 30 credits dedicated to Category 1-A.2 The remaining 90 credits of the 120-credit requirement may be obtained by combining CME credits earned from any of the 4 credit categories (ie, 1-A, 1-B, 2-A, or 2-B). A maximum of 60 Category 1-B credits for osteopathic preceptoring may be applied to the basic 120-credit requirement. In addition, the AOA, like the American Medical Association (AMA),3 awards a Certificate of Excellence to physicians who demonstrate exceptional commitments to CME.1 A more detailed description of how CME credit is categorized by the AOA is provided in Table 2. As stated in the 2010-2012 CME cycle guide,1 CME credit is not awarded for volunteer work, postgraduate studies toward advanced degrees, or medical facility tours. No credit is awarded for preceptoring physician assistant students. 
Table 2.
AOA CME Program, 2010-2012: Categories and Basic Requirements for CME Credits Awarded in 3-Year Cycle
Credit Requirement
Category and Content Mandatory Optionala
Category 1
Category 1-A 30 90
Formal education programs sponsored by AOA-accredited CME sponsors
Osteopathic medical teaching
CME on the Internet (real-time, interactive simultaneous conferencing; includes pre- and posttest; allows participants to ask questions during or after presentation; maximum: 9 credits)
Risk management and managed care programs (AOA sponsored, clinical in nature, and meet the faculty requirement for AOA Category 1-A CME credit)
Standardized federal aviation courses (aviation medicine and flight surgeon primary course)
Federal programs (for participants who are on active duty in the US military or are employed by a uniformed service)
Grand rounds (when submitted as a “series of programs,” as opposed to being submitted on a lecture-by-lecture basis)
Faculty development programs (maximum: 15 credits)b
Judging osteopathic clinical case presentations and research poster presentations (maximum: 10 credits)
Standardized life support courses (maximum: 8 credits)c
Bioterrorism programs that are AOA accredited (face-to-face) (maximum: 8 credits)c
Category 1-B 90
Development and publication of scientific papers and electronically communicated programs intended for physician education
Osteopathic preceptoring (maximum: 60 credits)
Administering certifying board examinations and conducting inspections of osteopathic health care facilities, colleges, and osteopathic postdoctoral training institutions
Passing an AOA recertification examination or a Certification of Added Qualifications examination (maximum: 15 credits)
Attendance at committee and departmental meetings for the review and evaluation of patient care at either an osteopathic or allopathic institution
CME on the Internet (not real-time, interactive conferencing; maximum: 9 credits)
Reading the JAOA or its supplements and passing a JAOA CME quizd
Faculty development programs (AOA sponsored)
Managed care programs (if the faculty requirement is not met)
Risk management programs (administrative in nature)
Federal programs
Journal reading (scientific journals approved by the AOA's CCME and passing the respective CME quiz with a minimum grade of 70%)
Test construction committee work (written test item submitted to an official AOA certifying board or NBOME [maximum: 20 credits] or used in oral or practical examinations [maximum: 10 credits]; clinical cases when developed and submitted to NBOME for COMLEX-USA Level 2-PE [maximum: 20 credits])
Postgraduate in-service examination committee work (specialty boards)
Other osteopathic CME activities approved by the AOA's CCME
Category 2
Category 2-A 90
Formal educational programs that are designed to enhance clinical competency and improve patient care that are sponsored by entities that meet the quality standards of the AOA, the AMA PRA, or the AAFP
CME on the Internet (real-time, interactive conferencing; includes pre- and posttest; allows participants to ask questions during or after presentation)
Risk management programs (clinical in nature, AMA PRA Category 1 sponsored, and AAFP approved)
Bioterrorism programs that are AMA PRA Category 1 accredited or AAFP approved (face-to-face)
Managed care programs (clinical in nature, AMA PRA Category 1 sponsored, and AAFP approved)
Category 2-B 90
Journal-type CME on the Internet
Home study
Scientific exhibit preparation and presentation
CME on the Internet
Risk management programs (administrative in nature)
Passing an American Board of Medical Specialties recertification examination or a Certification of Added Qualifications examination (maximum: 15 credits)
Other CME activities approved by the AOAs CCME
Total CME Requirement 120e
  a The optional Category 1-A requirements listed in this figure are interchangeable. One may select 90 additional credits from any of the 4 continuing medical education (CME) credit types and in any combination, as long as the mandatory 30-credit requirement for Category 1 credit is met.
  b Osteopathic physicians who exceed the maximum limit of 15 Category 1-A CME credits for faculty development programs can apply those excess credits to Category 1-B CME credit if the programs were provided by a Category 1 CME sponsor accredited by the American Osteopathic Association (AOA).
  c Osteopathic physicians who exceed the maximum limit of 8 credits of Category 1-A CME credit in these programs can apply those excess credit hours to Category 1-B CME credit up to the limits indicated in the 2010-2012 CME guide.
  d JAOA—The Journal of the American Osteopathic Association grants 2 Category 1-B CME credits 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 Osteopathic.org can take the quizzes online (http://www.osteopathic.org/quiz). Alternatively, readers can complete the JAOA quiz and mail it with their AOA member number to the Division of CME.
  e Physicians who obtain 150 CME credits in a 3-year CME cycle are recognized and awarded an AOA Certificate of Excellence in CME.
  Abbreviations: AAFP, American Academy of Family Physicians; AMA PRA, American Medical Association Physician Recognition Award; 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 2010-2012: Guide for Osteopathic Physicians.1
Table 2.
AOA CME Program, 2010-2012: Categories and Basic Requirements for CME Credits Awarded in 3-Year Cycle
Credit Requirement
Category and Content Mandatory Optionala
Category 1
Category 1-A 30 90
Formal education programs sponsored by AOA-accredited CME sponsors
Osteopathic medical teaching
CME on the Internet (real-time, interactive simultaneous conferencing; includes pre- and posttest; allows participants to ask questions during or after presentation; maximum: 9 credits)
Risk management and managed care programs (AOA sponsored, clinical in nature, and meet the faculty requirement for AOA Category 1-A CME credit)
Standardized federal aviation courses (aviation medicine and flight surgeon primary course)
Federal programs (for participants who are on active duty in the US military or are employed by a uniformed service)
Grand rounds (when submitted as a “series of programs,” as opposed to being submitted on a lecture-by-lecture basis)
Faculty development programs (maximum: 15 credits)b
Judging osteopathic clinical case presentations and research poster presentations (maximum: 10 credits)
Standardized life support courses (maximum: 8 credits)c
Bioterrorism programs that are AOA accredited (face-to-face) (maximum: 8 credits)c
Category 1-B 90
Development and publication of scientific papers and electronically communicated programs intended for physician education
Osteopathic preceptoring (maximum: 60 credits)
Administering certifying board examinations and conducting inspections of osteopathic health care facilities, colleges, and osteopathic postdoctoral training institutions
Passing an AOA recertification examination or a Certification of Added Qualifications examination (maximum: 15 credits)
Attendance at committee and departmental meetings for the review and evaluation of patient care at either an osteopathic or allopathic institution
CME on the Internet (not real-time, interactive conferencing; maximum: 9 credits)
Reading the JAOA or its supplements and passing a JAOA CME quizd
Faculty development programs (AOA sponsored)
Managed care programs (if the faculty requirement is not met)
Risk management programs (administrative in nature)
Federal programs
Journal reading (scientific journals approved by the AOA's CCME and passing the respective CME quiz with a minimum grade of 70%)
Test construction committee work (written test item submitted to an official AOA certifying board or NBOME [maximum: 20 credits] or used in oral or practical examinations [maximum: 10 credits]; clinical cases when developed and submitted to NBOME for COMLEX-USA Level 2-PE [maximum: 20 credits])
Postgraduate in-service examination committee work (specialty boards)
Other osteopathic CME activities approved by the AOA's CCME
Category 2
Category 2-A 90
Formal educational programs that are designed to enhance clinical competency and improve patient care that are sponsored by entities that meet the quality standards of the AOA, the AMA PRA, or the AAFP
CME on the Internet (real-time, interactive conferencing; includes pre- and posttest; allows participants to ask questions during or after presentation)
Risk management programs (clinical in nature, AMA PRA Category 1 sponsored, and AAFP approved)
Bioterrorism programs that are AMA PRA Category 1 accredited or AAFP approved (face-to-face)
Managed care programs (clinical in nature, AMA PRA Category 1 sponsored, and AAFP approved)
Category 2-B 90
Journal-type CME on the Internet
Home study
Scientific exhibit preparation and presentation
CME on the Internet
Risk management programs (administrative in nature)
Passing an American Board of Medical Specialties recertification examination or a Certification of Added Qualifications examination (maximum: 15 credits)
Other CME activities approved by the AOAs CCME
Total CME Requirement 120e
  a The optional Category 1-A requirements listed in this figure are interchangeable. One may select 90 additional credits from any of the 4 continuing medical education (CME) credit types and in any combination, as long as the mandatory 30-credit requirement for Category 1 credit is met.
  b Osteopathic physicians who exceed the maximum limit of 15 Category 1-A CME credits for faculty development programs can apply those excess credits to Category 1-B CME credit if the programs were provided by a Category 1 CME sponsor accredited by the American Osteopathic Association (AOA).
  c Osteopathic physicians who exceed the maximum limit of 8 credits of Category 1-A CME credit in these programs can apply those excess credit hours to Category 1-B CME credit up to the limits indicated in the 2010-2012 CME guide.
  d JAOA—The Journal of the American Osteopathic Association grants 2 Category 1-B CME credits 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 Osteopathic.org can take the quizzes online (http://www.osteopathic.org/quiz). Alternatively, readers can complete the JAOA quiz and mail it with their AOA member number to the Division of CME.
  e Physicians who obtain 150 CME credits in a 3-year CME cycle are recognized and awarded an AOA Certificate of Excellence in CME.
  Abbreviations: AAFP, American Academy of Family Physicians; AMA PRA, American Medical Association Physician Recognition Award; 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 2010-2012: Guide for Osteopathic Physicians.1
×
The Division of CME officially closed the 2007-2009 CME cycle on May 31, 2011. In the past, AOA members have had 17 months from the close of a CME cycle to submit documentation of earned CME. At the close of the 2010-2012 CME cycle, which is December 31, 2012, AOA members will have 5 months to submit their documentation. In other words, if a physician does not meet the CME requirement for the 2010-2012 cycle by May 31, 2013, that physician will lose his or her AOA Membership (ie, become a nonmember of the AOA). If he or she is AOA-board certified, he or she will lose that certification. The CCME considers exemptions, reductions, and waivers to its CME requirements on a case-by-case basis. However, no waiver for this 120-credit requirement will be granted unless due cause or inability to obtain credits are demonstrated to the CCME. 
For new AOA physician-members, CME requirements are 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-credit requirement for CME, 50 Category 1 or Category 2 credits 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,4 the American Osteopathic Board of Anesthesiology,5 and the American Osteopathic Board of Neuromusculoskeletal Medicine6 is higher, at 150 credits per 3-year CME cycle. 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 later in 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 (ie, 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. As discussed in previous articles,7-9 requirements for licensure vary by state. However, there are generally 3 methods by which a DO can become licensed, as follows10:
  •  
    successful completion of a medical licensing examination administered by the state licensing board
  •  
    acceptance of the certificate issued by the National Board of Osteopathic Medical Examiners
  •  
    reciprocity or endorsement of a license previously received from another state
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. 
A number of states also require continuing medical education (CME) as a condition of reregistering licenses. Forty-five states currently require CME for osteopathic license renewal (Table 3).11 Although the AOA CME program is on a 3-year CME cycle, state licensure boards have either a 1-year, 2-year, or 3-year CME cycle for their license renewal requirements. 
Table 3.
CME Requirements for License Renewal by State
State CME Requirements
Alabama 25 Category 1 credits per year
Alaska 25 AOA Category 1 or 2 or AMA PRA Category 1 credits per 1 year
Arizona 20 credits, of which 12 annually must be AOA Category 1-A credit and no more than 8 annually of AMA PRA Category 1 credit
Arkansas 20 Category 1 or 2 credits per year
California 150 Category 1 or 2 credits (AOA or state-board approved) every 3 years; 60 must be Category 1 credit; 12 must be in pain management and the treatment of terminally ill and dying patients (specialists in pathology and radiology are exempt); for general internists and family physicians with more than 25% of their patient population aged 65 years or older, 20 credits must be in geriatric medicine or the care of older patients
Colorado None
Connecticut 50 credits every 2 years
Delaware 40 Category 1 credits (AOA or AMA PRA) every 2 years
District of Columbia No requirements for physicians in continuous practice
Florida 40 credits biennially; 20 credits must be AOA Category 1-A relating to the practice of osteopathic medicine or under osteopathic auspices, 13 to 15 general credits can be AOA or AMA PRA approved; course credits by completion of live, participatory attendance are mandated in professional and medical ethics education (1 credit), Florida laws and rules (1 credit), prevention of medical errors (2 credits), and prescribing of controlled substances (1 credit); additional courses include HIV/AIDS (1 credit) and domestic violence (2 credits every third biennium)
Georgia 40 Category 1 credits (AOA or AMAPRA) every 2 years
Hawaii 40 Category 1 credits during each 2-year licensing cycle (even years)
Idaho 40 practice-relevant Category 1 credits every 2 years
Illinois 150 Category 1 or 2 credits per prerenewal period; 60 credits must be obtained through formal, type A CME programs; remaining 90 credits may be obtained through informal, type B CME programs or activities
Indiana None
Iowa 40 Category 1 credits (AOA or AMA PRA) biennially, which must include training for identifying and reporting abuse. For licensees who regularly provide primary health care to children: 2 credits of training in child abuse identification and reporting in the previous 5 years. For licensees who regularly provide primary health care to adults: 2 credits of training in dependent adult abuse identification and reporting in the previous 5 years. For licensees who regularly provide primary health care to adults and children, separate courses of 2 credits each as outlined above or a combined 2-credit course that includes curricula for identifying and reporting child abuse and dependent adult abuse in the previous 5 years. Fees and CME credits prorated to facilitate renewal process.
