Abstract
The author provides an update on the current CME cycle, which began on January 1, 2010, and will end on December 31, 2012. The author also details minor changes to the requirements for Category 1 CME sponsors accredited by the AOA and describes new online CME opportunities. The current article also explains changes regarding the AOA's awarding and recording of specialty CME credit hours for AOA board-certified osteopathic physicians. In addition, the article includes information to assist osteopathic specialists and subspecialists in requesting AOA Category 1-A credit for courses accredited by the Accreditation Council for Continuing Medical Education.
A physician must maintain a current, full, and unrestricted license to practice medicine in the United States, its territories, or Canada. Continuing medical education (CME)—often required for medical licensure—refers to a specific form of continuing education that helps medical professionals learn about new and developing areas in their fields of expertise to help them retain, develop, and enhance their knowledge, ability, and professional performance. Physicians' continued professional development in turn helps them serve patients and the community in a more effective and efficient manner.
Activities for CME may consist of live events, written publications, online programs, and audio, video, or other electronic presentations. Content for CME activities is developed, reviewed, and delivered by faculty who are experts in their individual clinical areas.
Within the United States, CME for physicians is regulated by the Accreditation Council on Continuing Medical Education (ACCME) and the Council on Continuing Medical Education (CCME) of the American Osteopathic Association (AOA). The CCME is committed to identifying and responding to the needs of osteopathic physicians (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 1), are required to participate in the AOA CME program and to meet specific CME credit-hour requirements for each 3-year CME cycle.
The present article provides an update of the AOA CME program for the new CME cycle, which began on January 1, 2010, and will end on December 31, 2012. Topic areas include recent changes in CME policies and the continuing challenges with the awarding and recording of CME credit hours for osteopathic physicians who are specialty certified. More detailed information regarding CME guidelines for the current CME cycle is provided in
Continuing Medical Education 2010-2012: Guide for Osteopathic Physicians.
1
Credit Hours
Continuing medical education credit hours are granted by the AOA from any of 4 categories: 1-A, 1-B, 2-A, or 2-B (
Figure 2). In general, CME credit from Category 1 is osteopathic (ie, AOA-accredited); Category 2 credit is nonosteopathic; type A credit is granted for formal, didactic courses; and type B credit is for less formal CME activities, such as hospital committee work or reading the scientific content in an osteopathic journal approved by the CCME (eg,
JAOA—The Journal of the American Osteopathic Association) in conjunction with completing the respective CME quiz.
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.
2 The remaining 90 hours of the 120-hour 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 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.
1,3 A more detailed description of how CME credit is categorized by the AOA is provided in
Figure 3. 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.
As of December 2010, the Division of CME is still recording CME credits for the 2007-2009 CME cycle for those physicians who have not fulfilled their AOA CME requirement. During the 2007-2009 cycle, 37,060 DOs earned Category 1-A credit by attending formal education programs and performing osteopathic medical teaching sponsored by AOA Category 1 CME sponsors, and 24,539 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.”
4 The Division of CME has recorded 11 million credits of AOA Category 1-B credit reported by osteopathic physicians during the 2007-2009 cycle. For the 2010-2012 CME cycle, a total of 5.5 million credits had been recorded as of March 30, 2011.
The CCME considers exemptions, reductions, and waivers to its CME requirements on a case-by-case basis. However, no waiver for this 120-hour requirement will be granted unless due cause or inability to obtain hours are demonstrated to the CCME.
For new AOA physician-members, CME requirements are reduced according to a proration schedule based on the date when the DO joined the AOA after the beginning of a new 3-year CME cycle. For those DOs who have specialty board certification through the AOA, of the total 120-hour requirement for CME credits, 50 hours of either Category 1 or Category 2 credit must be earned in CME activities related to the primary specialty field. However, the total CME requirement for DOs certified by the American Osteopathic Board of Family Physicians, the American Osteopathic Board of Anesthesiology, and the American Osteopathic Board of Neuromusculoskelectal Medicine is higher, at 150 hours per 3-year CME cycle.
5 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 editions of the present article,
6,7 requirements for licensure vary by state. However, there are generally 3 methods by which a DO can become licensed, as follows
8:
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 (NBOME)
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 state licensing boards (including the District of Columbia) require CME for license renewal (
Figure 4).
9 Although the AOA CME program is on a 3-year CME cycle, state licensure boards have either a 2-year or 3-year CME cycle for their license renewal requirements.
