Abstract
The current continuing medical education (CME) cycle began on January 1, 2007, and will end on December 31, 2009. The author provides an update on trends in osteopathic CME programs, details minor changes to the requirements for Category 1 CME sponsors accredited by the American Osteopathic Association, and describes new online CME opportunities. The current article also explains changes regarding the American Osteopathic Association's awarding and recording of CME credit hours for osteopathic physicians who have specialty board certification. In addition, the article includes information to assist osteopathic specialists and subspecialists in requesting American Osteopathic Association Category 1-A credit for courses accredited by the Accreditation Council for Continuing Medical Education.
A physician must maintain a current, full, and unrestricted license to practice medicine in the United States, its territories, or Canada. Continuing medical education (CME) helps physicians learn about new and developing areas in their fields of expertise. Activities for CME may consist of live events, written publications, online programs, and audio, video, or other electronic presentations. Content for CME activities is developed, reviewed, and delivered by faculty who are experts in their individual clinical areas. The Council on Continuing Medical Education (CCME) of the American Osteopathic Association (AOA) is committed to identifying and responding to the needs of osteopathic physicians (DOs) in order to facilitate ongoing improvement in the quality of patient care. The CCME also encourages voluntary participation in CME by AOA nonmembers. However, all members of the AOA, other than those otherwise exempted (
Figure 1), are required to participate in the AOA CME program and to meet specific CME credit-hour requirements for each 3-year CME cycle. Currently, 84% of all AOA members have a CME requirement.
The present article provides an update of the AOA CME program for the current CME cycle, which began on January 1, 2007, and will end on December 31, 2009. Topic areas include earning CME for relicensure, recent changes in CME policies, and the continuing struggle with the awarding and recording of CME credit hours for DOs who are specialty-certified.
Continuing medical education credit hours are granted by the AOA from any of four categories: 1-A, 1-B, 2-A, or 2-B (
Figure 2). In general, CME credit from Category 1 is osteopathic (ie, AOA-accredited); Category 2 credit is nonosteopathic; type A credit is granted for formal, didactic courses; and type B credit is for less formal CME activities, such as hospital committee work or reading the scientific content in
JAOA—The Journal of the American Osteopathic Association in conjunction with completing a
JAOA CME quiz.
At its February 2003 meeting, the AOA Board of Trustees (BOT) set the CME requirement for AOA membership at 120 credit hours, with a minimum of 30 hours dedicated to earning Category 1-A credits.
1 The CCME considers exemptions, reductions, and waivers to its CME requirements on a case-by-case basis. However, no waiver for this 120-hour requirement will be granted unless due cause or inability to obtain hours is demonstrated to the CCME. The remaining 90 hours of the 120-hour requirement may be obtained by combining CME credits earned from any of the four credit categories (ie, 1-A, 1-B, 2-A, or 2-B). A maximum of 60 hours of Category 1-B credit for osteopathic preceptoring may be applied to the basic 120-hour requirement. In addition, the AOA, like the American Medical Association (AMA), awards a Certificate of Excellence to physicians who demonstrate exceptional commitments to CME.
2,3 A more detailed description of how CME credit is categorized by the AOA can be found in
Figure 3.
As of December 2008, a total of 33,918 osteopathic physicians have earned Category 1-A credit by attending formal education programs sponsored by AOA Category 1 CME sponsors. In addition, 2325 DOs have earned Category 1-A credit by participating in “osteopathic medical teaching,” as designated by the AOA Division of CME.
2 A total of 28,647 DOs have participated in such activities as “hospital inspections/specialty board examinations,” “hospital committee meetings,” “osteopathic medical teaching/preceptorship,” “other osteopathic CME,” and “scientific papers/publication.”
2 The Division of CME has recorded 8.9 million hours of Category 1-B credit for preceptoring by 11,866 DOs. For Category 2-A and 2-B combined, the Division of CME has recorded 1.9 million hours of CME by 19,990 DOs.
For new AOA physician-members, CME requirements are reduced according to a proration schedule, based on the date when the DO joined the AOA after the beginning of a new 3-year CME cycle. For those DOs who have specialty board certification through the AOA, of the total 120-hour requirement for CME credits, 50 hours of either Category 1 or Category 2 credit must be earned in CME activities related to the primary specialty field. However, the total CME requirement for DOs certified by the American Osteopathic Board of Family Physicians is higher, at 150 hours per 3-year CME cycle.
4 Failure to fulfill the AOA's CME requirement may result in loss of AOA specialty board certification. In recent years, the majority of the CCME's discussions and changes to the CME program have related to this component of member requirements, as further detailed beginning on page 166 of the present article.
Physician-members have opportunities to earn CME credit from many osteopathic medical organizations. A brief summary of programs sponsored or cosponsored by AOA-accredited CME sponsors are provided in the
The DO magazine's “Coming Events” department at the back of each issue. Additional information regarding such programs is available on the DO-Online calendar, which is accessible through the Calendar link on the navigation bar at the top of the Web site (see
http://www.do-online.org). More detailed information regarding CME guidelines for the current 2007-2009 CME cycle is available on DO-Online at
http://www.do-online.org/index.cfm?PageID=cme_main.
CME Requirements for State Licensure Renewal
Forty-three state licensing boards require CME for license renewal (
Figure 4).
5 Although the AOA CME program is on a 3-year CME cycle, state licensure boards have either a 2-year or 3-year CME cycle for their requirements. Medical licenses are granted to those physicians meeting all state requirements at the discretion of the state board. All physicians—DOs and allopathic physicians (MDs)—must pass examinations to obtain state licenses to practice.
Osteopathic physicians are licensed to practice medicine in the United States by licensing boards in each state. Requirements for licensure vary by state, but there are generally three methods by which a DO can become licensed to practice medicine:
Successful completion of a medical licensing examination administered by the state licensing board—A state board may prepare its own examination or administer an examination that has been prepared and purchased from a specialized agency. The US Medical Licensing Examination (USMLE) and the Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) are currently the most widely used tests.
Acceptance of the certificate issued by the National Board of Osteopathic Medical Examiners (NBOME)—This certificate is awarded after an applicant has satisfied the NBOME requirements, including successfully passing the COMLEX-USA.
Reciprocity or endorsement of a license previously received from another state—Typically, the license presented for reciprocity or endorsement must have been issued on the basis of a written examination.
Although a DO may satisfy the basic licensing requirements for a given state, meeting these requirements does not guarantee licensure. State licensing boards evaluate each applicant on an individual basis. For example, a state licensing board verifies personal and professional information provided by the applicant and appraises the moral character of the applicant. Some states also mandate CME content, such as knowledge of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), risk management, and end-of-life palliative care. In addition, many states require that a certain percentage of CME credit hours be in Category 1.
Readers are encouraged to review the
US Osteopathic Licensure Summary,
5 which is available in the members-only section of DO-Online. State licensure requirements, categorized by profession, are also available on the CE Medicus Web site at
http://www.cemedicus.com/common_state_requirements/index.htm. Web links to the state licensing boards can be found at
http://www.osteopathic.org/index.cfm?PageID=ado_license. Physician-members who are interested in additional information about state licensing requirements are strongly encouraged to contact their individual state licensing boards, which are listed in the appendix on pages 175-179.
DO-Online's CME Center
DO-Online's “Spotlight on CME” Web site (see
http://www.docmeonline.com) gives physician-members ready access to hundreds of hours of accredited online CME courses. With the help of this feature, AOA members can search through a catalog of online CME activities and quizzes, access and complete those activities and quizzes online, and receive a printable screen certificate immediately afterward. Credits for CME activities completed online are automatically applied to members' CME activity reports (CARs).
Physician-members can view their current CARs at any time through DO-Online's “Spotlight on CME” Web site. In addition, CARs from previous CME cycles are archived online for at least 6 years after the end of a cycle (eg, reports for the 2004-2006 cycle will be archived on the site through 2012). However, only those DOs who are AOA members and registered DO-Online users can review their CARs online. Those members who have not created an account to view their CAR information may do so by contacting the AOA Department of Membership at (800) 621-1773, extension 8284.