Kansas 50 credits per 1 year, 100 credits per 2 years, 150 credits per 3 years
Kentucky 60 Category 1 or 2 credits over 3 years; 30 credits must be Category 1 credit (AOA or AMA PRA); 2 credits must be in the area of HIV/AIDS
Louisiana 20 Category 1 credits (AOA or AMA PRA) per year
Maine 100 state board–approved CME credits per 2-year period; 40 credits must be AOA Category 1-A credit for the following practice areas: family medicine, family practice, general practice, and internal medicine; 40 Category 1 credits in designated specialty area for specialists
Maryland 50 Category 1 credits every 2 years for unlimited license renewal
Massachusetts 100 credits per 2-year period; 40 credits must be Category 1 credit (AOA or AMA) and should include 4 Category 1 and 6 Category 2 credits in risk management; remaining 60 credits can be Category 2 credit
Michigan 150 credits over 3 years; 60 credits must be AOA Category 1 credit, 90 credits must be Category 2 credit
Minnesota 75 Category 1 credits (AOA or AMA PRA) per 3-year period
Mississippi 40 AOA Category 1-A credits or AMA PRA Category 1 credits biennially
Missouri 50 credits (AOA or AMA Category 1) every 2 years
Montana None
Nebraska 50 Category 1 credits (AOA or AMA PRA) every 2 years
Nevada 35 AOA Category 1-A credits per year or 35 AMA PRA Category 1 credits per year; minimum of 10 Category 1 or 1-A credit
New Hampshire 150 credits per 3-year period; 60 credits must be Category 1 AOA or AMA PRA
New Jersey 100 credits every 2 years; 40 must be Category 1 credit
New Mexico Active membership in AOA or 75 Category 1 credits (AOA or AMA PRA) per 3-year period
New York None
North Carolina 150 Category 1 or 2 credits (AOA or AMA PRA) per 3-year cycle; 60 must be Category 1 credit
North Dakota 60 Category 1 credits (AOA or AMA PRA) per 3-year period
Ohio 100 Category 1 or 2 credits over a 2-year period; 40 must be AOA Category 1 credit
Oklahoma 16 AOA Category 1-A credits per year; 1 credit must be in the area of proper prescribing, dispensing, and administering of controlled dangerous substances obtained at a seminar approved by the State Board of Osteopathic Examiners
Oregon 60 credits per 2 years
Pennsylvania 100 Category 1 or 2 credits every 2 years; 20 must be AOA Category 1-A credit, 12 must be in the area of patient safety and/or risk management
Rhode Island 40 Category 1 credits per 2 years; 2 credits must be concerning universal precautions, infection control, modes of transmission, bioterrorism, OSHA, and other regulatory requirements
South Carolina 40 Category 1 credits every 2 years; 30 must be directly related to the type of patient care the licensee renders
South Dakota None
Tennessee 40 AOA Category 1 or 2-A credits per 2 years; 1 must be in prescribing practices
Texas 24 AOA Category 1-A or 2-B credits or AMA PRA Category 1 credit per 1-year period; 1 must be in the area of ethics and/or professional responsibility
Utah 40 Category 1 (AOA or AMA PRA) credits every 2 years
Vermont 30 Category 1 or 2 credits every 2 years; 12 must be osteopathic (AOA Category 1)
Virginia 60 Category 1 or 2 credits within the 2 years immediately preceding renewal; 30 must be Category 1 credit, 15 of which must be earned in an attendance-type setting
Washington 150 Category 1 or 2 credits every 3 years; 60 must be Category 1 credit
West Virginia 32 Category 1 or 2 credits (AOA or state society approved); 16 must be AOA Category 1 credit, and 2 must be in end-of-life care, including pain management
Wisconsin 30 Category 1 credits (AOA or AMA PRA) every 2 years prior to registration
Wyoming 30 Category 1 credits every 2 years
  a Osteopathic physicians should verify the material reported here with their state licensing boards as listed on http://www.ama-assn.org/resources/doc/med-ed-products/continuing-medical-education-licensure.pdf. 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 2010 osteopathic medical education issue is indicated in boldface.
  Abbreviations: ABMS, American Board of Medical Specialties; ACCME, Accreditation Council for Continuing Medical Education; AMA, American Medical Association; CCME, Council on Continuing Medical Education; HIV, human immunodeficiency virus; OSHA, US Department of Labor Occupational Safety and Health Administration; PRA, Physician Recognition's Award.
Table 3.
CME Requirements for License Renewal by State
State CME Requirements
Alabama 25 Category 1 credits per year
Alaska 25 AOA Category 1 or 2 or AMA PRA Category 1 credits per 1 year
Arizona 20 credits, of which 12 annually must be AOA Category 1-A credit and no more than 8 annually of AMA PRA Category 1 credit
Arkansas 20 Category 1 or 2 credits per year
California 150 Category 1 or 2 credits (AOA or state-board approved) every 3 years; 60 must be Category 1 credit; 12 must be in pain management and the treatment of terminally ill and dying patients (specialists in pathology and radiology are exempt); for general internists and family physicians with more than 25% of their patient population aged 65 years or older, 20 credits must be in geriatric medicine or the care of older patients
Colorado None
Connecticut 50 credits every 2 years
Delaware 40 Category 1 credits (AOA or AMA PRA) every 2 years
District of Columbia No requirements for physicians in continuous practice
Florida 40 credits biennially; 20 credits must be AOA Category 1-A relating to the practice of osteopathic medicine or under osteopathic auspices, 13 to 15 general credits can be AOA or AMA PRA approved; course credits by completion of live, participatory attendance are mandated in professional and medical ethics education (1 credit), Florida laws and rules (1 credit), prevention of medical errors (2 credits), and prescribing of controlled substances (1 credit); additional courses include HIV/AIDS (1 credit) and domestic violence (2 credits every third biennium)
Georgia 40 Category 1 credits (AOA or AMAPRA) every 2 years
Hawaii 40 Category 1 credits during each 2-year licensing cycle (even years)
Idaho 40 practice-relevant Category 1 credits every 2 years
Illinois 150 Category 1 or 2 credits per prerenewal period; 60 credits must be obtained through formal, type A CME programs; remaining 90 credits may be obtained through informal, type B CME programs or activities
Indiana None
Iowa 40 Category 1 credits (AOA or AMA PRA) biennially, which must include training for identifying and reporting abuse. For licensees who regularly provide primary health care to children: 2 credits of training in child abuse identification and reporting in the previous 5 years. For licensees who regularly provide primary health care to adults: 2 credits of training in dependent adult abuse identification and reporting in the previous 5 years. For licensees who regularly provide primary health care to adults and children, separate courses of 2 credits each as outlined above or a combined 2-credit course that includes curricula for identifying and reporting child abuse and dependent adult abuse in the previous 5 years. Fees and CME credits prorated to facilitate renewal process.
Kansas 50 credits per 1 year, 100 credits per 2 years, 150 credits per 3 years
Kentucky 60 Category 1 or 2 credits over 3 years; 30 credits must be Category 1 credit (AOA or AMA PRA); 2 credits must be in the area of HIV/AIDS
Louisiana 20 Category 1 credits (AOA or AMA PRA) per year
Maine 100 state board–approved CME credits per 2-year period; 40 credits must be AOA Category 1-A credit for the following practice areas: family medicine, family practice, general practice, and internal medicine; 40 Category 1 credits in designated specialty area for specialists
Maryland 50 Category 1 credits every 2 years for unlimited license renewal
Massachusetts 100 credits per 2-year period; 40 credits must be Category 1 credit (AOA or AMA) and should include 4 Category 1 and 6 Category 2 credits in risk management; remaining 60 credits can be Category 2 credit
Michigan 150 credits over 3 years; 60 credits must be AOA Category 1 credit, 90 credits must be Category 2 credit
Minnesota 75 Category 1 credits (AOA or AMA PRA) per 3-year period
Mississippi 40 AOA Category 1-A credits or AMA PRA Category 1 credits biennially
Missouri 50 credits (AOA or AMA Category 1) every 2 years
Montana None
Nebraska 50 Category 1 credits (AOA or AMA PRA) every 2 years
Nevada 35 AOA Category 1-A credits per year or 35 AMA PRA Category 1 credits per year; minimum of 10 Category 1 or 1-A credit
New Hampshire 150 credits per 3-year period; 60 credits must be Category 1 AOA or AMA PRA
New Jersey 100 credits every 2 years; 40 must be Category 1 credit
New Mexico Active membership in AOA or 75 Category 1 credits (AOA or AMA PRA) per 3-year period
New York None
North Carolina 150 Category 1 or 2 credits (AOA or AMA PRA) per 3-year cycle; 60 must be Category 1 credit
North Dakota 60 Category 1 credits (AOA or AMA PRA) per 3-year period
Ohio 100 Category 1 or 2 credits over a 2-year period; 40 must be AOA Category 1 credit
Oklahoma 16 AOA Category 1-A credits per year; 1 credit must be in the area of proper prescribing, dispensing, and administering of controlled dangerous substances obtained at a seminar approved by the State Board of Osteopathic Examiners
Oregon 60 credits per 2 years
Pennsylvania 100 Category 1 or 2 credits every 2 years; 20 must be AOA Category 1-A credit, 12 must be in the area of patient safety and/or risk management
Rhode Island 40 Category 1 credits per 2 years; 2 credits must be concerning universal precautions, infection control, modes of transmission, bioterrorism, OSHA, and other regulatory requirements
South Carolina 40 Category 1 credits every 2 years; 30 must be directly related to the type of patient care the licensee renders
South Dakota None
Tennessee 40 AOA Category 1 or 2-A credits per 2 years; 1 must be in prescribing practices
Texas 24 AOA Category 1-A or 2-B credits or AMA PRA Category 1 credit per 1-year period; 1 must be in the area of ethics and/or professional responsibility
Utah 40 Category 1 (AOA or AMA PRA) credits every 2 years
Vermont 30 Category 1 or 2 credits every 2 years; 12 must be osteopathic (AOA Category 1)
Virginia 60 Category 1 or 2 credits within the 2 years immediately preceding renewal; 30 must be Category 1 credit, 15 of which must be earned in an attendance-type setting
Washington 150 Category 1 or 2 credits every 3 years; 60 must be Category 1 credit
West Virginia 32 Category 1 or 2 credits (AOA or state society approved); 16 must be AOA Category 1 credit, and 2 must be in end-of-life care, including pain management
Wisconsin 30 Category 1 credits (AOA or AMA PRA) every 2 years prior to registration
Wyoming 30 Category 1 credits every 2 years
  a Osteopathic physicians should verify the material reported here with their state licensing boards as listed on http://www.ama-assn.org/resources/doc/med-ed-products/continuing-medical-education-licensure.pdf. 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 2010 osteopathic medical education issue is indicated in boldface.
  Abbreviations: ABMS, American Board of Medical Specialties; ACCME, Accreditation Council for Continuing Medical Education; AMA, American Medical Association; CCME, Council on Continuing Medical Education; HIV, human immunodeficiency virus; OSHA, US Department of Labor Occupational Safety and Health Administration; PRA, Physician Recognition's Award.
×
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 credits be in Category 1. Because requirements are subject to change by the boards and licensing agencies, health care professionals and physicians are encouraged to carefully review all communications from their licensing board or agency before the deadline for license renewal. Physicians who have specific questions about license renewal requirements or specific CME activities should contact their licensing board or agency directly. 
Readers are encouraged to review the US Osteopathic Licensure Summary,11 which is available in the members-only section of Osteopathic.org. 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. A list of the boards is available in the password-protected area of Osteopathic.org. 
Osteopathic.org CME Center
Osteopathic.org's “Spotlight on CME” (http://www.docmeonline.com) gives physician-members ready access to hundreds of hours of accredited online CME courses. Physician-members can view their current CME activity reports (CARs) at any time through this 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 Osteopathic.org 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. 
All CME activity must be audited. Therefore, physician-members are not allowed to manually update their CME records. Physician-members should continue to submit their update requests for CME credit as well as any other correspondence regarding their CARs directly to the AOA Division of CME via e-mail (cme@osteopathic.org), fax ([312] 202-8202), or regular mail (AOA Division of CME, 142 E Ontario St, Chicago, IL 60611-2864). 