Some states also mandate CME content, such as knowledge of human immunodeficiency virus and AIDS, risk management, and end-of-life palliative care. In addition, many states require that a certain percentage of CME credit hours be in Category 1. Because requirements are subject to change by the boards and licensing agencies, healthcare 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,
9 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.
The AOA has a new and improved Web site.
Osteopathic.org's “Spotlight on CME” (see
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.
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.
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/accreditation/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,
6,7 the CCME has discussed at length various methods to assist subspecialists in obtaining AOA Category 1-A CME credit hours, which are not readily available within the osteopathic medical profession. The AOA BOT approved the CCME's Resolution B02 (A/2008—AOA Category 1-A CME Credit for Osteopathic Specialists/Subspecialists), which was intended to make the process of earning AOA Category 1-A credit easier for DO specialists and subspecialists.
Resolution B02 applies to AOA DO-members in specialties and subspecialties that have fewer than 250 AOA or ABMS board–certified osteopathic physicians. These DOs may satisfy a portion of their AOA Category 1-A requirement using credits from programs in their specialties and subspecialties that are accredited by the Accreditation Council for Continuing Medical Education (ACCME). Specialists and subspecialists qualifying under the resolution 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 and 10 such credits during the 2013-2015 cycle.
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. Non-accredited 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. Since 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. American Academy of Family Physicians (AAFP) prescribed credit is approved for CME activities that have been designed primarily for family physicians and have had AAFP member input.
Category 1 credits or AAFP prescribed 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 AMA PRA Category 1 credit or AAFP prescribed credits will “sunset” during CME cycles in the following manner
1:
2007-2009—20 AMA PRA Category 1 credits; 10 AOA Category 1-A credits
2010-2012—15 AMA PRA Category 1 credits; 15 AOA Category 1-A credits
2013-2015—10 AMA PRA Category 1 credits; 20 AOA Category 1-A credits
2016—0 AMA PRA Category 1 credits; 30 AOA Category 1-A credits
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.
Standardized and Bioterrorism Courses
Credits vs Hours
The AOA Board of Trustees approved a CCME resolution (B15 [A/2010]—CME Credits vs CME Hours) that the term “CME credits” be used instead of “CME hours” in all policy relating to CME and specialty CME credits to be consistent with the other 2 accrediting CME systems in the United States: the American Medical Association (ie, AMA PRA) and the AAFP.
Recent Action of the AOA BOT: February 2011
The AOA BOT approved the following 2 resolutions relating to the AOA CME program during its February 2011 business meeting:
JAOA CME Quiz Credits for Nonmembers—Nonmembers do not have access to the “members only” section of
Ostoepathic.org to take
JAOA CME quizzes. For members, CME credits are automatically recorded for those who take the
JAOA CME quizzes and pass with grades of 70% or better; CME certificates are provided to members who take the quizzes online. With the approval of Resolution 41, (Grading and Recording CME Credits for Non-Members—The
JAOA CME Quizzes) nonmembers who forward hard copies of completed quizzes to the AOA Division of CME will now be charged a fee of $25 per
JAOA quiz for staff time to grade, record, and provide a letter to the DO as documentation.
Revision to the Accreditation Requirements for Category 1 CME Sponsors—The
Accreditation Requirements: AOA Category 1 CME Sponsors10 has been updated to reflect the current policy for needs assessment for a program to be accredited in advance, the policy of determining CME credits, and the rules for applying CME to the 50-hour specialty credit requirement. The new language has been added to Section III Standards for Osteopathic Category 1-A Programs as shown in
Figure 6.
Report of the Education Policy and Procedure Review Committee III
The Education Policy and Procedure Review Committee (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 educational systems at the AOA should be less lengthy and burdensome for members.
During its January 2011 meeting, the AOA BOT also approved EPPRC III recommendations regarding the following 7 “CME Issues”:
Who should be a Category 1 sponsor?
Category 1 CME on the Internet
. CME-deficient members, incentives, and deterrents
Category 1-B role of Category 1 CME sponsors (specialty colleges)
AOA and ABMS dually boarded DOs and DOs boarded only by a specialty of the ABMS
CME quality initiatives
Category 1-A requirements for DOs who are dually certified in two primary specialties and DOs in smaller specialties with fewer than 250 board-certified members
These issues will be reviewed by the CCME at its April 2011 meeting to determine how the policies will be implemented and whether any budgetary concerns exist. Information will be disseminated once the CCME has reviewed and put an action plan in place.
