Physicians and Surgeons

Most California-licensed physicians and surgeons must complete a one-time CME course in pain management and the treatment of terminally ill and dying patients. This course must also include the subject of the risks of addiction associated with the use of Schedule II drugs. Pathologists and radiologists are exempted from this requirement.

A physician and surgeon may meet the requirement in one of the following methods. Pathologists and radiologists are exempted from this requirement.

1. By completing 12 CME hours in pain management and the treatment of terminally ill and dying patients. The 12 hours may be divided in any way that is relevant to the physician's specialty and practice setting. Acceptable courses may address either topic individually or both topics together. For example, one physician might take three hours of "pain management education" and nine hours of "the appropriate care and treatment of the terminally ill;" a second physician might opt to take six hours of "pain management" and six hours of "the appropriate care and treatment of the terminally ill;" a third physician might opt to take one 12-hour course that includes both topics. The Medical Board will accept any combination of the two topics totaling 12 hours. However, all courses must also include the risks of addiction associated with the use of Schedule II drugs. Physicians must complete the mandated hours by his or her second license renewal date after licensure. OR
2. By completing a one-time mandatory 12-hour CME course on the treatment and management of opiate-dependent patients. This course must include 8 hours of training in buprenorphine treatment or other similar medicinal treatment for opioid use disorders. Physicians who choose this alternative must complete the CME requirements by his or her next license renewal date after licensure. Physicians who meet the definition of a "qualifying physician" as determined by the Board pursuant to 21 U.S.C. section 823(g)(2)(G)(ii) as read on January 1, 2018, shall be deemed to have met these requirements.

The courses or programs must be presented by an organization accredited to provide CME by the ACCME, the AMA, the CMA, or the AAFP. In addition to accrediting CME providers, AMA, CMA, and AAFP may also present CME programs that will be accepted.

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

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

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

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

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

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

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

• Application for Waiver of Continuing Medical Education During Renewal Cycle

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

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

According to the AMA's website, the following CME activities may be certified for AMA PRA Category 1 Credit™ through an accredited CME provider:

• Live activities - CME activity that occurs at a specific time as scheduled by the accredited CME provider. Participation may be in person or remotely as is the case of teleconferences or live Internet webinars. These may be offered through a variety of delivery mechanisms; examples include, but are not limited to, national, regional or local conferences, workshops, seminars, regularly scheduled conferences, journal clubs, simulation workshops, structured learning activities presented during a committee meeting and live Internet webinars.

Faculty credit is a type of live activity for which physicians may earn AMA PRA Category 1 Credit™. There are two types of faculty credit:

• Accredited CME providers may choose to certify a live activity to award AMA PRA Category 1 Credit™ to faculty for an original presentation(s) at a live activity that is designated for such credit. If the providers choose not to offer faculty credit, physicians may claim this credit directly from the AMA.
• Accredited CME providers that are also accredited by either the Accreditation Council for Graduate Medical Education (ACGME) and/or Liaison Committee on Medical Education (LCME) may certify a live activity to award AMA PRA Category 1 Credit™ to faculty to recognize the learning that occurs in the preparation for teaching residents and/or medical students.
• Enduring materials - CME activities that endure over a specified time such as print, audio, video and Internet materials, such as monographs, podcasts, CD-ROMs, DVDs, archived webinars, as well as other web-based activities.
• Journal-based CME - CME activity in which an article, within a peer-reviewed, professional journal, is certified for AMA PRA Category 1 Credit™ prior to publication of the journal.
• Test item writing - CME activity wherein physicians learn through their contribution to the development of high stakes examinations, or certain peer-reviewed self-assessment activities, by researching, drafting and defending potential questions for examinations given by the National Board of Medical Examiners (NBME) or a member board of the American Board of Medical Specialties (ABMS), or for peer reviewed, published, self-assessment educational activities from a national medical specialty society. This must be a robust process which includes participation in a group peer review.
• Manuscript review (for journals) - CME activity in which a physician learns through the critical review of an assigned journal manuscript. The review must be of an original contribution for publication in a medical journal indexed by MEDLINE which requires multiple reviewers, and must be deemed acceptable by the editor.
• Performance improvement CME (PI CME) - CME activity in which an accredited CME provider structures a long-term three-stage process by which a physician or group of physicians learn about specific performance measures, assess their practice using the selected performance measures, implement interventions to improve performance related to these measures over a useful interval of time, and then reassess their practice using the same performance measures. A PI CME activity may address any facet (structure, process or outcome) of a physician's practice with direct implications for patient care.
• Internet point of care learning - CME activity structured by an accredited CME provider in which a physician engages in self-directed, online learning on topics relevant to their clinical practice. Learning for this activity includes a reflective process in which a physician must document their clinical question, the sources consulted and the application to practice.

All activities certified for AMA PRA Category 1 Credit™ by an accredited CME provider must meet all requirements for one of the above learning formats as well as the AMA's core requirements for all activity formats.

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

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

In addition, the Medical Board allows the following:

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