Recent Activities at the AOA
The CCME, which is chaired by Jeffrey S. Grove, DO, meets 3 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.osteopathic.org/inside-aoa/accreditatio/Documents/cme-ccme-members.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. The AOA BOT reviews resolutions by the various AOA bureaus, councils, and committees—including the CCME—twice a year. 
CME Credit for Specialists and Subspecialists
As previously described,7-9 the CCME has discussed at length various methods to assist subspecialists in obtaining AOA Category 1-A CME credits, which are not readily available within the osteopathic medical profession. 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 physician-members in specialties and subspecialties that have fewer than 300 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 ACCME. Specialists and subspecialists qualifying under the resolution are able to substitute 15 AMA Physician Recognition Award (PRA) Category 1 credits for AOA Category 1-A credits during the 2010-2012 CME cycle. This standing policy was approved by the AOA BOT and is further described under the section “EPPRC III Update.” The physician must be AOA or ABMS certified for the use of this policy. 
The AMA PRA and its credit system recognize physicians who demonstrate a commitment to staying current with advances in medicine by participating in certified CME activities. The ACCME is the organization that sets educational standards for CME activities and monitors its accredited providers' adherence to those standards. The ACCME accredits organizations but does not accredit individual activities. Nonaccredited organizations that would like to partner with an ACCME-accredited provider in the provision of quality CME can enter into joint sponsorship with an accredited organization. 
It is important to note that the ACCME does not reward the continuing educational accomplishments of individual physicians. Rather, those accomplishments are rewarded by other organizations that, for example, require physicians to complete a certain amount or type of CME for membership or relicensure. As such, CME providers are not ACCME-accredited for the purpose of granting credit. The requirements for granting credit are maintained by the other organizations themselves. Because different credentialing bodies have varying requirements, CME providers should be aware of the requirements of the particular credentialing body for which credit is being granted. To designate AMA PRA Category 1 credit, ACCME accreditation is required. Credit prescribed by the American Academy of Family Physicians (AAFP) is approved for CME activities that have been designed primarily for family physicians and have had AAFP member input. 
The CCME 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 programs. The CCME surveys all AOA Category 1 CME sponsors regarding their involvement with CME on the Internet. This issue is addressed further in this CME article. 
Recent Actions of the AOA BOT
The AOA BOT approved the following resolutions relating to the AOA CME program during its July 2011 business meeting:
  •  
    Revision to the AOA CME Guide for Osteopathic Physicians 2010-2012 CME Cycle—Test Construction Committee Work. In 2011, the AOA BOT approved a CCME resolution (B19 [A/2011]—Revisions to the AOA CME Guide for Osteopathic Physicians 2010-2012 CME Cycle—Test Construction Committee Work) to remove the requirement that the test construction committee's work had to be performed in a seminar-type atmosphere and consist of at least 3 attendees. In addition, the Council amended the policy to include that Category 1-B credit will also be awarded for developing and submitting clinical cases for osteopathic board examinations rather than just for examinations administered by the National Board of Osteopathic Medical Examiners.
  •  
    AOA Category 1-A CME Credit for Outcomes Measurement for AOA Category 1 CME Programs—The CCME amended its policy regarding “outcomes measurement” (Resolution B19 [M/2007]—AOA Category 1-A CME Credit for Outcomes Measurement for AOA Category 1-A CME Programs). At the January 2011 CME Sponsors Conference, the CCME discussed the policy for programs of fewer than 10 credits and how many credits, if any, could be awarded for completing an outcomes questionnaire. The AOA BOT amended Resolution B19 and approved 1 credit for completed questionnaires of programs less than 10 credits (Resolution B20 [A/2011]).
  •  
    Awarding Participants Category 1-A Credit for Attendance at the AODME Conference—The Council on CME amended its policy regarding AOA CME credit for participants who attend the AOA Association of Osteopathic Directors of Medical Education (AODME) conference. Previous attendees were awarded AOA Category 1-A credit for their attendance. On the basis of current AOA policy, the AOA BOT approved that the AODME conference be awarded AOA Category 1-A faculty development for up to 15 credits of AOA Category 1-A CME credit per cycle and the remaining credits be awarded AOA Category 1-B credit (B21 [A/2011]—Awarding Participants Category 1-A Credit for Attendance at the AODME Conference). Participants at the annual AOA Osteopathic Medical Education Conference are awarded up to 15 AOA Category 1-A Faculty Development credits each cycle that can be applied toward the 30 Category 1-A CME credit requirement.
Report of the Education Policy and Procedure Review Committee III—Update
The Education Policy and Procedure Review Committee III (EPPRC III) was formed as a special task force assigned by the AOA BOT in July 2009. Under direction of the chair, Robert S. Juhasz, DO, the EPPRC III developed strategies and resources to re-engineer policy and procedures of education bureaus, councils, and member services. The EPPRC III reviewed decisions from past appointed committees and task forces, looked at the current structure, and developed recommendations that recognize that educational systems at the AOA should be less lengthy and burdensome for members. 
As previously reported,9 during its January 2011 meeting, the AOA BOT approved EPPRC III recommendations regarding the 7 previously determined “CME Issues.” These issues were reviewed by the CCME at its April 2011 meeting to determine how the policies will be implemented and whether any budgetary concerns exist. The CCME has reviewed and put an action plan in place for some of the recommendations, as described in the following paragraphs. A report was presented at the CME Sponsors Conference on January 12, 2012, reflecting the action of each CME recommendation. The final report and additional information relating to EPPRC III can be found online at http://www.osteopathic.org/inside-aoa/events/midyear-meeting/Documents/2011-midyear-meeting-documents/EPPRC-III-reference-committee-final-report.pdf. 
CME Issue 1: Who should be a Category 1 sponsor? To meet the recommendations of EPPRC III that hospitals with HFAP accreditation or with AOA-approved training programs be eligible Category 1 sponsors, an advertisement was placed in the Council on Osteopathic Postdoctoral Training newsletter to encourage such hospitals to apply to the CCME to become AOA Category 1 CME sponsors. The responses of these institutions will be monitored during the next 2 years. 
CME Issue 2: Category 1 CME on the Internet. To determine why there has been little activity to provide CME on the Internet under the current requirements and to identify barriers and resources in developing CME on the Internet, the AOA will be conducting a “Request for Proposal” to all AOA Category 1 CME sponsors. A proposal based on the feedback of the responding sponsors will be distributed in June 2012 to all AOA Category 1 CME sponsors. 
CME Issue 3: CME-deficient members, incentives, and deterrents. At the recommendation of EPPRC III, the AOA appointed a task force to review CME policy and statistics on CME-deficient members, evaluate trends in providing incentives and deterrents, and recommend strategies to the AOA BOT at its 2012 midyear meeting. 
CME Issue 4: Category 1-B role of Category 1 CME sponsors (specialty colleges). To assist specialty colleges with reviewing requests for AOA Category 1-B credits, a policy was set that if the specialty college offered the program within that specialty or subspecialty, it would not have to go through the process of sending the request out for review by the respective peer. The specialty college can designate a staff member who must provide documented evidence that the program was covered in their program agenda. The designated staff member must sign the verification form and submit the documentation (as a copy of the program) to the CCME for review in its deliberations. The specialty colleges were notified in August 2011 of this policy. 
CME Issue 5: AOA and ABMS dually boarded DOs and DOs boarded only by a specialty of the ABMS. Osteopathic physicians who are both AOA and ABMS board certified should earn the same CME credits for membership as DOs who are AOA board certified only. Osteopathic physicians in specialties and subspecialties with fewer than 300 certified members should use up to 15 credits from AMA PRA Category 1 programs for AOA Category 1, earn up to 8 Category 1 credits in life support programs, and earn up to 9 credits of CME on the Internet from AOA-accredited Category 1 sponsors. Osteopathic physicians may earn Category 1-B credit for preceptoring osteopathic medical students. In addition, Category 1-A credit may be earned for lecturing on an osteopathic program and for clinical didactic teaching when lecturing to osteopathic trainees in a classroom style. 
In addition, DOs who are board certified only in an ABMS specialty should earn a minimum of 10 Category 1-A credits by attending AOA-sponsored CME programs during a 3-year cycle. Also, they must continue to meet the total 120-credit requirement for membership. Notification was sent to all DOs with ABMS board certification on January 27, 2012, by means of an AOA TouchPoints e-alert. They should be encouraged to participate as planners, attendees, presenters, or facilitators. 
CME Issue 6: Quality initiatives. As recommended by EPPRC III, the CCME continues to develop policies that reward CME sponsors that develop and offer programs that measure performance improvement, outcomes-based evaluation, and evidence-based CME, including CME plans regarding Osteopathic Continuous Certification. Also, the CCME should encourage Category 1 sponsors to measure outcomes as defined by the CCME from at least 1 program in the 2010-2012 CME cycle and require 1 program be measured for outcomes in the 2013-2015 CME cycle. At the January 2011 meeting, EPPRC III made the following recommendation:
 

The rule for 50% faculty or 50% time presentation by osteopathic faculty should be reduced to 30% as a pilot that will be monitored and reviewed during the 2010-2012 cycle. The definition of osteopathic faculty will be expanded to include clinical faculty. The CCME will define “clinical faculty” at its April 2012 CCME meeting. In current policy, waivers may be requested by all sponsors excluding family practice for $25 administrative fee. This policy needs greater dissemination and advertisement.

 
As opposed to meeting the 50% faculty CME requirement for programs to qualify for AOA Category 1-A credit, the program may now qualify for AOA Category 1-A credit with 30% faculty. For example, if a program is for 10 credits and there are a total of 10 faculty members presenting, only 3 of the 10 faculty members must be DOs for the program to qualify for AOA Category 1-A credit. As determined in the recommendation, the CCME is using the 30% faculty requirement as a pilot. All documents will conform to the AOA Uniformed Standards and be submitted for review and approval by the CCME at its October 2012 meeting. 
CME Issue 7: Category 1-A requirements for DOs in specialties with fewer than 300 board-certified members. As previously stated in the present article, for DOs in specialties or subspecialties with fewer than 300 certified members, AMA PRA Category 1 credit can be used to meet 15 of the 30 required Category 1-A credits. This revision is now a standing policy and has been updated with a revised form for requesting AOA Category 1-A credit. Physicians must be either AOA or ABMS certified. The form for requesting Category 1-A credit is available online at http://www.osteopathic.org/insideaoa/development/continuing-medical-education/Documents/request-for-category-1-A-credit-for-osteopathic-specialists-subspecialists.pdf. 
AOA Strategic Plan 2011-2012—CME
The CCME reviewed the goals to “re-engineer the Osteopathic CME System to meet the needs of all stakeholders.” The objectives and brief updates (in italics) reflecting the actions of the CCME are as follows:
  •  
    Review the current CME regulations regarding Category 1-A Internet–based CME and proposed revisions to those regulations. The Council surveyed all AOA Category 1-A sponsors regarding online CME to identify barriers and opportunities to encourage more CME on the Internet. The CCME has prepared and approved a draft “Request for Proposal” for distribution in June 2012.
  •  
    Develop options for members in smaller specialties and subspecialties to meet the requirement for Category 1-A CME. As noted previously, 15 AMA PRA Category 1 credits can now be applied for DOs in select specialties and subspecialties. This revision has been posted on the Internet and updated accordingly as approved by the AOA BOT. The specialty colleges were also informed accordingly.
  •  
    Identify the factors that facilitate and inhibit joint sponsorship of CME programs, communicate those results to the accredited CME sponsors, and propose changes in CME regulations to encourage joint sponsorship. The CCME briefly discussed these issues and determined that the following factors prevent joint CME sponsorship: (1) control, (2) labor, and (3) the lack of money or funding. The CCME will encourage CME sponsors to work together more, collaborate, and develop module business plans. They should conduct pilot programs and set up criteria for viable solutions.
  •  
    Conduct research on the demand for Web-based CME and develop incentives to encourage innovative and sustainable sources of revenue. The CCME will be conducting a pilot testing of CME on the Internet. The CCME has requested a budget for distributing money to those AOA Category 1 CME sponsors who request a grant based on the “Request for Proposal” that will go out in June 2012 to all AOA Category 1 CME sponsors. Money will be distributed to all if successful and will be based on participation.
Reporting CME Credits for Outcomes Measurement
At its July 2010 meeting, the ACCME discussed the issue of reporting CME credits for outcomes measurement. The question was raised whether a CME sponsor had to pay a second time for a program when submitting CME credit for individuals who complete outcomes measurements for that program. The Administrative Committee decided that there will be no program fee for recording CME credits for outcomes measurement. Sponsors of CME would only pay $0.10 × the total number of CME credits. 
Guidelines for AOA Specialty Board Certification
Board certification from the AOA demonstrates a DO's commitment to and expertise in a particular specialty or subspecialty of medicine. Osteopathic physicians who wish to maintain specialty board certification through the AOA are required to earn a minimum of 50 AOA CME credits 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 credits while also maintaining overall consistency among the specialties.12 Table 4 provides a summary of areas of divergence among specialties for the current 2010-2012 CME cycle, which has not changed from the 2007-2009 CME cycle. 