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 if a CME sponsor had to pay twice for the program when submitting CME credit for an outcomes measurement relating to that program. The Administrative Committee decided that there will be no program fee for recording outcomes measurement CME credits. CME sponsors would only pay $0.10 × the total numbers 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 hours of AOA Category 1 or Category 2 CME credit in their specialty areas during each 3-year CME cycle.
In February 2006, the AOA BOT approved the recommended guidelines for academic and professional activities that allow specialty-board–certified DOs to satisfy existing CME requirements (Resolution 45 [M/2006]—Specialty CME Reporting). These specialty-board “templates” were designed to provide physician-members with a variety of options for earning CME credits while also maintaining overall consistency among the specialties.
11 Figure 7 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.
For the activities noted in
Figure 7 (ie, AMA PRA Category 1 credit courses, formal teaching, and standardized life support), the maximum number of CME credit hours accepted per 3-year CME cycle must be designated at the beginning of each new CME cycle. All boards were surveyed in August 2010 for a recommendation for the 2010-2012 CME cycles.
7
Twenty-five credit hours of preceptoring per CME cycle may apply to physician-members' specialty-board requirements for those boards that have designated specialty credit hours for preceptoring. In contrast, these hours will not be applied to member records for DOs in the American Osteopathic Board of Surgery. For information regarding the use of preceptoring or other credits, physicians should contact their certifying boards.
The CCME and BOS formed a task force to review and discuss a policy to assist state societies, osteopathic hospitals, colleges of osteopathic medicine, and osteopathic foundations in determining activities that will be eligible for specialty credit hours for the current 2010-2012 CME cycle. As noted previously,
7 at its July 2009 meeting, the AOA BOT approved the following rules, which were proposed by AOA councils and bureaus, for applying CME to the 50-hour specialty credit requirement:
Credit for specialty CME provided by AOA CME sponsors other than the relevant specialty affiliate may only be awarded by the certifying board with jurisdiction.
Each specialty certifying board will establish a CME Advisory Subcommittee, which will monitor compliance of CME programs based on the approved template and its defined criteria as needed.
Physicians may petition the specialty certifying board's CME Advisory Subcommittee on a case-by-case basis for exception to the policy. To request this process, contact the AOA Division of CME at (800) 621-1773, extension 8262.
Contact information for each CME Advisory Subcommittee and information on submitting a petition for an exception to the policy will be posted on
Osteopathic.org.
In addition, AOA CME credit for certified physicians will be granted, per Resolution B13 (A/2009—Specialty Continuing Medical Education [CME] Policy), as follows:
CME credit sponsored by osteopathic specialty affiliates in the declared specialty will be applied to the requirement on an unlimited hour-by-hour basis.
CME credit from sponsors other than the individual's declared specialty affiliate may be awarded by the certifying board with jurisdiction up to a maximum of 25 credit hours per cycle.
A certified physician must present the lectures for it to be considered for specialty credit.
AOA-Accredited Category 1 CME Sponsors
Table 1.
AOA-Accredited Category 1 CME Sponsors (N=156) *
Organization
|
No. (%)
|
|---|
| ▪ Affiliates | |
| □ Nonpractice (AOA)† | 2 (<1) |
| ▪ Colleges | |
| □ Colleges of osteopathic medicine (AOA accredited) | 20 (13) |
| – Alumni groups† | NA |
| □ Specialty (AOA affliated)† | NA |
| ▪ Foundations (AOA Affiliated)† | 8 (5) |
| ▪ Hospitals | 45 (29) |
| ▪ Military | 1 (<1) |
| ▪ Philanthropic Organizations (AOA Affiliated)† | NA |
| ▪ Professional Associations | 1 (<1) |
| ▪ Societies | |
| □ Divisional (AOA affliated)† | NA |
| □ Specialty | 26 (17) |
□ State
| 53 (34)‡ |
Table 1.