The AOA has always maintained member CARs as private documents. However, a physician-member can download his or her CAR or request that it be sent via e-mail to a third party. The AOA releases a member's CAR to outside agencies (eg, state licensing boards, hospitals, attorneys, government agencies) only on written request by the physician-member. Through DO-Online, the AOA continues to maintain the confidentiality of this information, but individual physician-members have the added convenience of forwarding this information electronically at their discretion.
As previously noted in the
JAOA,
6 the AOA no longer routinely mails CARs to its physician-members. Members who do not have online access are asked to contact the AOA Division of CME to request an updated CAR, which can be sent by e-mail, fax, or mail. These requests can be submitted via phone ([800] 621-1773, extension 8262) or e-mail (
CME@osteopathic.org), they can be faxed to (312) 202-8202, or they can be mailed to the following address: American Osteopathic Association, Attn: Division of CME, 142 E Ontario St, Chicago, IL 60611-2864.
The CCME continues to believe that all CME activity should be audited. Therefore, physician-members are not allowed to manually enter or update their CME records online. Physician-members should continue to submit their update requests for CME credit directly to the AOA Division of CME, using the contact information in the previous paragraph.
Physician-members are encouraged to mail any other correspondence regarding their CARs to the Division of CME address previously mentioned.
Recent Activities at the AOA
The CCME meets three times annually (ie, January, April, November) to address members' concerns and routine business related to CME programming. 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. A listing of the current members of the CCME may be found at
http://www.do-online.org/pdf/CCMEList2008-2009.pdf.
At its July 2008 meeting, the AOA BOT appointed Michael J. Feinstein, DO, as the CCME's chairman. Dr Feinstein has served on the CCME for 12 years. He is a family physician based in San Diego, Calif, who is AOA board certified in family practice and a fellow of the American College of Osteopathic Family Physicians. Dr Feinstein, who was honored by the American Academy of Family Physicians as Family Physician of the Year in 1992, holds a full professorship in family medicine at Western University of Health Sciences College of Osteopathic Medicine of the Pacific in Pomona, Calif. He is also a past president (2002-2006) of the Osteopathic Medical Board of California, and he was recently appointed to the governing board of Lake Erie College of Osteopathic Medicine in Erie, Pa.
At its November 2007 meeting, the CCME discussed at length various methods to assist subspecialists in obtaining AOA Category 1-A CME credit hours. The CCME is concerned about problems related to the granting of subspecialty CME credit, which is not readily available within the osteopathic medical profession. The Council is aware that this issue continues to present challenges to the whole profession and is taking steps to address the problems.
After some discussion, the late Morton Morris, DO, JD, previous chairman of the CCME, appointed a subcommittee to examine proposals for recognizing allopathic CME programs for specialties and subspecialties in which CME credit hours are not available through osteopathic sponsors. At its April 2008 meeting, the CCME approved a resolution on this matter, which was also approved by the AOA BOT at its annual meeting in July 2008. Resolution B02 (A/2008), AOA Category 1-A CME Credit for Osteopathic Specialists/Subspecialists, is intended to make the process of earning AOA Category 1-A credit easier for DO specialists and subspecialists (
http://www.do-online.org/pdf/AOA_%20Category_Osteo_Spec_Subspec.July08.pdf).
Resolution B02 applies to DOs in specialties and subspecialties that have fewer than 250 AOA board-certified osteopathic physicians. These DOs may satisfy a portion of their AOA Category 1-A requirement using credits from programs in their specialties and subspecialties that are accredited by the Accreditation Council for Continuing Medical Education (ACCME). Specialists and subspecialists qualifying under the resolution will be able to substitute 20 ACCME Category 1 credits for AOA Category 1-A credits during the 2007-2009 CME cycle; 15 such credits during the 2010-2012 cycle; and 10 such credits during the 2013-2015 cycle. These ACCME credits will count toward the 30 total hours of AOA Category 1-A credit that AOA members are required to earn during each CME cycle.
Thus, the ACCME Category 1 credits will “sunset” during CME cycles in the following manner:
2007-2009—20 ACCME Category 1 credits; 10 AOA Category 1-A credits
2010-2012—15 ACCME Category 1 credits; 15 AOA Category 1-A credits
2013-2015—10 ACCME Category 1 credits; 20 AOA Category 1-A credits
2016—0 ACCME Category 1 credits; 30 AOA Category 1-A credits
The CCME also encourages all AOA-accredited CME sponsors to develop interactive, online Category 1-A programs and other innovative approaches to help provide osteopathic specialists and subspecialists with relevant, high-quality Category 1-A CME.
Furthermore, in November 2008, the CCME reaffirmed its policy regarding preceptoring physician-assistant students—namely that no CME credit hours will be awarded for such preceptoring. Credit hours may be granted only for preceptoring osteopathic medical students.
The CCME is in the process of rewriting its guidelines for the next CME cycle (ie, January 1, 2010-December 31, 2012).
CME on the Internet
In February 2008, the AOA BOT approved a resolution regarding Category 1-A CME opportunities available on the Internet (Resolution 6 [M/2008]—CME on the Internet). As dictated by the approved resolution (
http://www.do-online.org/pdf/cal_midyr08res06.pdf), Category 1-A credit hours will be awarded only to real-time, interactive, simultaneous conferencing that includes both an online pretest and posttest and that allows participants to ask questions during or immediately after the presentation. This change was also approved for AOA Category 2-A CME credit.
Guidelines for Osteopathic Specialty Board Certification
Medical specialty certification in the United States is a voluntary process.
7 Although general AOA CME requirements help DOs maintain their medical competence and their ability to diagnose illness and treat patients, these requirements are not specialty specific. American Osteopathic Association board certification demonstrates a DO's commitment to and expertise in a particular specialty or subspecialty of medicine. As previously noted, DOs who wish to maintain specialty board certification through the AOA are required to earn a minimum of 50 hours of AOA Category 1 or Category 2 CME credit in their specialty areas during each 3-year CME cycle.
In February 2006, the AOA BOT approved the recommended guidelines for academic and professional activities that allow specialty-board–certified DOs to satisfy existing CME requirements (Resolution 45 [M/2006]—Specialty CME Reporting). These specialty-board “templates” were designed to provide physician-members with a wide variety of options for earning CME credit hours while also maintaining overall consistency among the specialties.
6 Figure 5 provides a summary of areas of divergence among specialties. For the activities noted in
Figure 5 (ie, AOA specialty college seminars, ACCME courses, formal teaching, and standardized/basic life support), the maximum number of CME credit hours accepted per 3-year CME cycle must be designated at the beginning of each new CME cycle.
Although the number of credit hours accepted by each member board cannot change within a given cycle, some boards submitted their final recommendations for the 2007-2009 CME cycle after the start of the cycle. For example, the American Osteopathic Board of Internal Medicine indicated that it would accept only as many as 25 hours of ACCME courses, 25 hours of formal (ie, clinical didactic) teaching, and 5 hours of standardized life support courses.
In August 2006, the AOA entered all approved guidelines into its database. However, one question remained about the recommendations for “formal teaching”—should a preceptoring osteopathic medical student be considered eligible for specialty-board–mandated CME credit hours? In January 2007, the CCME discussed this topic in depth, eventually approving as many as 25 credit hours of preceptoring per CME cycle as applied to physician-members' specialty-board requirements. However, these hours will not be applied to member records for those DOs who are in specialties in which boards or colleges indicated objections to granting members CME credit for this activity (ie, American Osteopathic Board of Obstetrics and Gynecology, American Osteopathic Board of Surgery, and American College of Osteopathic Emergency Physicians). This change has been implemented for the current 2007-2009 CME cycle.