Table 4.
Bureau of Osteopathic Specialists: Maximum No. of CME Credit Hours Granted per Cycle by Activity Typea and Specialty Board
American Osteopathic Board of… AMA PRA Category 1 Formal Teaching Standardized Life Support
Anesthesiology 50 50 16
Dermatology 25 25 5
Emergency Medicine 25 25 16
Family Physicians 25 25 5
Internal Medicine 25 25 5
Neurology and Psychiatry 25 25 5
Neuromusculoskeletal Medicine 0 25 5
Nuclear Medicine 50 50 NAb
Obstetrics and Gynecology 50 50 5
Ophthalmology and Otolaryngologyc 50 50 NAb
Orthopedic Surgery 50 50 5
Pathology 50 50 NAb
Pediatrics 50 50 16
Physical Medicine and Rehabilitation 25 25 5
Preventive Medicine 50 50 5
Proctology 50 25 5
Radiology 50 50 16
Surgery 50 50 NAb
  a All activities must be related to the specialty for continuing medical education (CME) credit. Credit is awarded on an hour-by-hour basis for American Osteopathic Association (AOA) specialty college seminars. For each other type of seminar, the number of maximum credits per cycle varies. For example, a maximum of 5 credits is allowed for human immunodeficiency virus/AIDs and risk management seminars; a maximum of 15 credits is allowed for test construction and publications seminars; and a maximum of 25 credits is allowed for AOA state society, foundation, and college of osteopathic medicine seminars. A maximum of 25 credits 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 credits allowed for participating in the annual Osteopathic Medical Conference and Exposition.
  b Credit awarded on an hour-by-hour basis.
  c The full name of this board is the American Osteopathic Boards of Ophthalmology and Otolaryngology-Head and Neck Surgery.
  Abbreviations: AMA PRA, American Medical Association Physician Recognition Award; NA, not applicable.
Table 4.
Bureau of Osteopathic Specialists: Maximum No. of CME Credit Hours Granted per Cycle by Activity Typea and Specialty Board
American Osteopathic Board of… AMA PRA Category 1 Formal Teaching Standardized Life Support
Anesthesiology 50 50 16
Dermatology 25 25 5
Emergency Medicine 25 25 16
Family Physicians 25 25 5
Internal Medicine 25 25 5
Neurology and Psychiatry 25 25 5
Neuromusculoskeletal Medicine 0 25 5
Nuclear Medicine 50 50 NAb
Obstetrics and Gynecology 50 50 5
Ophthalmology and Otolaryngologyc 50 50 NAb
Orthopedic Surgery 50 50 5
Pathology 50 50 NAb
Pediatrics 50 50 16
Physical Medicine and Rehabilitation 25 25 5
Preventive Medicine 50 50 5
Proctology 50 25 5
Radiology 50 50 16
Surgery 50 50 NAb
  a All activities must be related to the specialty for continuing medical education (CME) credit. Credit is awarded on an hour-by-hour basis for American Osteopathic Association (AOA) specialty college seminars. For each other type of seminar, the number of maximum credits per cycle varies. For example, a maximum of 5 credits is allowed for human immunodeficiency virus/AIDs and risk management seminars; a maximum of 15 credits is allowed for test construction and publications seminars; and a maximum of 25 credits is allowed for AOA state society, foundation, and college of osteopathic medicine seminars. A maximum of 25 credits 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 credits allowed for participating in the annual Osteopathic Medical Conference and Exposition.
  b Credit awarded on an hour-by-hour basis.
  c The full name of this board is the American Osteopathic Boards of Ophthalmology and Otolaryngology-Head and Neck Surgery.
  Abbreviations: AMA PRA, American Medical Association Physician Recognition Award; NA, not applicable.
×
For the activities noted in Table 4 (ie, AMA PRA Category 1 credit courses, formal teaching, and standardized life support), the maximum number of CME credits accepted per 3-year CME cycle must be designated at the beginning of each new CME cycle. All boards were surveyed in August 2010 for a recommendation for the 2010-2012 CME cycles.8 
Twenty-five credits of preceptoring per CME cycle may apply to physician-members' specialty-board requirements for those boards that have designated specialty credits for preceptoring. In contrast, these credits will not be applied to member records for DOs in the American Osteopathic Board of Surgery. For information regarding the use of preceptoring or other credits, physicians should contact their certifying boards. 
As noted previously,8,9 the AOA BOT approved the following rules in July 2009 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 according to 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.
In addition, AOA CME credit sponsored by osteopathic specialty affiliates in the declared specialty will be applied to the requirement on an unlimited hour-by-hour basis, and 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 credits per cycle (Table 4). A certified physician must present the lectures for it to be considered for specialty credit. 
For more information, readers can access the AOA Specialty Continuing Medical Education (CME) Policy, which is available at http://www.osteopathic.org/inside-aoa/development/continuing-medical-education/Documents/specialty-cme-policy.pdf. 
AOA-Accredited Category 1 CME Sponsors
There are currently 156 AOA-accredited Category 1 CME sponsors (Table 5). A list of these sponsors is maintained on Osteopathic.org and is available at http://www.osteopathic.org/inside-aoa/accreditation/Documents/cme-sponsor-list.pdf. 
Table 5.
AOA-Accredited Category 1 CME Sponsors (N=156)a
Organization No. (%)
Affiliates
Nonpractice (AOA)b 2 (<1)
Colleges
Colleges of osteopathic medicine (AOA accredited) 21 (13)
Alumni groupsb NA
Specialty (AOA affiliated)b NA
Foundations (AOA Affiliated)b 8 (5)
Hospitals 43 (28)
Military 1 (<1)
Philanthropic Organizations (AOA Affiliated)c
Professional Associations 1 (<1)
Societies
Divisional (AOA affiliated)b NA
Specialty 26 (17)
State 54 (35)c
  a The number of continuing medical education (CME) sponsors in each category are accurate as of November 28, 2011. Percentages do not total 100 because of rounding.
  b Applications for sponsorship are currently limited to the organizations indicated.
  c The 54 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 separate district societies: Broward County, District 7: and Southwest, District 11).
  Abbreviations: AOA, American Osteopathic Association; NA, not applicable.
Table 5.
AOA-Accredited Category 1 CME Sponsors (N=156)a
Organization No. (%)
Affiliates
Nonpractice (AOA)b 2 (<1)
Colleges
Colleges of osteopathic medicine (AOA accredited) 21 (13)
Alumni groupsb NA
Specialty (AOA affiliated)b NA
Foundations (AOA Affiliated)b 8 (5)
Hospitals 43 (28)
Military 1 (<1)
Philanthropic Organizations (AOA Affiliated)c
Professional Associations 1 (<1)
Societies
Divisional (AOA affiliated)b NA
Specialty 26 (17)
State 54 (35)c
  a The number of continuing medical education (CME) sponsors in each category are accurate as of November 28, 2011. Percentages do not total 100 because of rounding.
  b Applications for sponsorship are currently limited to the organizations indicated.
  c The 54 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 separate district societies: Broward County, District 7: and Southwest, District 11).
  Abbreviations: AOA, American Osteopathic Association; NA, not applicable.
×
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.13 Once a sponsor has been selected for review, the AOA will request documentation of its CME activities and then use a checklist (Table 6) to determine whether all requirements have been met or whether certain deficiencies exist. The checklist has been modified since the 2011 publication.9 In addition, the CCME and AOA staff investigate all written complaints or deviations from AOA policy using standard compliance-review procedures.13,14 
Table 6.
Checklist of AOA Accreditation Requirements for Category 1 Continuing Medical Education (CME)
Checklist Itema Maximum Points
1. A description of the needs assessment process and procedure used in determining the content and topic of the program (include any supporting documents). 8
2. A copy of the CME program brochure or agenda distributed to participants at the CME program. 4
3. Copies of ALL program participants' (speakers and moderators in chronological order) curricula vitae (CVs) or biosketch defining their qualifications for involvement in the CME program. Partial credit is awarded based on the percentage of CVs and biosketches provided during the document survey review (eg, 5 CVs provided from a total of 10 speakers yields 4 points). All fractions are rounded down. 8b
4. A copy of each speaker's signed Disclosure Declaration Statement in chronological order. Partial credit is awarded based on the percentage of the disclosure statements provided during the document survey. 8c
5. A copy of the CME credits requested by the AOA-accredited sponsor for each participating physician in accordance with the attesting document. 4
6. A copy of the program administration evaluation document and the total number of evaluation documents returned by conference registrants. Provide 2 copies of the program evaluation documents that were returned by conference attendees. 4
7. A statement indicating the total number of registrants and the number of attestation forms returned by conference participants. 8d
8. A statement reflecting the distribution of program evaluation documents (ie, the beginning of the program, random survey, etc). 4
9. A policy statement on managing grievances relative to the returned program administration and evaluation document(s). 4
10. A copy of the program outcomes questionnaire and the total number of outcomes questionnaire documents returned by conference registrants. Provide 2 copies of the outcomes questionnaire documents that were returned by conference attendees (within 90 days after the program). 4
11. Provide:
A. Needs assessment per program topic. 12e
B. A statement relative to how topics and/or speakers were selected in direct response to needs assessment procedures. 4
12. If the program was commercially supported, the following additional items must be submitted:
A. A copy of the formal written agreement between the AOA CME sponsor and each commercial supporter reflecting that activity (program) is educational and not promotional. 8c
B. Proof that commercial support is appropriately acknowledged in any printed promotional materials. 4
C. A brief statement regarding all funding arrangements; include how funds received from commercial supporters were expended, how speakers were paid, such as, if speakers were directly funded by a third party agent (someone besides the AOA CME sponsor/provider), attach copy of the funding arrangement between the CME sponsor and the third party agent. 8c
D. A statement indicating how disclosure information regarding each speaker was given to the participants. 8c
Total Score 100f
  a Checklist items with a maximum score of 8 or 12 points are major items; those with a maximum score of 4 points are minor items. Category 1 CME Sponsors are encouraged to measure outcomes as defined by the Council on CME for at least 1 program in the 2010-2012 CME Cycle and will be required to measure 1 program for outcomes in the 2013-2015 CME Cycle.
  b Partial credit is awarded: less than 50% completed=0 points, 50%=4 points, 90%=8 points.
  c Partial credit is awarded: less than 90% completed=0 points, 90%=8 points.
  d Partial credit is awarded: 25% completed=2 points, 50%=4 points, 95%=8 points.
  e Partial credit is awarded: 25% completed=2 points, 50%=4 points, 75%=6 points, 95%=12 points.
  f If the total score is 100 points, a 3-year accreditation with commendation status is awarded; if 95 points or more, a 3-year accreditation is awarded; if 80-94 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.
Table 6.
Checklist of AOA Accreditation Requirements for Category 1 Continuing Medical Education (CME)
Checklist Itema Maximum Points
1. A description of the needs assessment process and procedure used in determining the content and topic of the program (include any supporting documents). 8
2. A copy of the CME program brochure or agenda distributed to participants at the CME program. 4
3. Copies of ALL program participants' (speakers and moderators in chronological order) curricula vitae (CVs) or biosketch defining their qualifications for involvement in the CME program. Partial credit is awarded based on the percentage of CVs and biosketches provided during the document survey review (eg, 5 CVs provided from a total of 10 speakers yields 4 points). All fractions are rounded down. 8b
4. A copy of each speaker's signed Disclosure Declaration Statement in chronological order. Partial credit is awarded based on the percentage of the disclosure statements provided during the document survey. 8c
5. A copy of the CME credits requested by the AOA-accredited sponsor for each participating physician in accordance with the attesting document. 4
6. A copy of the program administration evaluation document and the total number of evaluation documents returned by conference registrants. Provide 2 copies of the program evaluation documents that were returned by conference attendees. 4
7. A statement indicating the total number of registrants and the number of attestation forms returned by conference participants. 8d
8. A statement reflecting the distribution of program evaluation documents (ie, the beginning of the program, random survey, etc). 4
9. A policy statement on managing grievances relative to the returned program administration and evaluation document(s). 4
10. A copy of the program outcomes questionnaire and the total number of outcomes questionnaire documents returned by conference registrants. Provide 2 copies of the outcomes questionnaire documents that were returned by conference attendees (within 90 days after the program). 4
11. Provide:
A. Needs assessment per program topic. 12e
B. A statement relative to how topics and/or speakers were selected in direct response to needs assessment procedures. 4
12. If the program was commercially supported, the following additional items must be submitted:
A. A copy of the formal written agreement between the AOA CME sponsor and each commercial supporter reflecting that activity (program) is educational and not promotional. 8c
B. Proof that commercial support is appropriately acknowledged in any printed promotional materials. 4
C. A brief statement regarding all funding arrangements; include how funds received from commercial supporters were expended, how speakers were paid, such as, if speakers were directly funded by a third party agent (someone besides the AOA CME sponsor/provider), attach copy of the funding arrangement between the CME sponsor and the third party agent. 8c
D. A statement indicating how disclosure information regarding each speaker was given to the participants. 8c
Total Score 100f
  a Checklist items with a maximum score of 8 or 12 points are major items; those with a maximum score of 4 points are minor items. Category 1 CME Sponsors are encouraged to measure outcomes as defined by the Council on CME for at least 1 program in the 2010-2012 CME Cycle and will be required to measure 1 program for outcomes in the 2013-2015 CME Cycle.
  b Partial credit is awarded: less than 50% completed=0 points, 50%=4 points, 90%=8 points.
  c Partial credit is awarded: less than 90% completed=0 points, 90%=8 points.
  d Partial credit is awarded: 25% completed=2 points, 50%=4 points, 95%=8 points.
  e Partial credit is awarded: 25% completed=2 points, 50%=4 points, 75%=6 points, 95%=12 points.
  f If the total score is 100 points, a 3-year accreditation with commendation status is awarded; if 95 points or more, a 3-year accreditation is awarded; if 80-94 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.