AOA-Accredited Category 1 CME Sponsors (N=156) *
Organization
|
No. (%)
|
|---|
| ▪ Affiliates | |
| □ Nonpractice (AOA)† | 2 (<1) |
| ▪ Colleges | |
| □ Colleges of osteopathic medicine (AOA accredited) | 20 (13) |
| – Alumni groups† | NA |
| □ Specialty (AOA affliated)† | NA |
| ▪ Foundations (AOA Affiliated)† | 8 (5) |
| ▪ Hospitals | 45 (29) |
| ▪ Military | 1 (<1) |
| ▪ Philanthropic Organizations (AOA Affiliated)† | NA |
| ▪ Professional Associations | 1 (<1) |
| ▪ Societies | |
| □ Divisional (AOA affliated)† | NA |
| □ Specialty | 26 (17) |
□ State
| 53 (34)‡ |
×
On an ongoing schedule, the CCME and AOA staff monitor sponsor compliance (ie, “spot monitoring”) with AOA policies and the CCME-approved uniform guidelines for accrediting agencies of CME.
10 Once a sponsor has been selected for review, the AOA will request documentation of their CME activities and then use a checklist (
Figure 8) to determine whether all requirements have been met or whether certain deficiencies exist. The checklist has been modified since the 2010 publication.
7 In addition, the CCME and AOA staff investigate all written complaints or deviations from AOA policy using standard compliance-review procedures.
10,12
At its April 2010 meeting, the CCME approved that Category 1 CME sponsors be notified of their upcoming document survey review within 90 days of their re-accreditation. This policy will allow the Category 1 CME sponsor to change its review date this 1 time only throughout their AOA accreditation. Once the sponsor has made the request, they cannot change the date at a later time.
The Oklahoma State University College of Osteopathic Medicine was approved for Level 3 accreditation with commendation status—100 points (perfect score) on the document survey with inclusion of an outcomes measurement questionnaire.
The AOA Division of CME continues to provide the following informative materials to AOA-accredited Category 1 CME sponsors on a yearly basis (updates are shown in italics):
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. Sponsors were surveyed in December 2010 regarding their use of the AOA speakers' bureau to assist in determining if it should continue to be printed. Results are forthcoming.
List and mailing labels of DOs who have failed to submit their AOA CME credits to allow sponsors to contact those DOs and encourage them to fulfill their CME requirements. Individuals were notified of their deficiency in August via a postcard and information was provided to encourage them to submit their CME credits. Additional notifications were mailed in December 2010, January 2011, and February 2011. Official correspondence was mailed in March 2011 in a joint effort from the chair of membership and the chair of the CCME.
Annual listing of AOA member identification numbers for use in reporting CME credits.
Online Calendar
Physician-members have opportunities to earn CME credit from many osteopathic medical organizations. A brief summary of programs sponsored or cosponsored by AOA-accredited CME sponsors is available online via the “Calendar” link on the navigation bar at the top of the
Osteopathic.org homepage.
Category 1 CME sponsors can directly enter their events in the online CME calendar through a secure online interface. All calendar items are reviewed by the American Osteopathic Information Association before being posted to the site. Sponsors may also e-mail their calendar items to
meetings@osteopathic.org.
Readers with questions or concerns related to calendar updating are encouraged to contact Mike Zarski at
mzarski@osteotech.org or at (800) 621-1773, extension 8148.
Needs Assessment
At its midyear meeting in February 2009, the AOA BOT approved Resolution 38 (Needs Assessment, Pre-approval of CME Programs for AOA Category 1-A or Category 1-B Credit), effective July 1, 2009, that any AOA Category 1 CME sponsor that submits a formal request to the AOA Division of CME for approval of AOA Category 1-A or Category 1-B credit must provide a needs assessment. 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. The following criteria relating to needs assessments are now required on submissions to the CME Division (new information is indicated in italics):
The needs assessment must be conducted on an annual basis for each program.
A needs assessment must be included for each presentation.
The needs assessment must be timely and current for the field.
The needs assessment must be documented as tied to the program objectives and at least 1 source must be evidence based.
Exception to the requirement for needs assessments will be posted and CME sponsors will be notified.
The following programs are exempt from providing needs assessments, as follows:
OMM/OMT/OPP—state that it is “part of the profession” in documentation
Core competencies that are not clinical (professionalism, communications, systems based practices, etc—state “core competency required for specialty”
Faculty development programs
State requirements—such as risk management
Board preparation courses—state “based on pass rate on board scores”
This language was updated in
Accreditation Requirements: AOA Category 1 CME Sponsors10 and was approved by the CCME to make sure that all the CCME and AOA staff members were on the same page when referring to the requirements for needs assessment.
When there has been no prior approval of a sponsor's CME program, advertisements for the program must include the following language:
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.