The CCME continues to study the awarding of specialty CME credit hours. In November 2007, the Council e-mailed a two-question survey to all AOA certifying boards regarding the issue of how specialty credits should be designated for programs that are sponsored by other societies. The AOA Bureau of Osteopathic Specialists (BOS), in collaboration with the CCME, asked that the boards work with the osteopathic specialty colleges to respond to the survey, which included the following questions:
Will the AOA specialty boards accept credit hours designated as specialty credit from state societies as being sufficient to satisfy the specialty credit-hours requirement for meetings that are conducted by other societies?
Will the board require approval from the specialty affiliates to accept recommendations from the state societies?
The CCME reviewed the survey responses at its January 2008 meeting and asked the BOS to establish guidelines for processing osteopathic specialty credit hours.
At its April 2008 meeting, the Council revisited the issue of recording AOA specialty credits for osteopathic entities during the 2007-2009 CME cycle. The chairman of the AOA Department of Educational Affairs instructed CCME staff to begin the recording process of specialty credit hours as of March 6, 2008. The interim rules for applying CME credit to the 50-hour specialty credit requirement are as follows:
Continuing medical education credit from osteopathic specialty colleges applies to the specialty credit requirement on an unlimited hour-by-hour basis.
Continuing medical education credit from osteopathic state societies and AOA CME sponsors other than specialty colleges applies to the specialty credit requirement on an hour-by-hour basis up to a maximum of 25 hours per cycle. Osteopathic state societies and AOA CME sponsors other than specialty colleges will continue to self-designate the number of hours that apply to each specialty, as they have in the past.
The AOA BOS will continue to develop criteria to assist state societies and AOA CME sponsors other than specialty colleges in defining the correct amount of specialty credit for their CME programs. Once adopted, the criteria will also be used to evaluate the specialty credits designated by these institutions. The BOS will use a random audit process to evaluate compliance with the criteria. Until the criteria are developed and adopted, state societies and AOA CME sponsors other than specialty colleges should use basic rules of reasonableness in determining the number of credit hours that apply to their CME programs.
The CCME and BOS have formed a task force that is currently reviewing and discussing a policy to assist state societies, osteopathic hospitals, colleges of osteopathic medicine, and osteopathic foundations in determining activities that will be eligible for specialty credit hours during the 2010-2012 CME cycle. This matter will be revisited at the April 2009 “cluster meetings” of AOA councils and bureaus, with the goal of developing final rules for applying CME programs to the 50-hour specialty credit requirement. Any recommended rules on this matter will be considered by the AOA BOT at its July 2009 meeting.
AOA-Accredited Category 1 CME Sponsors
Table 1
AOA-Accredited Category 1 CME Sponsors (N=159) *
Organization
|
No. (%)
|
|---|
| ▪ Affiliates | |
| □ Nonpractice (AOA)† | NA |
| □ Female | 1 (<1) |
| ▪ Colleges | |
| □ Colleges of osteopathic medicine (AOA accredited) | 19 (12) |
| — Alumni groups† | NA |
| □ Specialty (AOA affliated)† | NA |
| ▪ Foundations (AOA affiliated)† | 9 (5) |
| ▪ Hospitals | 48 (30) |
| ▪ Military | 1 (<1) |
| ▪ Philanthropic organizations (AOA affiliated)† | NA |
| ▪ Professional associations | 1 (<1) |
| ▪ Societies | |
| □ Divisional (AOA affliated)† | NA |
| □ Specialty | 27 (17) |
| □ State | 54 (34)‡ |
Table 1
AOA-Accredited Category 1 CME Sponsors (N=159) *
Organization
|
No. (%)
|
|---|
| ▪ Affiliates | |
| □ Nonpractice (AOA)† | NA |
| □ Female | 1 (<1) |
| ▪ Colleges | |
| □ Colleges of osteopathic medicine (AOA accredited) | 19 (12) |
| — Alumni groups† | NA |
| □ Specialty (AOA affliated)† | NA |
| ▪ Foundations (AOA affiliated)† | 9 (5) |
| ▪ Hospitals | 48 (30) |
| ▪ Military | 1 (<1) |
| ▪ Philanthropic organizations (AOA affiliated)† | NA |
| ▪ Professional associations | 1 (<1) |
| ▪ Societies | |
| □ Divisional (AOA affliated)† | NA |
| □ Specialty | 27 (17) |
| □ State | 54 (34)‡ |
×
All AOA-accredited Category 1 CME sponsors are obligated to meet certain requirements to maintain their accreditation status. The CCME in 2008 updated the AOA accreditation standards for AOA Category 1 CME sponsors,
8 as approved by the BOT in previous years. Changes related to these standards appear in
Figure 6, which shows how the “checklist items” on the accreditation requirement document were amended to include the number of points to be awarded for each item—”major” items receive 8 points, and “minor” items receive 4 points.
At its April 2008 and November 2008 meetings, the Council revisited Standard 5.5, regarding language to be used for “advertising AOA Category 1-A CME credit” when a sponsor's CME program has not yet been approved by the CCME. The Council approved the following language to be used in such cases:
The [NAME OF SPONSOR] has requested that the AOA Council on Continuing Medical Education approve this program for [X] hours of AOA Category 1-A CME credit. Approval is currently pending.
On an ongoing schedule, CCME and AOA staff monitor sponsor compliance (ie, “spot monitoring”) with AOA policies and the CCME-approved Uniform Guidelines for Accrediting Agencies of Continuing Medical Education.
8 Once a sponsor has been selected for review, the AOA will request documentation of their CME activities and then use a checklist (
Figure 6) to determine whether all requirements have been met or whether certain deficiencies exist. In addition, CCME and AOA staff investigate all written complaints or deviations from AOA policy using standard compliance-review procedures.
8,9
In the most recent reviews, all AOA CME sponsors were in full compliance with the accreditation program except for two: one CME sponsor did not comply with the requirement to attend a CME sponsors' conference within its accreditation cycle, and the Council revoked one sponsor's accreditation for failure to comply with sponsoring a CME program within its accreditation term. Reviews of accreditation requirement documents also show that some sponsors do not submit “letters of agreement” revealing that their CME activities are funded by pharmaceutical companies.
The AOA Division of CME provides the following informative materials for AOA-accredited Category 1 CME sponsors:
Complete list of AOA CME courses submitted by AOA-accredited Category 1 CME sponsors on a quarterly basis to allow sponsors to verify that they have reported all their CME programs to the AOA.
AOA Speakers' Bureau Directory every 2 years as approved by the BOT to assist sponsors in obtaining speakers on unique topics.
List and mailing labels of osteopathic physicians who have failed to submit their AOA CME credits to allow sponsors to contact those DOs and encourage them to fulfill their CME requirements.
Annual listing of AOA member identification numbers for use in reporting CME credits.
Online Calendar
Changes are currently being made to the calendar on DO-Online to give Category 1 CME sponsors the ability to directly enter their own events in the calendar through a secure online interface. All added calendar items will be reviewed by the American Osteopathic Information Association (AOIA) before being posted to the site. This information was presented by Michael J. Zarski, JD, Executive Director of the AOIA, at the AOA's 14th Annual National CME Sponsors Conference in January 2008. Mr Zarski's entire presentation, titled “Update on DO-Online and Online CME Trends,” is available on DO-Online at
https://www.do-online.org/pdf/10_%20Zarski.pps. Sponsors may also e-mail their calendar items to
meetings@osteopathic.org.
For any questions or concerns related to calendar updating, readers are encouraged to contact Mr Zarski at (800) 621-1773.
National CME Sponsors Conference
The annual AOA National CME Sponsors Conference provides sponsors with up-to-date information regarding the latest requirements for maintaining their CME accreditation status. This conference is also 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 AOA's 15th Annual National CME Sponsors Conference was held from January 8, 2009, through January 10, 2009, at the Hyatt Regency Pier 66 Resort in Fort Lauderdale, Fla—in conjunction with the 19th Annual Osteopathic Medical Education Leadership Conference and AOA Committee on College Accreditation Training Workshop. In an effort to provide the CME sponsor with the most current information available, the theme of this year's National CME Sponsors Conference was “The Evolving World of CME.”