×
The Council has been charged with developing a crosswalk for evaluating AOA Category 1 CME sponsors for random site visits based on the unified standards requirements. This charge is part of the EPPRC III recommendations. At the October 2011 CCME meeting, the chair of the CCME appointed a subcommittee to work with staff to develop guidelines for review at the April 2012 meeting. 
Needs Assessment
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.13 Quality CME programs should focus on the determined needs of physicians as assessed by proven methods of needs assessment such as medical audits, pretest item analyses, self assessments, and questionnaires. Needs assessments must be conducted on an annual basis for each program, be included for each presentation, be timely and current for the field, and be documented as tied to the program objectives (at least 1 source must be evidence based). Programs related to osteopathic manipulative medicine, core competencies, faculty development, state requirements, and board preparation courses are exempt from providing a needs assessment. 
National CME Sponsors Conference
The AOA's 18th Annual National CME Sponsors Conference was held from January 12, 2012, through January 14, 2012, at the Westin Beach Resort & Spa in Fort Lauderdale, Florida, in conjunction with the 22nd 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 “Promoting Life-Long Learning through Osteopathic CME.” 
A total of 126 participants, including CCME members, speakers, and AOA staff, attended this year's conference. The keynote address was delivered by Fitzhugh Mullans, MD, whose presentation was titled “The Growth of the Physician Workforce 2012 & Beyond.” Detailed information on the program can be downloaded at http://www.osteopathic.org/inside-aoa/events/Pages/CME-Sponsors-Conference.aspx. 
A workshop (ie, breakout session) at the conference allowed participants to break into their respective groups and voice their praise or concerns regarding the topics addressed by each speaker. Workshops were held for each main topic (ie, outcome-based evaluation and needs assessment, grant writing workshop, Internet CME [eg, how to do a Webinar], and how to change physicians practice habits by using CME) and discussed by each of the respective groups (ie, acute care facilities, divisional societies, colleges of osteopathic medicine, specialty affiliates, and osteopathic foundations). 
The AOA's 19th Annual National CME Sponsors Conference will be held January 4 through January 6, 2013, in Scottsdale, Arizona. Additional information will be posted on Osteopathic.org as it becomes available. 
CME Webinar: Risk Evaluation and Mitigation Strategy
The Council conducted a CME Webinar on the “In's and Out's of REMS [Risk Evaluation and Mitigation Strategy]” Thursday, January 12, and invited all AOA Category 1 CME sponsors to participate. Theresa Togo, RPh, MBA, from the US Food and Drug Administration presented the REMS directive for opioid drugs. The strategy mandates CME for physicians to provide training in the proper use and disposal of opioids. All physicians who prescribe pain medication should be educated about appropriate prescribing behavior as the number of deaths related to use of pain medications is substantial. The presentation was part of the January 2012 CME Sponsors Conference to provide guidance to CME sponsors in how to provide opioid REMS education, including steps the US Food and Drug Administration and industry are taking to formulate a strategy to develop a specialty-specific CME activity addressing the opioid REMS and grant opportunities. Several resources were provided in advance of the conference to all sponsors. 
Activities of the CCME
The CCME will be considering whether to award AOA CME credit for ethics programs. In addition, the CCME will be surveying AOA Category 1 CME sponsors regarding the use of electronic signatures, which was allowed as part of a pilot program. For those CME sponsors that are currently using an electronic signature, the CCME will be requesting that they submit a report to provide feedback to the CCME regarding their experience. 
CME Program Trends and Statistics
As the AOA CME program develops, the proportion of physician-members who have CME requirements from their state or specialty boards (Table 7) grows. As of December 2011, the number of AOA members with statemandated or specialty-board–mandated CME requirements is 32,325. 
Table 7.
AOA Members With a CME Requirement
AOA Members, No.
3-Year Cycle CME Requirementa Dropped from Membership
1973 to 1976b NA NA
1977 to 1979 10,373 239
1980 to 1982 12,050 159
1983 to 1985 11,881 298
1986 to 1988 12,901 43
1989 to 1991 16,093 159
1992 to 1994 16,040 146
1995 to 1997 19,315 214
1998 to 2000 21,383 219
2001 to 2003 23,770 259
2004 to 2006 25,964 296
2007 to 2009 30,332 320
2010 to 2012c 32,325 NA
  a The number of American Osteopathic Association (AOA) physician-members who have a continuing medical educaton (CME) requirement are those whose state or specialty boards mandate a CME requirement for relicensure.
  b Numbers are not reported for the 1973-1976 CME cycle because the program was in its testing phase during those years.
  c Number reported for the 2010-2012 cycle is current as of December 1, 2011.
  Abbreviation: NA, not available.
Table 7.
AOA Members With a CME Requirement
AOA Members, No.
3-Year Cycle CME Requirementa Dropped from Membership
1973 to 1976b NA NA
1977 to 1979 10,373 239
1980 to 1982 12,050 159
1983 to 1985 11,881 298
1986 to 1988 12,901 43
1989 to 1991 16,093 159
1992 to 1994 16,040 146
1995 to 1997 19,315 214
1998 to 2000 21,383 219
2001 to 2003 23,770 259
2004 to 2006 25,964 296
2007 to 2009 30,332 320
2010 to 2012c 32,325 NA
  a The number of American Osteopathic Association (AOA) physician-members who have a continuing medical educaton (CME) requirement are those whose state or specialty boards mandate a CME requirement for relicensure.
  b Numbers are not reported for the 1973-1976 CME cycle because the program was in its testing phase during those years.
  c Number reported for the 2010-2012 cycle is current as of December 1, 2011.
  Abbreviation: NA, not available.
×
The type of CME credit recorded by the AOA has changed over time (Table 8). While earned Category 1-A credit has fluctuated, earned Category 1-B credit has experienced dramatic growth—increasing from 5.7 million credits in the 1995-1997 CME cycle to 11 million credits in the 2007-2009 CME cycle. 
Table 8.
Total Number of CME Credits Recorded (in Millions) by the AOA for Each 3-Year CME Cycle
CME Credit Category
3-Year Cycle 1-A 1-B 2a Total
1973 to 1976 1.3 0.1 1.1 2.5
1977 to 1979 1.4 0.8 0.5 2.7
1980 to 1982 1.5 1.3 0.6 3.4
1983 to 1985 1.5 1.4 0.8 3.7
1986 to 1988 1.8 3.0 1.1 5.9
1989 to 1991 2.2 3.7 1.3 7.2
1992 to 1994 2.3 4.1 1.2 7.6
1995 to 1997 2.5 5.7 1.6 9.8
1998 to 2000 3.0 7.3 1.7 12.0
2001 to 2003 2.9 8.6 1.6 13.1
2004 to 2006 2.6 9.2 2.1 13.9
2007 to 2009 2.7 11.0 1.8 15.5
2010 to 2012b 1.5 6.3 0.7 8.5
  a Numbers reported for continuing medical education (CME) credit Category 2 include all Category 2-A and Category 2-B credits recorded.
  b Data are current as of December 18, 2011.
  Abbreviations: AOA, American Osteopathic Association; NA, not available.
Table 8.
Total Number of CME Credits Recorded (in Millions) by the AOA for Each 3-Year CME Cycle
CME Credit Category
3-Year Cycle 1-A 1-B 2a Total
1973 to 1976 1.3 0.1 1.1 2.5
1977 to 1979 1.4 0.8 0.5 2.7
1980 to 1982 1.5 1.3 0.6 3.4
1983 to 1985 1.5 1.4 0.8 3.7
1986 to 1988 1.8 3.0 1.1 5.9
1989 to 1991 2.2 3.7 1.3 7.2
1992 to 1994 2.3 4.1 1.2 7.6
1995 to 1997 2.5 5.7 1.6 9.8
1998 to 2000 3.0 7.3 1.7 12.0
2001 to 2003 2.9 8.6 1.6 13.1
2004 to 2006 2.6 9.2 2.1 13.9
2007 to 2009 2.7 11.0 1.8 15.5
2010 to 2012b 1.5 6.3 0.7 8.5
  a Numbers reported for continuing medical education (CME) credit Category 2 include all Category 2-A and Category 2-B credits recorded.
  b Data are current as of December 18, 2011.
  Abbreviations: AOA, American Osteopathic Association; NA, not available.
×
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 320 members in the 2007-2009 CME cycle and a low of 43 members in the 1986-1988 CME cycle (Table 7). In the past, members were given a 17-month grace period to fulfill requirements from the previous CME cycle. As stated earlier, DOs will now have only 5 months to submit their documentation. Therefore, drop date for the 2010-2012 CME cycle will be available after May 31, 2013. 
Similarly, the total number of CME credits recorded by the AOA has increased considerably during each successive 3-year CME cycle (Table 8). This growth reflects the increasing number of AOA members who have statemandated or specialty-board–mandated CME requirements and the steadily increasing average number of CME credits recorded per member. 
Conclusion
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. 
   Financial Disclosures: None reported.
 
   Editor's Note: This JAOA theme issue on osteopathic medical education includes annual updates from the American Osteopathic Association's departments of accreditation and education. Last year's article on AOA continuing medical education can be accessed online at http://www.jaoa.org/content/111/4/264.full.
 
   Editor's Note: The following is a list of physician resources regarding guidelines and regulations related to commercial support for CME:  
 
References
Continuing Medical Education 2010-2012: Guide for Osteopathic Physicians. Chicago, IL: American Osteopathic Association; December 2009. http://www.osteopathic.org/inside-aoa/development/continuing-medical-education/Documents/cme-guide-2010-2012.pdf. Accessed March 2, 2012.
Rodgers DJ. AOA continuing medical education. J Am Osteopath Assoc. 2003;103(11):531-538. http://www.jaoa.org/content/103/11/531.full.pdf+html. Accessed March 2, 2012.
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 2, 2012.
Verification & maintenance of certification. American Osteopathic Board of Family Physicians Web site. http://www.aobfp.org/verification-cert/index.html. Accessed March 2, 2012.
Constitution and Bylaws, Regulations and Requirements of the American Osteopathic Board of Anesthesiology. East Lansing, MI: American Osteopathic Board of Anesthesiology; 2003.
Board certification. American Osteopathic Board of Neuromusculoskeletal Medicine Web site. http://aobnmm.org/board-certification/. Accessed March 2, 2012.
Rodgers DJ. AOA continuing medical education. J Am Osteopath Assoc. 2009;109(3):160-179. http://www.jaoa.org/content/109/3/160.full. Accessed March 2, 2012.
Rodgers DJ. AOA continuing medical education. J Am Osteopath Assoc. 2010;110(3):168-182. [PubMed]
Rodgers DJ. AOA continuing medical education. J Am Osteopath Assoc. 2011;111(4):264-278. [PubMed]
Licensing of osteopathic physicians. American Osteopathic Association Web site. http://www.osteopathic.org/osteopathic-health/about-dos/do-licensing/Pages/default.aspx. Accessed March 16, 2011.
Division of State and Socioeconomic Affairs. US Osteopathic Licensure Summary, March 2011. Chicago, IL: American Osteopathic Association; 2010.
Rodgers DJ. Osteopathic continuing medical education. J Am Osteopath Assoc. 2007;107(2):67-81. http://www.jaoa.org/content/107/2/67.full. Accessed March 2, 2012.
Division of Continuing Medical Education. Accreditation Requirements: Category 1 CME Sponsors. Chicago, IL: American Osteopathic Association; 2011. http://www.osteopathic.org/inside-aoa/accreditation/Documents/cme-accreditation-requirements.pdf. Accessed December 16, 2011.
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/content/104/11/493.full. Accessed March 2, 2012.
Figure.
Members of the American Osteopathic Association (AOA) exempted from the AOA's continuing medical education (CME) credit 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.
Members of the American Osteopathic Association (AOA) exempted from the AOA's continuing medical education (CME) credit 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).
Table 1.
Categories of Continuing Medical Education Credits Granted by the American Osteopathic Association
Type
Category A – Formal B – Less Formal
1 – Osteopathic 1-A 1-B
2 – Nonosteopathic 2-A 2-B
Table 1.