National CME Sponsors Conference
The AOA's 17th Annual National CME Sponsors Conference was held from January 13, 2011, through January 15, 2011, at the Paris Hotel in Las Vegas, Nevada, in conjunction with the 21st 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 “Betting on Quality CME.”
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, needs assessment, outcomes measurement, and “the care and feeding of your CME planning committee”) and discussed by each of the respective groups (eg, acute care facilities, divisional societies, colleges of osteopathic medicine, specialty affiliates).
The AOA's 18th Annual National CME Sponsors Conference will be held January 12 through January 14, 2012, in Fort Lauderdale, Florida. Additional information will be posted on
Osteopathic.org as it becomes available.
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 2) grows. As of April 2011, the number of AOA members with state-mandated or specialty-board–mandated CME requirements is 35,239.
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 |
2010 to2012§
| 35,239 | 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 |
2010 to2012§
| 35,239 | NA |
×
The type of CME credit recorded by the AOA has changed over time (
Table 3). While earned Category 1-A credit has fluctuated, earned Category 1-B credit has experienced dramatic growth—increasing from 5.7 million hours in the 1995-1997 CME cycle to at least 11 million hours in the 2007-2009 CME cycle.
Table 3.
Total Number of CME Credit Hours Recorded (in Millions) by the AOA for Each 3-Year CME Cycle
|
CME Credit Category
| | |
|
|---|
3-Year Cycle
| 1-A
| 1-B
| 2*
| Total
|
|---|
| 1973 to 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 2012†
| .8 | 4.3 | .2 | 5.5 |
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† | 2.7 | 11.0 | 1.8 | 15.5 |
2010 to 2012†
| .8 | 4.3 | .2 | 5.5 |
×
The number of DOs whose AOA memberships were dropped as a result of failure to complete the CME requirement has fluctuated between a high of 298 members in the 1983-1985 CME cycle and a low of 43 members in the 1986-1988 CME cycle (
Table 2). Members are given a 17-month grace period to fulfill requirements from the previous CME cycle. A total of 296 members were dropped from membership on May 31, 2008, for not meeting the 2004-2006 CME requirement. Drop data for the 2007-2009 CME cycle will not be available until May 31, 2011.
Similarly, the total number of CME credit hours recorded by the AOA has increased considerably during each successive 3-year CME cycle (
Table 3). This growth is a reflection of the increasing number of AOA members who have state-mandated or specialty-board–mandated CME requirements and of the steadily increasing average number of CME credits recorded per member.
Code for Interactions With Companies
The Council reviewed the document titled
Code for Interactions With Companies13 from Norman Kahn, MD, Executive Vice President and CEO of the Council of Medical Specialty Societies. The AOSED and the Bureau of Osteopathic Specialty Societies also were asked to review the document. The AOA will review this document in the near future for a level of transparency. A list of regulatory organizations and government agencies that provide information regarding commercial support of CME is provided in
Figure 9.
CEJA Report on Industry Funding of CME—Update
A report titled Financial Relationships with Industry in Continuing Medical Education was developed by the AMA Committee on Ethics and Judicial Affairs (CEJA) to provide “an ethical framework to guide professional practice with respect to financial relationships in the context of [CME].” The AMA House of Delegates reviewed the report and referred it back to CEJA for more work several times.
In response to CEJA's fourth attempt to pass the report, the Association of Clinical Researchers and Educators (ACRE) recommended that the report be rejected by the AMA House of Delegates. According to the ACRE, the report does not provide substantial evidence to support CEJA's proposal and “improperly asks individual physicians and institutions of medicine to not accept industry funding to support professional educational activities.”
14
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: 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 members and non-members of the American Osteopathic Association who have continuing medical education requirements.
Rodgers DJ. AOA continuing medical education. J Am Osteopath Assoc. 2010;110(3):168-182.
Division of State and Socioeconomic Affairs. US Osteopathic Licensure Summary, March 2011. Chicago, IL: American Osteopathic Association; 2010.
Rodgers DJ. AOA continuing medical education [published correction appears in
J Am Osteopath Assoc. 2004;104(12):514].
J Am Osteopath Assoc. 2004;104(11):493-502.
http://www.jaoa.org/cgi/content/full/104/11/493. Accessed March 16, 2011.
Pharmaceutical Research and Manufacturers of America. Code on Interactions With Healthcare Professionals. Washington, DC: Pharmaceutical Research and Manufacturers of America; July 2008.