A total of 113 individual registrants, including speakers, attended this year's National CME Sponsors Conference. The keynote address was delivered by Scott A. Wolf, DO, Medical Director for Patient Management at Aetna Inc in Hartford, Conn. Dr Wolf's presentation, titled “Evidence Based Medicine, Disease Management, and Its Effects on Education,” featured a broad overview of healthcare in the United States, including challenges in the healthcare system and in physician training and education, managed care responses to these challenges, and patient-centered medical home models in the future of healthcare.
Conference topics and guest speakers covered a wide range of issues related to CME. Detailed information on the program agenda and presentations can be downloaded at:
https://www.do-online.org/index.cfm?PageID=cme_sponsmain. The next few paragraphs in this section briefly summarize the key presentations.
Jeffrey S. Grove, DO, Vice Chairman of the AOA CCME, delivered a presentation on AOA Category 1-A credit for osteopathic specialists and subspecialists. Dr Grove noted that Category 1-A credits are based on maintaining meaningful CME for AOA members, and that these members need to have relevant, geographically based, high-quality CME. Methods for updating and reporting AOA CME specialty credit hours were addressed by Stephen M. Scheinthal, DO, Vice Chairman of the AOA BOS and Associate Director and Chief of Geriatric Behavioral Health at the University of Medicine and Dentistry of New Jersey-School of Osteopathic Medicine in Stratford.
Nancy Davis, PhD, Executive Director of the National Institute for Quality Improvement and Education in Homestead, Pa, discussed trends toward performance improvement resulting from Institute of Medicine reports, as well as methods for making CME more relevant to clinical practice. Dr Davis covered steps for practice-based quality improvement in CME based on Six Sigma business management strategies and other quality improvement models.
Issues and trends related to the commercial support of CME were presented by Mike Saxton, MEd, Senior Director and Team Leader of the Medical Education Group, US External Medical Affairs at Pfizer Inc in New York, NY. Pamela Mason, Director of the Medical Education Grants Office at AstraZeneca Pharmaceuticals LP in Wilmington, Del, also addressed the commercial support of CME. Specifically, she discussed revisions to the code on industry policies and processes of the Pharmaceutical Research and Manufacturers of America [PhRMA], the pharmaceutical industry's trade and lobbying group. Ms Mason noted that the pharmaceutical industry has the responsibility of ensuring the safe and appropriate use of its products through education that is fair and balanced, evidence-based, in the full context of available therapeutic options, and independent of commercial bias. Changes to the PhRMA code are discussed in greater detail in a later section of the current article.
An update on AOA CME policy was presented at the National CME Sponsors Conference by the current author. Gautam J. Desai, DO, Physician Educator in the Department of Academic and Medical Affairs at the Kansas City (Mo) University of Medicine and BioSciences discussed methods of integrating osteopathic manipulative treatment (OMT) into CME. Dr Desai also reviewed the reasons that many DOs do not use OMT, such as lack of modeling by preceptors and reduced frequency of OMT teaching, and he summarized OMT techniques that are used to treat patients with various conditions, such as cardiovascular disease and chronic bronchitis. Planning core competencies into CME programs was the subject of the presentation by James E. Preston, DO, Director of Osteopathic Medical Education at Firelands Regional Medical Center Main Campus in Sandusky, Ohio.
The use of the Internet in CME programs was the subject of three presentations at the conference. Jennifer Spear Smith, PhD, Executive Director of the Professional Education Support Department at Wyeth Pharmaceuticals Inc in Collegeville, Pa, discussed the preparation of CME proposals for the online grant process. The advantages and disadvantages of online Category 1 CME programs were addressed by two speakers from the Office of Professional and Continuing Education at the University of North Texas Health Science Center—Texas College of Osteopathic Medicine in Fort Worth. These speakers, Pam McFadden, Associate Vice President, and Andrew Crim, Executive Director, noted that advantages of online programs, including reaching a greater audience, making learning outcomes easier to track, and achieving enhanced effectiveness at improving clinical practice. However, disadvantages included the possibility that some faculty and participants may be resistant to using an online CME system. Finally, an update on DO-Online and online CME trends was provided by Mr Zarski.
Concerns addressed in social networking (ie, breakout) sessions at the 15th Annual National CME Sponsors Conference centered on current and proposed CME requirements and processes, particularly those related to healthcare facilities, state societies, and specialty societies. Discussions included the following topics:
speaker databases
quality improvement and technology
new methods of presenting CME, including both simulations and hands-on activities
templates for outcomes measurement for sponsors
strategies for grant success
needs assessment data and surveys
concerns regarding declining commercial support for CME
maintenance of certification (MOC) 2012
a proposed new AOA clearinghouse for CME
future conferences and Webcasting
Also in the social networking sessions, the following recommendations were made to the CCME:
Provide examples of outcomes measurement surveys that have been used by other CME sponsors.
Define the antitrust policy related to members-only events. Registration fees to nonmembers should exceed the cost of member registration plus dues.
Provide examples of best practice.
The AOA's 16th Annual National CME Sponsors Conference will be held in the San Diego, Calif, area from January 7, 2010, to January 9, 2010. Additional information will be posted on DO-Online as it becomes available.
CME Program Trends and Statistics
The AOA CME program continues to develop annually, as does the proportion of physician-members who have CME requirements from their state or specialty boards (
Table 2). As of March 2, 2009, the number of AOA members with state-mandated or specialty-board–mandated CME requirements was 30,332. As of February 26, 2009, AOA membership totaled 39,293. Therefore, approximately 77% of AOA members now have a mandated CME requirement.
Table 2
AOA Members With a CME Requirement
|
AOA Members, No.
| |
|---|
3-Year Cycle
| CME Requirement*
| Dropped from Membership
|
|---|
| 1973 to 1976† | 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 | NA |
Table 2
AOA Members With a CME Requirement
|
AOA Members, No.
| |
|---|
3-Year Cycle
| CME Requirement*
| Dropped from Membership
|
|---|
| 1973 to 1976† | 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 | NA |
×
The type of CME credit recorded by the AOA has changed over time (
Table 3). Earned Category 1-A credit in formal, osteopathic CME programs increased steadily and incrementally from 2.5 million hours in the 1995-1997 CME cycle to 2.9 million hours in the 2001-2003 CME cycle. Earned Category 1-B credit, which is less formal osteopathic CME credit, experienced even more dramatic growth—increasing from 5.7 million hours in the 1995-1997 CME cycle to 9.2 million hours in the 2004-2006 CME cycle.
Table 3
Total Number of CME Credit Hours Recorded (in Millions) by the AOA for Each 3-Year CME Cycle
|
CME Credit Category
| | |
|
|---|
3-Year Cycle
| 1-A
| 1-B
| 2*
| Total
|
|---|
| 1973 to 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‡ | 1.6 | 4.5 | 2.1 | 8.2 |
Table 3
Total Number of CME Credit Hours Recorded (in Millions) by the AOA for Each 3-Year CME Cycle
|
CME Credit Category
| | |
|
|---|
3-Year Cycle
| 1-A
| 1-B
| 2*
| Total
|
|---|
| 1973 to 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‡ | 1.6 | 4.5 | 2.1 | 8.2 |
×
The number of DOs whose AOA membership was dropped as a result of failure to complete the CME requirement has fluctuated between a high of 298 members in the 1983-1985 CME cycle and a low of 43 members in the 1986-1988 CME cycle (
Table 2). Association members are given an 18-month grace period to fulfill requirements from the previous CME cycle. A total of 296 members were dropped from membership on May 31, 2008, for not meeting the 2004-2006 CME requirement.
Similarly, the total number of CME credit hours recorded by the AOA has increased considerably during each successive 3-year CME cycle (
Table 3). This growth is a reflection of the increasing number of AOA members who have state-mandated or specialty-board–mandated CME requirements and of the steadily increasing average number of CME credit hours recorded per member.
PhRMA Code on Interactions With Healthcare Professionals
As previously indicated, the PhRMA in July 2008 unveiled revised industry guidelines, which restrict pharmaceutical company sales representatives from providing gifts (eg, food, pens, coffee mugs, trips to resorts) to physicians.