Categories of Continuing Medical Education Credits Granted by the American Osteopathic Association
Type
Category A – Formal B – Less Formal
1 – Osteopathic 1-A 1-B
2 – Nonosteopathic 2-A 2-B
×
Table 2.
AOA CME Program, 2010-2012: Categories and Basic Requirements for CME Credits Awarded in 3-Year Cycle
Credit Requirement
Category and Content Mandatory Optionala
Category 1
Category 1-A 30 90
Formal education programs sponsored by AOA-accredited CME sponsors
Osteopathic medical teaching
CME on the Internet (real-time, interactive simultaneous conferencing; includes pre- and posttest; allows participants to ask questions during or after presentation; maximum: 9 credits)
Risk management and managed care programs (AOA sponsored, clinical in nature, and meet the faculty requirement for AOA Category 1-A CME credit)
Standardized federal aviation courses (aviation medicine and flight surgeon primary course)
Federal programs (for participants who are on active duty in the US military or are employed by a uniformed service)
Grand rounds (when submitted as a “series of programs,” as opposed to being submitted on a lecture-by-lecture basis)
Faculty development programs (maximum: 15 credits)b
Judging osteopathic clinical case presentations and research poster presentations (maximum: 10 credits)
Standardized life support courses (maximum: 8 credits)c
Bioterrorism programs that are AOA accredited (face-to-face) (maximum: 8 credits)c
Category 1-B 90
Development and publication of scientific papers and electronically communicated programs intended for physician education
Osteopathic preceptoring (maximum: 60 credits)
Administering certifying board examinations and conducting inspections of osteopathic health care facilities, colleges, and osteopathic postdoctoral training institutions
Passing an AOA recertification examination or a Certification of Added Qualifications examination (maximum: 15 credits)
Attendance at committee and departmental meetings for the review and evaluation of patient care at either an osteopathic or allopathic institution
CME on the Internet (not real-time, interactive conferencing; maximum: 9 credits)
Reading the JAOA or its supplements and passing a JAOA CME quizd
Faculty development programs (AOA sponsored)
Managed care programs (if the faculty requirement is not met)
Risk management programs (administrative in nature)
Federal programs
Journal reading (scientific journals approved by the AOA's CCME and passing the respective CME quiz with a minimum grade of 70%)
Test construction committee work (written test item submitted to an official AOA certifying board or NBOME [maximum: 20 credits] or used in oral or practical examinations [maximum: 10 credits]; clinical cases when developed and submitted to NBOME for COMLEX-USA Level 2-PE [maximum: 20 credits])
Postgraduate in-service examination committee work (specialty boards)
Other osteopathic CME activities approved by the AOA's CCME
Category 2
Category 2-A 90
Formal educational programs that are designed to enhance clinical competency and improve patient care that are sponsored by entities that meet the quality standards of the AOA, the AMA PRA, or the AAFP
CME on the Internet (real-time, interactive conferencing; includes pre- and posttest; allows participants to ask questions during or after presentation)
Risk management programs (clinical in nature, AMA PRA Category 1 sponsored, and AAFP approved)
Bioterrorism programs that are AMA PRA Category 1 accredited or AAFP approved (face-to-face)
Managed care programs (clinical in nature, AMA PRA Category 1 sponsored, and AAFP approved)
Category 2-B 90
Journal-type CME on the Internet
Home study
Scientific exhibit preparation and presentation
CME on the Internet
Risk management programs (administrative in nature)
Passing an American Board of Medical Specialties recertification examination or a Certification of Added Qualifications examination (maximum: 15 credits)
Other CME activities approved by the AOAs CCME
Total CME Requirement 120e
  a The optional Category 1-A requirements listed in this figure are interchangeable. One may select 90 additional credits from any of the 4 continuing medical education (CME) credit types and in any combination, as long as the mandatory 30-credit requirement for Category 1 credit is met.
  b Osteopathic physicians who exceed the maximum limit of 15 Category 1-A CME credits for faculty development programs can apply those excess credits to Category 1-B CME credit if the programs were provided by a Category 1 CME sponsor accredited by the American Osteopathic Association (AOA).
  c Osteopathic physicians who exceed the maximum limit of 8 credits of Category 1-A CME credit in these programs can apply those excess credit hours to Category 1-B CME credit up to the limits indicated in the 2010-2012 CME guide.
  d JAOA—The Journal of the American Osteopathic Association grants 2 Category 1-B CME credits 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 Osteopathic.org can take the quizzes online (http://www.osteopathic.org/quiz). Alternatively, readers can complete the JAOA quiz and mail it with their AOA member number to the Division of CME.
  e Physicians who obtain 150 CME credits in a 3-year CME cycle are recognized and awarded an AOA Certificate of Excellence in CME.
  Abbreviations: AAFP, American Academy of Family Physicians; AMA PRA, American Medical Association Physician Recognition Award; 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 2010-2012: Guide for Osteopathic Physicians.1
Table 2.
AOA CME Program, 2010-2012: Categories and Basic Requirements for CME Credits Awarded in 3-Year Cycle
Credit Requirement
Category and Content Mandatory Optionala
Category 1
Category 1-A 30 90
Formal education programs sponsored by AOA-accredited CME sponsors
Osteopathic medical teaching
CME on the Internet (real-time, interactive simultaneous conferencing; includes pre- and posttest; allows participants to ask questions during or after presentation; maximum: 9 credits)
Risk management and managed care programs (AOA sponsored, clinical in nature, and meet the faculty requirement for AOA Category 1-A CME credit)
Standardized federal aviation courses (aviation medicine and flight surgeon primary course)
Federal programs (for participants who are on active duty in the US military or are employed by a uniformed service)
Grand rounds (when submitted as a “series of programs,” as opposed to being submitted on a lecture-by-lecture basis)
Faculty development programs (maximum: 15 credits)b
Judging osteopathic clinical case presentations and research poster presentations (maximum: 10 credits)
Standardized life support courses (maximum: 8 credits)c
Bioterrorism programs that are AOA accredited (face-to-face) (maximum: 8 credits)c
Category 1-B 90
Development and publication of scientific papers and electronically communicated programs intended for physician education
Osteopathic preceptoring (maximum: 60 credits)
Administering certifying board examinations and conducting inspections of osteopathic health care facilities, colleges, and osteopathic postdoctoral training institutions
Passing an AOA recertification examination or a Certification of Added Qualifications examination (maximum: 15 credits)
Attendance at committee and departmental meetings for the review and evaluation of patient care at either an osteopathic or allopathic institution
CME on the Internet (not real-time, interactive conferencing; maximum: 9 credits)
Reading the JAOA or its supplements and passing a JAOA CME quizd
Faculty development programs (AOA sponsored)
Managed care programs (if the faculty requirement is not met)
Risk management programs (administrative in nature)
Federal programs
Journal reading (scientific journals approved by the AOA's CCME and passing the respective CME quiz with a minimum grade of 70%)
Test construction committee work (written test item submitted to an official AOA certifying board or NBOME [maximum: 20 credits] or used in oral or practical examinations [maximum: 10 credits]; clinical cases when developed and submitted to NBOME for COMLEX-USA Level 2-PE [maximum: 20 credits])
Postgraduate in-service examination committee work (specialty boards)
Other osteopathic CME activities approved by the AOA's CCME
Category 2
Category 2-A 90
Formal educational programs that are designed to enhance clinical competency and improve patient care that are sponsored by entities that meet the quality standards of the AOA, the AMA PRA, or the AAFP
CME on the Internet (real-time, interactive conferencing; includes pre- and posttest; allows participants to ask questions during or after presentation)
Risk management programs (clinical in nature, AMA PRA Category 1 sponsored, and AAFP approved)
Bioterrorism programs that are AMA PRA Category 1 accredited or AAFP approved (face-to-face)
Managed care programs (clinical in nature, AMA PRA Category 1 sponsored, and AAFP approved)
Category 2-B 90
Journal-type CME on the Internet
Home study
Scientific exhibit preparation and presentation
CME on the Internet
Risk management programs (administrative in nature)
Passing an American Board of Medical Specialties recertification examination or a Certification of Added Qualifications examination (maximum: 15 credits)
Other CME activities approved by the AOAs CCME
Total CME Requirement 120e
  a The optional Category 1-A requirements listed in this figure are interchangeable. One may select 90 additional credits from any of the 4 continuing medical education (CME) credit types and in any combination, as long as the mandatory 30-credit requirement for Category 1 credit is met.
  b Osteopathic physicians who exceed the maximum limit of 15 Category 1-A CME credits for faculty development programs can apply those excess credits to Category 1-B CME credit if the programs were provided by a Category 1 CME sponsor accredited by the American Osteopathic Association (AOA).
  c Osteopathic physicians who exceed the maximum limit of 8 credits of Category 1-A CME credit in these programs can apply those excess credit hours to Category 1-B CME credit up to the limits indicated in the 2010-2012 CME guide.
  d JAOA—The Journal of the American Osteopathic Association grants 2 Category 1-B CME credits 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 Osteopathic.org can take the quizzes online (http://www.osteopathic.org/quiz). Alternatively, readers can complete the JAOA quiz and mail it with their AOA member number to the Division of CME.
  e Physicians who obtain 150 CME credits in a 3-year CME cycle are recognized and awarded an AOA Certificate of Excellence in CME.
  Abbreviations: AAFP, American Academy of Family Physicians; AMA PRA, American Medical Association Physician Recognition Award; 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 2010-2012: Guide for Osteopathic Physicians.1
×
Table 3.
CME Requirements for License Renewal by State
State CME Requirements
Alabama 25 Category 1 credits per year
Alaska 25 AOA Category 1 or 2 or AMA PRA Category 1 credits per 1 year
Arizona 20 credits, of which 12 annually must be AOA Category 1-A credit and no more than 8 annually of AMA PRA Category 1 credit
Arkansas 20 Category 1 or 2 credits per year
California 150 Category 1 or 2 credits (AOA or state-board approved) every 3 years; 60 must be Category 1 credit; 12 must be in pain management and the treatment of terminally ill and dying patients (specialists in pathology and radiology are exempt); for general internists and family physicians with more than 25% of their patient population aged 65 years or older, 20 credits must be in geriatric medicine or the care of older patients
Colorado None
Connecticut 50 credits every 2 years
Delaware 40 Category 1 credits (AOA or AMA PRA) every 2 years
District of Columbia No requirements for physicians in continuous practice
Florida 40 credits biennially; 20 credits must be AOA Category 1-A relating to the practice of osteopathic medicine or under osteopathic auspices, 13 to 15 general credits can be AOA or AMA PRA approved; course credits by completion of live, participatory attendance are mandated in professional and medical ethics education (1 credit), Florida laws and rules (1 credit), prevention of medical errors (2 credits), and prescribing of controlled substances (1 credit); additional courses include HIV/AIDS (1 credit) and domestic violence (2 credits every third biennium)
Georgia 40 Category 1 credits (AOA or AMAPRA) every 2 years
Hawaii 40 Category 1 credits during each 2-year licensing cycle (even years)
Idaho 40 practice-relevant Category 1 credits every 2 years
Illinois 150 Category 1 or 2 credits per prerenewal period; 60 credits must be obtained through formal, type A CME programs; remaining 90 credits may be obtained through informal, type B CME programs or activities
Indiana None
Iowa 40 Category 1 credits (AOA or AMA PRA) biennially, which must include training for identifying and reporting abuse. For licensees who regularly provide primary health care to children: 2 credits of training in child abuse identification and reporting in the previous 5 years. For licensees who regularly provide primary health care to adults: 2 credits of training in dependent adult abuse identification and reporting in the previous 5 years. For licensees who regularly provide primary health care to adults and children, separate courses of 2 credits each as outlined above or a combined 2-credit course that includes curricula for identifying and reporting child abuse and dependent adult abuse in the previous 5 years. Fees and CME credits prorated to facilitate renewal process.
Kansas 50 credits per 1 year, 100 credits per 2 years, 150 credits per 3 years
Kentucky 60 Category 1 or 2 credits over 3 years; 30 credits must be Category 1 credit (AOA or AMA PRA); 2 credits must be in the area of HIV/AIDS
Louisiana 20 Category 1 credits (AOA or AMA PRA) per year
Maine 100 state board–approved CME credits per 2-year period; 40 credits must be AOA Category 1-A credit for the following practice areas: family medicine, family practice, general practice, and internal medicine; 40 Category 1 credits in designated specialty area for specialists
Maryland 50 Category 1 credits every 2 years for unlimited license renewal
Massachusetts 100 credits per 2-year period; 40 credits must be Category 1 credit (AOA or AMA) and should include 4 Category 1 and 6 Category 2 credits in risk management; remaining 60 credits can be Category 2 credit
Michigan 150 credits over 3 years; 60 credits must be AOA Category 1 credit, 90 credits must be Category 2 credit
Minnesota 75 Category 1 credits (AOA or AMA PRA) per 3-year period
Mississippi 40 AOA Category 1-A credits or AMA PRA Category 1 credits biennially
Missouri 50 credits (AOA or AMA Category 1) every 2 years
Montana None
Nebraska 50 Category 1 credits (AOA or AMA PRA) every 2 years
Nevada 35 AOA Category 1-A credits per year or 35 AMA PRA Category 1 credits per year; minimum of 10 Category 1 or 1-A credit
New Hampshire 150 credits per 3-year period; 60 credits must be Category 1 AOA or AMA PRA
New Jersey 100 credits every 2 years; 40 must be Category 1 credit
New Mexico Active membership in AOA or 75 Category 1 credits (AOA or AMA PRA) per 3-year period
New York None
North Carolina 150 Category 1 or 2 credits (AOA or AMA PRA) per 3-year cycle; 60 must be Category 1 credit
North Dakota 60 Category 1 credits (AOA or AMA PRA) per 3-year period
Ohio 100 Category 1 or 2 credits over a 2-year period; 40 must be AOA Category 1 credit
Oklahoma 16 AOA Category 1-A credits per year; 1 credit must be in the area of proper prescribing, dispensing, and administering of controlled dangerous substances obtained at a seminar approved by the State Board of Osteopathic Examiners
Oregon 60 credits per 2 years
Pennsylvania 100 Category 1 or 2 credits every 2 years; 20 must be AOA Category 1-A credit, 12 must be in the area of patient safety and/or risk management
Rhode Island 40 Category 1 credits per 2 years; 2 credits must be concerning universal precautions, infection control, modes of transmission, bioterrorism, OSHA, and other regulatory requirements
South Carolina 40 Category 1 credits every 2 years; 30 must be directly related to the type of patient care the licensee renders
South Dakota None
Tennessee 40 AOA Category 1 or 2-A credits per 2 years; 1 must be in prescribing practices
Texas 24 AOA Category 1-A or 2-B credits or AMA PRA Category 1 credit per 1-year period; 1 must be in the area of ethics and/or professional responsibility
Utah 40 Category 1 (AOA or AMA PRA) credits every 2 years
Vermont 30 Category 1 or 2 credits every 2 years; 12 must be osteopathic (AOA Category 1)
Virginia 60 Category 1 or 2 credits within the 2 years immediately preceding renewal; 30 must be Category 1 credit, 15 of which must be earned in an attendance-type setting
Washington 150 Category 1 or 2 credits every 3 years; 60 must be Category 1 credit
West Virginia 32 Category 1 or 2 credits (AOA or state society approved); 16 must be AOA Category 1 credit, and 2 must be in end-of-life care, including pain management
Wisconsin 30 Category 1 credits (AOA or AMA PRA) every 2 years prior to registration
Wyoming 30 Category 1 credits every 2 years
  a Osteopathic physicians should verify the material reported here with their state licensing boards as listed on http://www.ama-assn.org/resources/doc/med-ed-products/continuing-medical-education-licensure.pdf. 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 2010 osteopathic medical education issue is indicated in boldface.
  Abbreviations: ABMS, American Board of Medical Specialties; ACCME, Accreditation Council for Continuing Medical Education; AMA, American Medical Association; CCME, Council on Continuing Medical Education; HIV, human immunodeficiency virus; OSHA, US Department of Labor Occupational Safety and Health Administration; PRA, Physician Recognition's Award.
Table 3.
CME Requirements for License Renewal by State
State CME Requirements
Alabama 25 Category 1 credits per year
Alaska 25 AOA Category 1 or 2 or AMA PRA Category 1 credits per 1 year
Arizona 20 credits, of which 12 annually must be AOA Category 1-A credit and no more than 8 annually of AMA PRA Category 1 credit
Arkansas 20 Category 1 or 2 credits per year
California 150 Category 1 or 2 credits (AOA or state-board approved) every 3 years; 60 must be Category 1 credit; 12 must be in pain management and the treatment of terminally ill and dying patients (specialists in pathology and radiology are exempt); for general internists and family physicians with more than 25% of their patient population aged 65 years or older, 20 credits must be in geriatric medicine or the care of older patients
Colorado None
Connecticut 50 credits every 2 years
Delaware 40 Category 1 credits (AOA or AMA PRA) every 2 years
District of Columbia No requirements for physicians in continuous practice
Florida 40 credits biennially; 20 credits must be AOA Category 1-A relating to the practice of osteopathic medicine or under osteopathic auspices, 13 to 15 general credits can be AOA or AMA PRA approved; course credits by completion of live, participatory attendance are mandated in professional and medical ethics education (1 credit), Florida laws and rules (1 credit), prevention of medical errors (2 credits), and prescribing of controlled substances (1 credit); additional courses include HIV/AIDS (1 credit) and domestic violence (2 credits every third biennium)
Georgia 40 Category 1 credits (AOA or AMAPRA) every 2 years
Hawaii 40 Category 1 credits during each 2-year licensing cycle (even years)
Idaho 40 practice-relevant Category 1 credits every 2 years
Illinois 150 Category 1 or 2 credits per prerenewal period; 60 credits must be obtained through formal, type A CME programs; remaining 90 credits may be obtained through informal, type B CME programs or activities
Indiana None
Iowa 40 Category 1 credits (AOA or AMA PRA) biennially, which must include training for identifying and reporting abuse. For licensees who regularly provide primary health care to children: 2 credits of training in child abuse identification and reporting in the previous 5 years. For licensees who regularly provide primary health care to adults: 2 credits of training in dependent adult abuse identification and reporting in the previous 5 years. For licensees who regularly provide primary health care to adults and children, separate courses of 2 credits each as outlined above or a combined 2-credit course that includes curricula for identifying and reporting child abuse and dependent adult abuse in the previous 5 years. Fees and CME credits prorated to facilitate renewal process.
Kansas 50 credits per 1 year, 100 credits per 2 years, 150 credits per 3 years
Kentucky 60 Category 1 or 2 credits over 3 years; 30 credits must be Category 1 credit (AOA or AMA PRA); 2 credits must be in the area of HIV/AIDS
Louisiana 20 Category 1 credits (AOA or AMA PRA) per year
Maine 100 state board–approved CME credits per 2-year period; 40 credits must be AOA Category 1-A credit for the following practice areas: family medicine, family practice, general practice, and internal medicine; 40 Category 1 credits in designated specialty area for specialists
Maryland 50 Category 1 credits every 2 years for unlimited license renewal
Massachusetts 100 credits per 2-year period; 40 credits must be Category 1 credit (AOA or AMA) and should include 4 Category 1 and 6 Category 2 credits in risk management; remaining 60 credits can be Category 2 credit
Michigan 150 credits over 3 years; 60 credits must be AOA Category 1 credit, 90 credits must be Category 2 credit
Minnesota 75 Category 1 credits (AOA or AMA PRA) per 3-year period
Mississippi 40 AOA Category 1-A credits or AMA PRA Category 1 credits biennially
Missouri 50 credits (AOA or AMA Category 1) every 2 years
Montana None
Nebraska 50 Category 1 credits (AOA or AMA PRA) every 2 years
Nevada 35 AOA Category 1-A credits per year or 35 AMA PRA Category 1 credits per year; minimum of 10 Category 1 or 1-A credit
New Hampshire 150 credits per 3-year period; 60 credits must be Category 1 AOA or AMA PRA
New Jersey 100 credits every 2 years; 40 must be Category 1 credit
New Mexico Active membership in AOA or 75 Category 1 credits (AOA or AMA PRA) per 3-year period
New York None
North Carolina 150 Category 1 or 2 credits (AOA or AMA PRA) per 3-year cycle; 60 must be Category 1 credit
North Dakota 60 Category 1 credits (AOA or AMA PRA) per 3-year period
Ohio 100 Category 1 or 2 credits over a 2-year period; 40 must be AOA Category 1 credit
Oklahoma 16 AOA Category 1-A credits per year; 1 credit must be in the area of proper prescribing, dispensing, and administering of controlled dangerous substances obtained at a seminar approved by the State Board of Osteopathic Examiners
Oregon 60 credits per 2 years
Pennsylvania 100 Category 1 or 2 credits every 2 years; 20 must be AOA Category 1-A credit, 12 must be in the area of patient safety and/or risk management
Rhode Island 40 Category 1 credits per 2 years; 2 credits must be concerning universal precautions, infection control, modes of transmission, bioterrorism, OSHA, and other regulatory requirements
South Carolina 40 Category 1 credits every 2 years; 30 must be directly related to the type of patient care the licensee renders
South Dakota None
Tennessee 40 AOA Category 1 or 2-A credits per 2 years; 1 must be in prescribing practices
Texas 24 AOA Category 1-A or 2-B credits or AMA PRA Category 1 credit per 1-year period; 1 must be in the area of ethics and/or professional responsibility
Utah 40 Category 1 (AOA or AMA PRA) credits every 2 years
Vermont 30 Category 1 or 2 credits every 2 years; 12 must be osteopathic (AOA Category 1)
Virginia 60 Category 1 or 2 credits within the 2 years immediately preceding renewal; 30 must be Category 1 credit, 15 of which must be earned in an attendance-type setting
Washington 150 Category 1 or 2 credits every 3 years; 60 must be Category 1 credit
West Virginia 32 Category 1 or 2 credits (AOA or state society approved); 16 must be AOA Category 1 credit, and 2 must be in end-of-life care, including pain management
Wisconsin 30 Category 1 credits (AOA or AMA PRA) every 2 years prior to registration
Wyoming 30 Category 1 credits every 2 years
  a Osteopathic physicians should verify the material reported here with their state licensing boards as listed on http://www.ama-assn.org/resources/doc/med-ed-products/continuing-medical-education-licensure.pdf. 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 2010 osteopathic medical education issue is indicated in boldface.
  Abbreviations: ABMS, American Board of Medical Specialties; ACCME, Accreditation Council for Continuing Medical Education; AMA, American Medical Association; CCME, Council on Continuing Medical Education; HIV, human immunodeficiency virus; OSHA, US Department of Labor Occupational Safety and Health Administration; PRA, Physician Recognition's Award.
×
Table 4.
Bureau of Osteopathic Specialists: Maximum No. of CME Credit Hours Granted per Cycle by Activity Typea and Specialty Board
American Osteopathic Board of… AMA PRA Category 1 Formal Teaching Standardized Life Support
Anesthesiology 50 50 16
Dermatology 25 25 5
Emergency Medicine 25 25 16
Family Physicians 25 25 5
Internal Medicine 25 25 5
Neurology and Psychiatry 25 25 5
Neuromusculoskeletal Medicine 0 25 5
Nuclear Medicine 50 50 NAb
Obstetrics and Gynecology 50 50 5
Ophthalmology and Otolaryngologyc 50 50 NAb
Orthopedic Surgery 50 50 5
Pathology 50 50 NAb
Pediatrics 50 50 16
Physical Medicine and Rehabilitation 25 25 5
Preventive Medicine 50 50 5
Proctology 50 25 5
Radiology 50 50 16
Surgery 50 50 NAb
  a All activities must be related to the specialty for continuing medical education (CME) credit. Credit is awarded on an hour-by-hour basis for American Osteopathic Association (AOA) specialty college seminars. For each other type of seminar, the number of maximum credits per cycle varies. For example, a maximum of 5 credits is allowed for human immunodeficiency virus/AIDs and risk management seminars; a maximum of 15 credits is allowed for test construction and publications seminars; and a maximum of 25 credits is allowed for AOA state society, foundation, and college of osteopathic medicine seminars. A maximum of 25 credits 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 credits allowed for participating in the annual Osteopathic Medical Conference and Exposition.
  b Credit awarded on an hour-by-hour basis.
  c The full name of this board is the American Osteopathic Boards of Ophthalmology and Otolaryngology-Head and Neck Surgery.
  Abbreviations: AMA PRA, American Medical Association Physician Recognition Award; NA, not applicable.
Table 4.
Bureau of Osteopathic Specialists: Maximum No. of CME Credit Hours Granted per Cycle by Activity Typea and Specialty Board
American Osteopathic Board of… AMA PRA Category 1 Formal Teaching Standardized Life Support
Anesthesiology 50 50 16
Dermatology 25 25 5
Emergency Medicine 25 25 16
Family Physicians 25 25 5
Internal Medicine 25 25 5
Neurology and Psychiatry 25 25 5
Neuromusculoskeletal Medicine 0 25 5
Nuclear Medicine 50 50 NAb
Obstetrics and Gynecology 50 50 5
Ophthalmology and Otolaryngologyc 50 50 NAb
Orthopedic Surgery 50 50 5
Pathology 50 50 NAb
Pediatrics 50 50 16
Physical Medicine and Rehabilitation 25 25 5
Preventive Medicine 50 50 5
Proctology 50 25 5
Radiology 50 50 16
Surgery 50 50 NAb
  a All activities must be related to the specialty for continuing medical education (CME) credit. Credit is awarded on an hour-by-hour basis for American Osteopathic Association (AOA) specialty college seminars. For each other type of seminar, the number of maximum credits per cycle varies. For example, a maximum of 5 credits is allowed for human immunodeficiency virus/AIDs and risk management seminars; a maximum of 15 credits is allowed for test construction and publications seminars; and a maximum of 25 credits is allowed for AOA state society, foundation, and college of osteopathic medicine seminars. A maximum of 25 credits 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 credits allowed for participating in the annual Osteopathic Medical Conference and Exposition.
  b Credit awarded on an hour-by-hour basis.
  c The full name of this board is the American Osteopathic Boards of Ophthalmology and Otolaryngology-Head and Neck Surgery.