10 The revised rules are intended to end a problem that has bedeviled pharmaceutical marketers for years—the negative image of the drug company representative, armed with pizza and restaurant gift certificates, inviting a prescribing physician out for a golf game. Critics have bemoaned such gifts as bribes that sway physicians away from the best interests of their patients.
The 36-page document containing the revised PhRMA guidelines
10 has 15 main rules, which went into effect in January 2009. The most important changes to the previous guidelines are the following: (1) a complete ban on giving free meals to physicians when the meals have no educational value, and (2) a complete ban on taking physicians to entertainment or recreational events, such as golf and baseball games. Sales representatives are allowed to provide occasional, modest meals to physicians, but only in the settings of physician offices or hospitals and in conjunction with educational presentations.
Other Issues Related to Commercial Support of CME
A number of regulatory organizations and government agencies provide information to physicians regarding guidelines and regulations related to the commercial support of CME. Among the Web sites featuring this information are the following:
Macy Foundation Report on CME
In November 2007, the Josiah Macy, Jr, Foundation hosted a conference in Bermuda to address complex issues concerning “Continuing Education in the Health Professions.” Commissioned background papers covered a wide range of topics related to continuing education, including learning methods used by physicians and other healthcare professionals, the role of information technology, financing issues, and certification issues. The chairman's summary of the conference
11 included strong statements about commercial support of CME, noting that such commercial support risks distorting educational content and invites bias, raises concerns about the vows of health professionals to place patients' interests first, and endangers the professional commitment to evidence-based decision making. The chairman's summary also included a discussion of approaches physicians can take to obtain the best education, as well as a detailed discussion of the financing of CME programs.
The final report on the full proceedings of the Macy Foundation conference was published 6 months after the chairman's summary.
12 This report featured a more detailed discussion of methods for changing the system of continuing education in the healthcare professions for the better.
Comment
Continuing medical education refers to a specific form of continuing education that helps professionals in the medical field maintain competence and learn about new and developing issues in their areas of expertise. Within the United States, CME for physicians is regulated by the ACCME and the AOA.
The AOA CCME reaffirms its support for the objectives of the AOA CME program, including the scientific and clinical application of new knowledge, skills, and techniques to alter the practices of DOs for the benefit of patients.
The main objectives of the CCME's role in the AOA CME program are the following:
assist CME sponsors in enhancing DOs' abilities to solve medical problems
provide CME sponsors with new knowledge to assist in the professional education of DOs
encourage clinical application of new scientific and clinical knowledge and new skills and techniques
present up-to-date information about medical ethics and morals in medical practice
ensure responsiveness to quality-assurance issues that may derive benefit from CME activities
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.
Appendix
The state licensing board information presented in this appendix is adapted from the Division of State and Socioeconomic Affairs' US Osteopathic Licensure Summary,
2009,5 and is provided for the convenience of members of the American Osteopathic Association (AOA). Readers are encouraged to confirm mailing addresses before sending personal materials to state licensing boards. Readers of the JAOA
are encouraged to contact the American Osteopathic Association's director for state government and international affairs, Linda L. Mascheri, by phone at (800) 621-1773, extension 8184, or by e-mail at lmascheri@osteopathic.org regarding any corrections to the information presented in this appendix.
STATE REQUIREMENTS
|
|---|
| Alabama |
| Alabama State Board of Medical Examiners Jackie Baskin, Director of Licensure PO Box 946 Montgomery, AL 36101-0946 (334) 242-4116 http://www.albme.org |
| Alaska |
| Alaska State Medical Board Leslie A. Gallant, Executive Administrator 550 W Seventh Ave, Suite 1500 Anchorage, AK 99501-3514 (907) 269-8163 http://www.commerce.state.ak.us/occ/pmed.htm |
| Arizona |
| Arizona Board of Osteopathic Examiners in Medicine and Surgery Elaine LeTarte, Executive Director 9535 E Doubletree Ranch Rd Scottsdale, AZ 85258-5539 (480) 657-7703 http://www.azdo.gov |
| Arkansas |
| Arkansas State Medical Board Peggy P. Cryer, Executive Secretary 2100 Riverfront Dr Little Rock, AR 72202-1793 (501) 296-1802 http://www.armedicalboard.org |
| California |
| Osteopathic Medical Board of California Donald L. Krpan, DO, Executive Director 1300 National Dr, Suite 150 Sacramento, CA 95834-1991 (916) 263-3100 http://www.dca.ca.gov/osteopathic |
| Colorado |
| Colorado Board of Medical Examiners Cheryl Hara, PA, JD, Program Director 1560 Broadway, Suite 1300 Denver, CO 80202-5140 (303) 894-7690 http://www.dora.state.co.us/medical |
| Connecticut |
| Connecticut Medical Examining Board Jeff Kardys, Board Liaison PO Box 340308, Hartford, CT 06134-0308 (860) 509-7590 http://www.dph.state.ct.us |
| Delaware |
| Delaware Board of Medical Practice Gayle MacAfee, Executive Director Cannon Building 861 Silver Lake Blvd, Suite 203 Dover, DE 19904-2467 (302) 739-4522 http://www.dpr.delaware.gov |
| District of Columbia |
| District of Columbia Board of Medicine Executive Director 717 14th St NW, Suite 600 Washington, DC 20005-3200 (202) 724-4900 www.dchealth.dc.gov |
| Florida |
| Florida Board of Osteopathic Medicine 4052 Bald Cypress Way Bin #C-06 Tallahassee, FL 32399-1753 (850) 245-4161 http://www.doh.state.fl.us/mqa/osteopath |
| Georgia |
| Georgia Composite State Board of Medical Examiners LaSharn Hughes, Executive Director 2 Peachtree St NW, 36th Fl Atlanta, GA 30303-3181 (404) 656-3913 http://www.medicalboard.georgia.gov |
| Hawaii |
| Hawaii Medical Board Constance Cabral, Executive Officer Department of Commerce and Consumer Affairs PO Box 3469 Honolulu, HI 96801-3469 (808) 586-3000 http://www.hawaii.gov/dcca/areas/pvl/boards/medical |
| Idaho |
| Idaho State Board of Medicine Nancy Kerr, Executive Director 1755 Westgate Dr, Suite 140 Boise, ID 83704-7190 (208) 327-7000 http://www.bom.state.id.us |
| Illinois |
| Illinois Department of Financial and Professional Regulation, Division of Professional Regulation Daniel E. Bluthardt 320 W Washington St, 3rd Fl Springfield, IL 62786-0002 (217) 785-0800 http://www.idfpr.com |
| Indiana |
| Medical Licensing Board of Indiana Kristen Kelley, Board Director 402 W Washington St, Room W072 Indianapolis, IN 46204-2298 (317) 232-2960 http://www.in.gov/pla |
| Iowa |
| Iowa Board of Medicine Mark Bowden, Executive Director 400 SW 8th St, Suite C Des Moines, IA, 50309-4686 (515) 281-5171 http://www.medicalboard.iowa.gov |
| Kansas |
| Kansas Board of Healing Arts Jack Confer, Executive Director 235 SW Topeka Blvd Topeka, KS 66603-3068 (785) 296-7413 http://www.ksbha.org/ |
| Kentucky |
| Kentucky Board of Medical Licensure C. William Schmidt, Executive Director Hurstbourne Office Park 310 Whittington Pkwy, Suite 1B Louisville, KY 40222-4916 (502) 429-7150 http://www.kbml.ky.gov/ |
| Louisiana |
| Louisiana State Board of Medical Examiners Robert Marier, MD, MHA, Executive Director PO Box 30250 New Orleans, LA 70190-0250 (504) 568-6820 http://www.lsbme.louisiana.gov |
| Maine |
| Maine Board of Osteopathic Licensure Susan E. Strout, Executive Secretary 142 State House Sta Augusta, ME 04333-0142 (207) 287-2480 http://www.maine.gov/osteo |
| Maryland |
| Maryland Board of Physicians C. Irving Pinder, Executive Director PO Box 2571 Baltimore, MD 21215-0095 (800) 492-6836 http://www.mbp.state.md.us |
| Massachusetts |
| Massachusetts Board of Registration in Medicine Executive Director 200 Harvard Mill Square, Suite 350 Wakefield, MA 01880-3238 (781) 876-8200 http://www.massmedboard.org |
| Michigan |
| Michigan Board of Osteopathic Medicine and Surgery Rae Ramsdell, Licensing Director PO Box 30670 Lansing, MI 48909-8170 (517) 335-0918 http://www.michigan.gov/healthlicense |
| Minnesota |
| Minnesota Board of Medical Practice Robert A. Leach, JD, Executive Director 2829 University Ave SE, Suite 500 Minneapolis, MN 55414-3246 (612) 617-2130 http://www.bmp.state.mn.us |
| Mississippi |
| Mississippi State Board of Medical Licensure H. Vann Craig, MD, Executive Director 1867 Crane Ridge Dr, Suite 200B Jackson, MS 39216-4910 (601) 987-3079 http://www.msbml.state.ms.us |
| Missouri |
| Missouri State Board of Registration for the Healing Arts Tina M. Steinman, Executive Director 3605 Missouri Blvd Jefferson City, MO 65109-7111 (573) 751-0098 http://www.pr.mo.gov/healingarts.asp |
| Montana |
| Montana Board of Medical Examiners Jean Branscum, Executive Director PO Box 200513 Helena, MT 59620-0513 (406) 841-2360 http://www.medicalboard.mt.gov |
| Nebraska |
| Nebraska Board of Medicine and Surgery, Health and Human Services, Regulation and Licensure Credentialing Division Becky Wisell, Section Administrator PO Box 94986, Lincoln, NE 68509-4986 (402) 471-2118 http://www.hhs.state.ne.us |
| Nevada |
| Nevada State Board of Osteopathic Medicine Executive Director 2860 E Flamingo Rd, Suite D Las Vegas, NV 89121-5270 (702) 732-2147, extension 223 http://www.osteo.state.nv.us/board.htm |
| New Hampshire |
| New Hampshire State Board of Medicine Penny Taylor, Administrator 2 Industrial Park Dr, Suite 8 Concord, NH 03301-8520 (603) 271-1203 http://www.state.nh.us/medicine |
| New Jersey |
| New Jersey State Board of Medical Examiners William V. Roeder, JD, Executive Director PO Box 183 Trenton, NJ 08625-0183 (609) 826-7100 http://www.state.nj.us/lps/ca/medical.htm#bme5 |
| New Mexico |
| New Mexico Board of Osteopathic Medical Examiners Liz Z. Montoya, Board Administrator 2550 Cerrillos Rd Santa Fe, NM 87505-3260 (505) 476-4654 http://www.rld.state.nm.us/b&c/osteo |
| New York |
| New York State Board for Medicine Walter Ramos, Executive Secretary 89 Washington Ave, 2nd Fl, West Wing Albany, NY 12205 (518) 474-3817, extension 560 http://www.op.nysed.gov |
| North Carolina |
| North Carolina Medical Board R. David Henderson, JD, Executive Director PO Box 20007 Raleigh, NC 27619-0007 (919) 326-1100 http://www.ncmedboard.org/ |
| North Dakota |
| North Dakota State Board of Medical Examiners Duane Houdek, JD, Executive Secretary/Treasurer City Center Plaza, 418 E Broadway, Suite 12 Bismarck, ND 58501-4086 (701) 328-6500 http://www.ndbomex.com |
| Ohio |
| State Medical Board of Ohio Richard A. Whitehouse, Esq, Executive Director 30 E Broadway St, 3rd Fl Columbus, OH 43215-6127 (614) 466-3934 http://www.med.ohio.gov |
| Oklahoma |
| Oklahoma State Board of Osteopathic Examiners Deborah J. Bruce, JD, Executive Director 4848 N Lincoln Blvd, Suite 100 Oklahoma City, OK 73105-3335 (405) 528-8625 http://www.ok.gov/osboe |
| Oregon |
| Oregon Medical Board Kathleen Haley, JD, Executive Director 1500 SW 1st Ave, Suite 620 Portland, OR 97201-5847 (971) 673-2700 http://www.oregon.gov/BME |
| Pennsylvania |
| Pennsylvania State Board of Osteopathic Medicine Gina K. Bittner, Administrator PO Box 2649 Harrisburg, PA 17105-2649 (717) 783-4858 http://www.dos.state.pa.us |
| Rhode Island |
| Rhode Island Board of Medical Licensure and Discipline Robert S. Crausman, MD, Chief Administrator Department of Health, 3 Capitol Hill Connon Building, Rm 205 Providence, RI 02908-5097 (401) 222-3855 http://www.health.ri.gov/hsr/bmld |
| South Carolina |
| South Carolina Board of Medical Examiners Bruce F. Duke, Board Administrator 110 Centerview Dr, Suite 202 Columbia, SC 29210-1289 (803) 896-4500 http://www.llr.state.sc.us/pol/medical |
| South Dakota |
| South Dakota State Board of Medical and Osteopathic Examiners Margaret B. Hansen, Executive Director 101 N Main Ave, Suite 301 Sioux Falls, SD 57104-6411 (605) 367-7781 http://www.medicine.sd.gov |
| Tennessee |
| Tennessee Board of Osteopathic Examination Rosemarie Otto, Executive Director 227 French Landing, Suite 300 Heritage Pl Metro Center, Nashville, TN 37228-1608 (800) 778-4123 http://www.health.state.tn.us |
| Texas |
| Texas Medical Board Mari Robinson, JD, Acting Interim Executive Director PO Box 2018 Austin, TX 78768-2018 (512) 305-7010 http://www.tmb.state.tx.us |
| Utah |
| Utah Department of Commerce, Division of Occupational and Professional Licensure, Physicians Licensing Board Noel Taxin, Bureau Manager PO Box 146741 Salt Lake City, UT 84114-6741 (801) 530-6628 http://www.dopl.utah.gov |
| Vermont |
| Vermont Board of Osteopathic Physicians and Surgeons Christopher Winters, Director Office of Professional Regulation National Life Bldg, N Fl 2 Montpelier, VT 05620-3402 (802) 828-1134 http://www.vtprofessionals.org |
| Virginia |
| Virginia Board of Medicine William L. Harp, MD, Executive Director Perimeter Center, 9960 Mayland Dr, Suite 300 Richmond, VA 23233-1463 (804) 367-4600 http://www.dhp.virginia.gov |
| Washington |
| Washington State Board of Osteopathic Medicine and Surgery Blake Maresh, Executive Director PO Box 47866 Olympia, WA 98504-7866 (360) 236-4945 http://doh.wa.gov |
| West Virginia |
| West Virginia Board of Osteopathy Cheryl Schreiber, Executive Secretary 334 Penco Rd Weirton, WV 26062-3813 (304) 723-4638 http://www.wvbdosteo.org |
| Wisconsin |
| Wisconsin Medical Examining Board Thomas Ryan, Bureau Director 1400 E Washington Ave Madison, WI 53703-3041 (608) 266-2112 http://drl.wi.gov |
| Wyoming |
Wyoming Board of Medicine Kevin D. Bohnenblust, Executive Secretary 320 W 25th St, Suite 103 Cheyenne, WY 82001-3000 (307) 778-7053 http://wyomedboard.state.wy.us
|
Appendix
The state licensing board information presented in this appendix is adapted from the Division of State and Socioeconomic Affairs' US Osteopathic Licensure Summary,
2009,5 and is provided for the convenience of members of the American Osteopathic Association (AOA). Readers are encouraged to confirm mailing addresses before sending personal materials to state licensing boards. Readers of the JAOA
are encouraged to contact the American Osteopathic Association's director for state government and international affairs, Linda L. Mascheri, by phone at (800) 621-1773, extension 8184, or by e-mail at lmascheri@osteopathic.org regarding any corrections to the information presented in this appendix.