  Abbreviations: AMA PRA, American Medical Association Physician Recognition Award; NA, not applicable.
×
Table 5.
AOA-Accredited Category 1 CME Sponsors (N=156)a
Organization No. (%)
Affiliates
Nonpractice (AOA)b 2 (<1)
Colleges
Colleges of osteopathic medicine (AOA accredited) 21 (13)
Alumni groupsb NA
Specialty (AOA affiliated)b NA
Foundations (AOA Affiliated)b 8 (5)
Hospitals 43 (28)
Military 1 (<1)
Philanthropic Organizations (AOA Affiliated)c
Professional Associations 1 (<1)
Societies
Divisional (AOA affiliated)b NA
Specialty 26 (17)
State 54 (35)c
  a The number of continuing medical education (CME) sponsors in each category are accurate as of November 28, 2011. Percentages do not total 100 because of rounding.
  b Applications for sponsorship are currently limited to the organizations indicated.
  c The 54 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 separate district societies: Broward County, District 7: and Southwest, District 11).
  Abbreviations: AOA, American Osteopathic Association; NA, not applicable.
Table 5.
AOA-Accredited Category 1 CME Sponsors (N=156)a
Organization No. (%)
Affiliates
Nonpractice (AOA)b 2 (<1)
Colleges
Colleges of osteopathic medicine (AOA accredited) 21 (13)
Alumni groupsb NA
Specialty (AOA affiliated)b NA
Foundations (AOA Affiliated)b 8 (5)
Hospitals 43 (28)
Military 1 (<1)
Philanthropic Organizations (AOA Affiliated)c
Professional Associations 1 (<1)
Societies
Divisional (AOA affiliated)b NA
Specialty 26 (17)
State 54 (35)c
  a The number of continuing medical education (CME) sponsors in each category are accurate as of November 28, 2011. Percentages do not total 100 because of rounding.
  b Applications for sponsorship are currently limited to the organizations indicated.
  c The 54 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 separate district societies: Broward County, District 7: and Southwest, District 11).
  Abbreviations: AOA, American Osteopathic Association; NA, not applicable.
×
Table 6.
Checklist of AOA Accreditation Requirements for Category 1 Continuing Medical Education (CME)
Checklist Itema Maximum Points
1. A description of the needs assessment process and procedure used in determining the content and topic of the program (include any supporting documents). 8
2. A copy of the CME program brochure or agenda distributed to participants at the CME program. 4
3. Copies of ALL program participants' (speakers and moderators in chronological order) curricula vitae (CVs) or biosketch defining their qualifications for involvement in the CME program. Partial credit is awarded based on the percentage of CVs and biosketches provided during the document survey review (eg, 5 CVs provided from a total of 10 speakers yields 4 points). All fractions are rounded down. 8b
4. A copy of each speaker's signed Disclosure Declaration Statement in chronological order. Partial credit is awarded based on the percentage of the disclosure statements provided during the document survey. 8c
5. A copy of the CME credits requested by the AOA-accredited sponsor for each participating physician in accordance with the attesting document. 4
6. A copy of the program administration evaluation document and the total number of evaluation documents returned by conference registrants. Provide 2 copies of the program evaluation documents that were returned by conference attendees. 4
7. A statement indicating the total number of registrants and the number of attestation forms returned by conference participants. 8d
8. A statement reflecting the distribution of program evaluation documents (ie, the beginning of the program, random survey, etc). 4
9. A policy statement on managing grievances relative to the returned program administration and evaluation document(s). 4
10. A copy of the program outcomes questionnaire and the total number of outcomes questionnaire documents returned by conference registrants. Provide 2 copies of the outcomes questionnaire documents that were returned by conference attendees (within 90 days after the program). 4
11. Provide:
A. Needs assessment per program topic. 12e
B. A statement relative to how topics and/or speakers were selected in direct response to needs assessment procedures. 4
12. If the program was commercially supported, the following additional items must be submitted:
A. A copy of the formal written agreement between the AOA CME sponsor and each commercial supporter reflecting that activity (program) is educational and not promotional. 8c
B. Proof that commercial support is appropriately acknowledged in any printed promotional materials. 4
C. A brief statement regarding all funding arrangements; include how funds received from commercial supporters were expended, how speakers were paid, such as, if speakers were directly funded by a third party agent (someone besides the AOA CME sponsor/provider), attach copy of the funding arrangement between the CME sponsor and the third party agent. 8c
D. A statement indicating how disclosure information regarding each speaker was given to the participants. 8c
Total Score 100f
  a Checklist items with a maximum score of 8 or 12 points are major items; those with a maximum score of 4 points are minor items. Category 1 CME Sponsors are encouraged to measure outcomes as defined by the Council on CME for at least 1 program in the 2010-2012 CME Cycle and will be required to measure 1 program for outcomes in the 2013-2015 CME Cycle.
  b Partial credit is awarded: less than 50% completed=0 points, 50%=4 points, 90%=8 points.
  c Partial credit is awarded: less than 90% completed=0 points, 90%=8 points.
  d Partial credit is awarded: 25% completed=2 points, 50%=4 points, 95%=8 points.
  e Partial credit is awarded: 25% completed=2 points, 50%=4 points, 75%=6 points, 95%=12 points.
  f If the total score is 100 points, a 3-year accreditation with commendation status is awarded; if 95 points or more, a 3-year accreditation is awarded; if 80-94 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.
Table 6.
Checklist of AOA Accreditation Requirements for Category 1 Continuing Medical Education (CME)
Checklist Itema Maximum Points
1. A description of the needs assessment process and procedure used in determining the content and topic of the program (include any supporting documents). 8
2. A copy of the CME program brochure or agenda distributed to participants at the CME program. 4
3. Copies of ALL program participants' (speakers and moderators in chronological order) curricula vitae (CVs) or biosketch defining their qualifications for involvement in the CME program. Partial credit is awarded based on the percentage of CVs and biosketches provided during the document survey review (eg, 5 CVs provided from a total of 10 speakers yields 4 points). All fractions are rounded down. 8b
4. A copy of each speaker's signed Disclosure Declaration Statement in chronological order. Partial credit is awarded based on the percentage of the disclosure statements provided during the document survey. 8c
5. A copy of the CME credits requested by the AOA-accredited sponsor for each participating physician in accordance with the attesting document. 4
6. A copy of the program administration evaluation document and the total number of evaluation documents returned by conference registrants. Provide 2 copies of the program evaluation documents that were returned by conference attendees. 4
7. A statement indicating the total number of registrants and the number of attestation forms returned by conference participants. 8d
8. A statement reflecting the distribution of program evaluation documents (ie, the beginning of the program, random survey, etc). 4
9. A policy statement on managing grievances relative to the returned program administration and evaluation document(s). 4
10. A copy of the program outcomes questionnaire and the total number of outcomes questionnaire documents returned by conference registrants. Provide 2 copies of the outcomes questionnaire documents that were returned by conference attendees (within 90 days after the program). 4
11. Provide:
A. Needs assessment per program topic. 12e
B. A statement relative to how topics and/or speakers were selected in direct response to needs assessment procedures. 4
12. If the program was commercially supported, the following additional items must be submitted:
A. A copy of the formal written agreement between the AOA CME sponsor and each commercial supporter reflecting that activity (program) is educational and not promotional. 8c
B. Proof that commercial support is appropriately acknowledged in any printed promotional materials. 4
C. A brief statement regarding all funding arrangements; include how funds received from commercial supporters were expended, how speakers were paid, such as, if speakers were directly funded by a third party agent (someone besides the AOA CME sponsor/provider), attach copy of the funding arrangement between the CME sponsor and the third party agent. 8c
D. A statement indicating how disclosure information regarding each speaker was given to the participants. 8c
Total Score 100f
  a Checklist items with a maximum score of 8 or 12 points are major items; those with a maximum score of 4 points are minor items. Category 1 CME Sponsors are encouraged to measure outcomes as defined by the Council on CME for at least 1 program in the 2010-2012 CME Cycle and will be required to measure 1 program for outcomes in the 2013-2015 CME Cycle.
  b Partial credit is awarded: less than 50% completed=0 points, 50%=4 points, 90%=8 points.
  c Partial credit is awarded: less than 90% completed=0 points, 90%=8 points.
  d Partial credit is awarded: 25% completed=2 points, 50%=4 points, 95%=8 points.
  e Partial credit is awarded: 25% completed=2 points, 50%=4 points, 75%=6 points, 95%=12 points.
  f If the total score is 100 points, a 3-year accreditation with commendation status is awarded; if 95 points or more, a 3-year accreditation is awarded; if 80-94 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.
×
Table 7.
AOA Members With a CME Requirement
AOA Members, No.
3-Year Cycle CME Requirementa Dropped from Membership
1973 to 1976b NA NA
1977 to 1979 10,373 239
1980 to 1982 12,050 159
1983 to 1985 11,881 298
1986 to 1988 12,901 43
1989 to 1991 16,093 159
1992 to 1994 16,040 146
1995 to 1997 19,315 214
1998 to 2000 21,383 219
2001 to 2003 23,770 259
2004 to 2006 25,964 296
2007 to 2009 30,332 320
2010 to 2012c 32,325 NA
  a The number of American Osteopathic Association (AOA) physician-members who have a continuing medical educaton (CME) requirement are those whose state or specialty boards mandate a CME requirement for relicensure.
  b Numbers are not reported for the 1973-1976 CME cycle because the program was in its testing phase during those years.
  c Number reported for the 2010-2012 cycle is current as of December 1, 2011.
  Abbreviation: NA, not available.
Table 7.
AOA Members With a CME Requirement
AOA Members, No.
3-Year Cycle CME Requirementa Dropped from Membership
1973 to 1976b NA NA
1977 to 1979 10,373 239
1980 to 1982 12,050 159
1983 to 1985 11,881 298
1986 to 1988 12,901 43
1989 to 1991 16,093 159
1992 to 1994 16,040 146
1995 to 1997 19,315 214
1998 to 2000 21,383 219
2001 to 2003 23,770 259
2004 to 2006 25,964 296
2007 to 2009 30,332 320
2010 to 2012c 32,325 NA
  a The number of American Osteopathic Association (AOA) physician-members who have a continuing medical educaton (CME) requirement are those whose state or specialty boards mandate a CME requirement for relicensure.
  b Numbers are not reported for the 1973-1976 CME cycle because the program was in its testing phase during those years.
  c Number reported for the 2010-2012 cycle is current as of December 1, 2011.
  Abbreviation: NA, not available.
×
Table 8.
Total Number of CME Credits Recorded (in Millions) by the AOA for Each 3-Year CME Cycle
CME Credit Category
3-Year Cycle 1-A 1-B 2a Total
1973 to 1976 1.3 0.1 1.1 2.5
1977 to 1979 1.4 0.8 0.5 2.7
1980 to 1982 1.5 1.3 0.6 3.4
1983 to 1985 1.5 1.4 0.8 3.7
1986 to 1988 1.8 3.0 1.1 5.9
1989 to 1991 2.2 3.7 1.3 7.2
1992 to 1994 2.3 4.1 1.2 7.6
1995 to 1997 2.5 5.7 1.6 9.8
1998 to 2000 3.0 7.3 1.7 12.0
2001 to 2003 2.9 8.6 1.6 13.1
2004 to 2006 2.6 9.2 2.1 13.9
2007 to 2009 2.7 11.0 1.8 15.5
2010 to 2012b 1.5 6.3 0.7 8.5
  a Numbers reported for continuing medical education (CME) credit Category 2 include all Category 2-A and Category 2-B credits recorded.
  b Data are current as of December 18, 2011.
  Abbreviations: AOA, American Osteopathic Association; NA, not available.
Table 8.
Total Number of CME Credits Recorded (in Millions) by the AOA for Each 3-Year CME Cycle
CME Credit Category
3-Year Cycle 1-A 1-B 2a Total
1973 to 1976 1.3 0.1 1.1 2.5
1977 to 1979 1.4 0.8 0.5 2.7
1980 to 1982 1.5 1.3 0.6 3.4
1983 to 1985 1.5 1.4 0.8 3.7
1986 to 1988 1.8 3.0 1.1 5.9
1989 to 1991 2.2 3.7 1.3 7.2
1992 to 1994 2.3 4.1 1.2 7.6
1995 to 1997 2.5 5.7 1.6 9.8
1998 to 2000 3.0 7.3 1.7 12.0
2001 to 2003 2.9 8.6 1.6 13.1
2004 to 2006 2.6 9.2 2.1 13.9
2007 to 2009 2.7 11.0 1.8 15.5
2010 to 2012b 1.5 6.3 0.7 8.5
  a Numbers reported for continuing medical education (CME) credit Category 2 include all Category 2-A and Category 2-B credits recorded.
  b Data are current as of December 18, 2011.
  Abbreviations: AOA, American Osteopathic Association; NA, not available.
×