STATE REQUIREMENTS
|
|---|
| Alabama |
| Alabama State Board of Medical Examiners Jackie Baskin, Director of Licensure PO Box 946 Montgomery, AL 36101-0946 (334) 242-4116 http://www.albme.org |
| Alaska |
| Alaska State Medical Board Leslie A. Gallant, Executive Administrator 550 W Seventh Ave, Suite 1500 Anchorage, AK 99501-3514 (907) 269-8163 http://www.commerce.state.ak.us/occ/pmed.htm |
| Arizona |
| Arizona Board of Osteopathic Examiners in Medicine and Surgery Elaine LeTarte, Executive Director 9535 E Doubletree Ranch Rd Scottsdale, AZ 85258-5539 (480) 657-7703 http://www.azdo.gov |
| Arkansas |
| Arkansas State Medical Board Peggy P. Cryer, Executive Secretary 2100 Riverfront Dr Little Rock, AR 72202-1793 (501) 296-1802 http://www.armedicalboard.org |
| California |
| Osteopathic Medical Board of California Donald L. Krpan, DO, Executive Director 1300 National Dr, Suite 150 Sacramento, CA 95834-1991 (916) 263-3100 http://www.dca.ca.gov/osteopathic |
| Colorado |
| Colorado Board of Medical Examiners Cheryl Hara, PA, JD, Program Director 1560 Broadway, Suite 1300 Denver, CO 80202-5140 (303) 894-7690 http://www.dora.state.co.us/medical |
| Connecticut |
| Connecticut Medical Examining Board Jeff Kardys, Board Liaison PO Box 340308, Hartford, CT 06134-0308 (860) 509-7590 http://www.dph.state.ct.us |
| Delaware |
| Delaware Board of Medical Practice Gayle MacAfee, Executive Director Cannon Building 861 Silver Lake Blvd, Suite 203 Dover, DE 19904-2467 (302) 739-4522 http://www.dpr.delaware.gov |
| District of Columbia |
| District of Columbia Board of Medicine Executive Director 717 14th St NW, Suite 600 Washington, DC 20005-3200 (202) 724-4900 www.dchealth.dc.gov |
| Florida |
| Florida Board of Osteopathic Medicine 4052 Bald Cypress Way Bin #C-06 Tallahassee, FL 32399-1753 (850) 245-4161 http://www.doh.state.fl.us/mqa/osteopath |
| Georgia |
| Georgia Composite State Board of Medical Examiners LaSharn Hughes, Executive Director 2 Peachtree St NW, 36th Fl Atlanta, GA 30303-3181 (404) 656-3913 http://www.medicalboard.georgia.gov |
| Hawaii |
| Hawaii Medical Board Constance Cabral, Executive Officer Department of Commerce and Consumer Affairs PO Box 3469 Honolulu, HI 96801-3469 (808) 586-3000 http://www.hawaii.gov/dcca/areas/pvl/boards/medical |
| Idaho |
| Idaho State Board of Medicine Nancy Kerr, Executive Director 1755 Westgate Dr, Suite 140 Boise, ID 83704-7190 (208) 327-7000 http://www.bom.state.id.us |
| Illinois |
| Illinois Department of Financial and Professional Regulation, Division of Professional Regulation Daniel E. Bluthardt 320 W Washington St, 3rd Fl Springfield, IL 62786-0002 (217) 785-0800 http://www.idfpr.com |
| Indiana |
| Medical Licensing Board of Indiana Kristen Kelley, Board Director 402 W Washington St, Room W072 Indianapolis, IN 46204-2298 (317) 232-2960 http://www.in.gov/pla |
| Iowa |
| Iowa Board of Medicine Mark Bowden, Executive Director 400 SW 8th St, Suite C Des Moines, IA, 50309-4686 (515) 281-5171 http://www.medicalboard.iowa.gov |
| Kansas |
| Kansas Board of Healing Arts Jack Confer, Executive Director 235 SW Topeka Blvd Topeka, KS 66603-3068 (785) 296-7413 http://www.ksbha.org/ |
| Kentucky |
| Kentucky Board of Medical Licensure C. William Schmidt, Executive Director Hurstbourne Office Park 310 Whittington Pkwy, Suite 1B Louisville, KY 40222-4916 (502) 429-7150 http://www.kbml.ky.gov/ |
| Louisiana |
| Louisiana State Board of Medical Examiners Robert Marier, MD, MHA, Executive Director PO Box 30250 New Orleans, LA 70190-0250 (504) 568-6820 http://www.lsbme.louisiana.gov |
| Maine |
| Maine Board of Osteopathic Licensure Susan E. Strout, Executive Secretary 142 State House Sta Augusta, ME 04333-0142 (207) 287-2480 http://www.maine.gov/osteo |
| Maryland |
| Maryland Board of Physicians C. Irving Pinder, Executive Director PO Box 2571 Baltimore, MD 21215-0095 (800) 492-6836 http://www.mbp.state.md.us |
| Massachusetts |
| Massachusetts Board of Registration in Medicine Executive Director 200 Harvard Mill Square, Suite 350 Wakefield, MA 01880-3238 (781) 876-8200 http://www.massmedboard.org |
| Michigan |
| Michigan Board of Osteopathic Medicine and Surgery Rae Ramsdell, Licensing Director PO Box 30670 Lansing, MI 48909-8170 (517) 335-0918 http://www.michigan.gov/healthlicense |
| Minnesota |
| Minnesota Board of Medical Practice Robert A. Leach, JD, Executive Director 2829 University Ave SE, Suite 500 Minneapolis, MN 55414-3246 (612) 617-2130 http://www.bmp.state.mn.us |
| Mississippi |
| Mississippi State Board of Medical Licensure H. Vann Craig, MD, Executive Director 1867 Crane Ridge Dr, Suite 200B Jackson, MS 39216-4910 (601) 987-3079 http://www.msbml.state.ms.us |
| Missouri |
| Missouri State Board of Registration for the Healing Arts Tina M. Steinman, Executive Director 3605 Missouri Blvd Jefferson City, MO 65109-7111 (573) 751-0098 http://www.pr.mo.gov/healingarts.asp |
| Montana |
| Montana Board of Medical Examiners Jean Branscum, Executive Director PO Box 200513 Helena, MT 59620-0513 (406) 841-2360 http://www.medicalboard.mt.gov |
| Nebraska |
| Nebraska Board of Medicine and Surgery, Health and Human Services, Regulation and Licensure Credentialing Division Becky Wisell, Section Administrator PO Box 94986, Lincoln, NE 68509-4986 (402) 471-2118 http://www.hhs.state.ne.us |
| Nevada |
| Nevada State Board of Osteopathic Medicine Executive Director 2860 E Flamingo Rd, Suite D Las Vegas, NV 89121-5270 (702) 732-2147, extension 223 http://www.osteo.state.nv.us/board.htm |
| New Hampshire |
| New Hampshire State Board of Medicine Penny Taylor, Administrator 2 Industrial Park Dr, Suite 8 Concord, NH 03301-8520 (603) 271-1203 http://www.state.nh.us/medicine |
| New Jersey |
| New Jersey State Board of Medical Examiners William V. Roeder, JD, Executive Director PO Box 183 Trenton, NJ 08625-0183 (609) 826-7100 http://www.state.nj.us/lps/ca/medical.htm#bme5 |
| New Mexico |
| New Mexico Board of Osteopathic Medical Examiners Liz Z. Montoya, Board Administrator 2550 Cerrillos Rd Santa Fe, NM 87505-3260 (505) 476-4654 http://www.rld.state.nm.us/b&c/osteo |
| New York |
| New York State Board for Medicine Walter Ramos, Executive Secretary 89 Washington Ave, 2nd Fl, West Wing Albany, NY 12205 (518) 474-3817, extension 560 http://www.op.nysed.gov |
| North Carolina |
| North Carolina Medical Board R. David Henderson, JD, Executive Director PO Box 20007 Raleigh, NC 27619-0007 (919) 326-1100 http://www.ncmedboard.org/ |
| North Dakota |
| North Dakota State Board of Medical Examiners Duane Houdek, JD, Executive Secretary/Treasurer City Center Plaza, 418 E Broadway, Suite 12 Bismarck, ND 58501-4086 (701) 328-6500 http://www.ndbomex.com |
| Ohio |
| State Medical Board of Ohio Richard A. Whitehouse, Esq, Executive Director 30 E Broadway St, 3rd Fl Columbus, OH 43215-6127 (614) 466-3934 http://www.med.ohio.gov |
| Oklahoma |
| Oklahoma State Board of Osteopathic Examiners Deborah J. Bruce, JD, Executive Director 4848 N Lincoln Blvd, Suite 100 Oklahoma City, OK 73105-3335 (405) 528-8625 http://www.ok.gov/osboe |
| Oregon |
| Oregon Medical Board Kathleen Haley, JD, Executive Director 1500 SW 1st Ave, Suite 620 Portland, OR 97201-5847 (971) 673-2700 http://www.oregon.gov/BME |
| Pennsylvania |
| Pennsylvania State Board of Osteopathic Medicine Gina K. Bittner, Administrator PO Box 2649 Harrisburg, PA 17105-2649 (717) 783-4858 http://www.dos.state.pa.us |
| Rhode Island |
| Rhode Island Board of Medical Licensure and Discipline Robert S. Crausman, MD, Chief Administrator Department of Health, 3 Capitol Hill Connon Building, Rm 205 Providence, RI 02908-5097 (401) 222-3855 http://www.health.ri.gov/hsr/bmld |
| South Carolina |
| South Carolina Board of Medical Examiners Bruce F. Duke, Board Administrator 110 Centerview Dr, Suite 202 Columbia, SC 29210-1289 (803) 896-4500 http://www.llr.state.sc.us/pol/medical |
| South Dakota |
| South Dakota State Board of Medical and Osteopathic Examiners Margaret B. Hansen, Executive Director 101 N Main Ave, Suite 301 Sioux Falls, SD 57104-6411 (605) 367-7781 http://www.medicine.sd.gov |
| Tennessee |
| Tennessee Board of Osteopathic Examination Rosemarie Otto, Executive Director 227 French Landing, Suite 300 Heritage Pl Metro Center, Nashville, TN 37228-1608 (800) 778-4123 http://www.health.state.tn.us |
| Texas |
| Texas Medical Board Mari Robinson, JD, Acting Interim Executive Director PO Box 2018 Austin, TX 78768-2018 (512) 305-7010 http://www.tmb.state.tx.us |
| Utah |
| Utah Department of Commerce, Division of Occupational and Professional Licensure, Physicians Licensing Board Noel Taxin, Bureau Manager PO Box 146741 Salt Lake City, UT 84114-6741 (801) 530-6628 http://www.dopl.utah.gov |
| Vermont |
| Vermont Board of Osteopathic Physicians and Surgeons Christopher Winters, Director Office of Professional Regulation National Life Bldg, N Fl 2 Montpelier, VT 05620-3402 (802) 828-1134 http://www.vtprofessionals.org |
| Virginia |
| Virginia Board of Medicine William L. Harp, MD, Executive Director Perimeter Center, 9960 Mayland Dr, Suite 300 Richmond, VA 23233-1463 (804) 367-4600 http://www.dhp.virginia.gov |
| Washington |
| Washington State Board of Osteopathic Medicine and Surgery Blake Maresh, Executive Director PO Box 47866 Olympia, WA 98504-7866 (360) 236-4945 http://doh.wa.gov |
| West Virginia |
| West Virginia Board of Osteopathy Cheryl Schreiber, Executive Secretary 334 Penco Rd Weirton, WV 26062-3813 (304) 723-4638 http://www.wvbdosteo.org |
| Wisconsin |
| Wisconsin Medical Examining Board Thomas Ryan, Bureau Director 1400 E Washington Ave Madison, WI 53703-3041 (608) 266-2112 http://drl.wi.gov |
| Wyoming |
Wyoming Board of Medicine Kevin D. Bohnenblust, Executive Secretary 320 W 25th St, Suite 103 Cheyenne, WY 82001-3000 (307) 778-7053 http://wyomedboard.state.wy.us
|
×
US TERRITORIES
|
|---|
| Guam |
| Guam Board of Medical Examiners MaryLou Loualhati, Acting Administrator, Health Professional Licensing Office, 123 Chalan Kareta Vietnam Veterans Hwy, Mangilao, GU 96923 (011) 671-735-7406-8 No web site available |
| Puerto Rico |
| Board of Medical Examiners of Puerto Rico Ivonne M. Fernandez Colon, Executive Director, PO Box 13969, San Juan, PR 00908 (787) 782-8937 No web site available |
| Virgin Islands |
Virgin Islands Board of Medical Examiners Lydia Scott, Executive Assistant Department of Health 48 Sugar Estate, St Thomas, VI 00802 (340) 774-0117 No web site available
|
US TERRITORIES
|
|---|
| Guam |
| Guam Board of Medical Examiners MaryLou Loualhati, Acting Administrator, Health Professional Licensing Office, 123 Chalan Kareta Vietnam Veterans Hwy, Mangilao, GU 96923 (011) 671-735-7406-8 No web site available |
| Puerto Rico |
| Board of Medical Examiners of Puerto Rico Ivonne M. Fernandez Colon, Executive Director, PO Box 13969, San Juan, PR 00908 (787) 782-8937 No web site available |
| Virgin Islands |
Virgin Islands Board of Medical Examiners Lydia Scott, Executive Assistant Department of Health 48 Sugar Estate, St Thomas, VI 00802 (340) 774-0117 No web site available
|
×
Editor's note: Although most articles in T
he J
ournal's annual Osteopathic Medical Education theme issue focus on recent changes to programming and updates to demographic data within the profession, the current article—though it also provides such summative information—is intended as an accessible and fairly comprehensive point of reference for the 77% of American Osteopathic Association members who have continuing medical education requirements.
Editor's note: The author dedicates this article to the memory of Morton Morris, DO, JD, previous chairman of the American Osteopathic Association's (AOA) Council on Continuing Medical Education (CCME). Dr Morris served on the CCME for 13 years, until his death in May 2008. Dr Morris was a beloved member of the osteopathic medical family and a great asset to the CCME, as well as a mentor, an educator, and a friend.
Verification & maintenance of certification. American Osteopathic Board of Family Physicians Web site; 2000. Available at:
http://www.aobfp.org/index.html. Accessed February 3, 2009.
Division of State and Socioeconomic Affairs. US Osteopathic Licensure Summary, January 2008. Chicago, Ill: American Osteopathic Association; 2007.
Ayres RE, Scheinthal S, Ramirez AF, Bell EC. Osteopathic certification evolving into a continuous certification model.
J Am Osteopath Assoc. 2008;108:159-165. Available at:
http://www.jaoa.org/cgi/content/full/108/3/159. Accessed February 3, 2009.
Division of Continuing Medical Education.
Accreditation Requirements: Category 1 CME Sponsors. Chicago, Ill: American Osteopathic Association; 2007. Available at:
http://do-online.org/pdf/acc_cmespo.pdf. Accessed February 3, 2009.
Rodgers DJ. AOA continuing medical education [published correction appears in
J Am Osteopath Assoc. 2004;104:514].
J Am Osteopath Assoc. 2004;104:493-502. Available at:
http://www.jaoa.org/cgi/content/full/104/11/493. Accessed February 3, 2009.
Fletcher SW. Chairman's summary of the conference. In: Hager M, Russell S, Fletcher SW, eds.
Continuing Education in the Health Professions: Improving Healthcare Through Lifelong Learning. New York, NY: Josiah Macy, Jr, Foundation; 2008. Available at:
http://www.josiahmacyfoundation.org/documents/Macy_ContEd_1_7_08.pdf. Accessed February 3, 2009.