CME Requirements: Everything You Need to Know
Introduction
As the end of the year approaches, physicians in Pennsylvania become concerned with completing their licensing procedures with the Commonwealth. This brief article is designed to help answer any questions you may have about the CME requirements for licensing in Pennsylvania, and to provide information on resources for acquiring patient safety/risk management credits. We hope that this provides you with a better understanding of CME.
Frequently Asked Questions
Additional Information
FREQUENTLY ASKED QUESTIONS
What are the State CME licensure requirements for MDs?
According to the Pennsylvania Medical Society website's Patient Safety/Risk Management CME Resources (www.pamedsoc.org). Physicians must have 100 CME credits over the past two years and 12 must be in patient safety/risk management in order to renew their licenses. A minimum of 20 of the total credit hours must be AMA PRA Category 1TM credits.
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What Counts for patient safety/risk management requirement?
The State Board of Medicine has approved the following list of topics that will satisfy the patient safety/risk management requirement:
- Improving medical records and record keeping
- Reducing medical errors
- Professional conduct and ethics
- Improving communication among physicians and with other health care personnel
- Communication between physicians and patients
- Preventive medicine education
- Health care quality improvement
As long as the CME activity falls within these topics, you can count it toward the patient safety/risk management requirement. The course does not have to state, and very likely may not, that it is a patient safety or risk management course.
Examples of activities that you can use for patient safety/risk management credits include attendance at Morbidity and Mortality Conferences, courses attended that include topics related to those listed above (count only those session that are related), completing online and print-based activities in the areas listed above, or those specifically targeting patient safety or risk management as the topic.
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Do the patient safety or risk management credit hours need to be in Category 1 or Category 2?
According to the regulations, the patient safety or risk management credit hours can be in either Category 1 or Category 2.
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If I have 12 Category 1 credit hours in patient safety or risk management topics, may I count these for both the Category 1 requirement and the patient safety/risk management requirement?
Yes. If any of the patient-safety credit hours that a physician has earned are Category 1 credit hours, they can be counted toward both the Category 1 requirement and the patient safety/risk management requirement.
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How do I prove Category 2 credits if I am audited?
The regulations state that Category 2 credit hours must be documented in the form of a physician log or diary.
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What if I don't know my License Renewal Registration Code?
Here are the directions to receive the registration code for medical license renewal online. Each Physician is notified originally via Mail of the registration code.
- If a practitioner has no record of his registration code to renew his/her license on-line,
- The Pa State Board of Medicine will forward the number via email.
- Email your request to the state board of Medicine:
st-medicine@state.pa.us, (State in the email your request for the registration code and provide the last digits of physicians' social security number, date of birth and physicians' full name)
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Who will I need to report to in order to renew my license?
The State Board of Medicine is not requiring a report of CME at the time of license renewal. The license renewal form will contain an area for physicians to attest that they have completed the required hours. By attesting that the requirement is completed, a physician may be subject to a random audit by the Board of Medicine. If audited, a physician will need to show evidence of the completion of the required credit hours. Failure to produce the requested evidence will result in a fine and possible suspension of license.
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What is AMA PRA CATEGORY 1 TM CME Credit?
The American Medical Association (AMA) defines a national standard of continuing medical education (CME): "...educational activities which serve to maintain, develop, or increase the knowledge, skills, and professional performance and relationships that a physician uses to provide services for patients, the public, or the profession. CME represents that body of knowledge and skills generally recognized and accepted by the profession as within the basic medical sciences, the discipline of clinical medicine, and the provision of health care to the public" (www.ama-assn.org).
Not all continuing educational activities that physicians may engage in, however, are CME. Physicians may participate in worthwhile continuing educational activities that are not related directly to their professional work, and these activities are not CME. Typically service on committees or direct patient care activities are not considered CME. Continuing educational activities that respond to a physician's non-professional educational need or interest, such as personal financial planning, and appreciation of literature or music, are not CME (www.accme.org).
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Who regulates CME?
Two organizations share the responsibility nationally for CME accreditation.
The Accreditation Council for Continuing Medical Education (ACCME) accredits organizations (like Jefferson and other academic medical centers) to provide AMA Category 1 credit.
The American Medical Association (AMA) identifies the types of activities that can receive credit, and sets the rules for which whether an activity can be designated as Category 1 or claimed as Category 2. In addition, the AMA directly gives credit for some specific Category 1 activities that not designated by an ACCME accredited provider (i.e., publishing an article).
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What are the different types of CME credits?
Each of the accrediting bodies uses its own language regarding CME. Below is a description of the most common types of CME credit.
Allopathic Physicians
AMA PRA Category 1 creditTM is the most widely recognized term for physician CME. Category 1 activities have been formally planned and designated for credit toward the AMA Physicians Recognition Award (PRA) by an ACCME accredited provider. The following activities can be designated by an ACCME-approved provider for Category 1 credit:
- Live activities
- Enduring materials (i.e. CD-Rom or videotape)
- Journal-based CME
- Web-based activities
- New procedures and skills courses that train and certify physicians to conduct new medical procedures
New ways that you can earn Category 1 Credits through an accredited provider*
- Presenting at a Category 1 conference, seminar, or symposium
- Test Item Writing
- Performance Improvement CME
- Point of Care CME
- Manuscript Reviews
*these require specific designation for credit by a provider, and should not be claimed on your own
The ACCME approved provider distributes Certificates to the participants, and is required to maintain records of participation for six years.
Physicians may also earn Category 1 credit for activities that are not designated as such by providers. To receive credit for these activities, you must submit a request directly to AMA. A description of these activities and how to earn credits for them are outlined in the attached chart. They include:
- Publishing articles
- Poster presentations
- Obtaining a medically related advanced degree
- American Board of Medical Specialties (ABMS) member board certification and recertification
- ACGME accredited education
- International conference recognition
To obtain an application for AMA directly credited Category 1 activities, go to www.ama-assn.org/go/cme or call the AMA at 312 464 5296.
Category 2 credit is the term used by AMA for activities physicians undertake on their own that should be beneficial to their practice. These activities are not formally planned and designated for Category 1 credit by accredited providers. Examples include:
- Consultations with peers and experts
- Medical research and study online
- Using non-designated enduring materials
- Teaching residents, medical students or other health professionals
- Reading authoritative medical literature
- Self assessment activities
- Medical writing
- Preceptorships
It is the physician's responsibility to identify and document Category 2 activities. However, these activities must meet the AMA definition of CME (see above), and comply with the AMA ethical opinions on Gifts to Physicians and Ethical Issues in CME, and be a "worthwhile learning experience related to his/her practice."
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Are there additional resources for Patient Safety and Risk Management Credits?
Over the past two years, more and more resources have been identified to help physicians obtain the required credits in patient safety and risk management.
Through Jefferson-approved Category 1 CME activities:
- the program director of CME approved grand rounds and other regularly scheduled conferences can identify specific sessions that fall within the topics identified by the State Board of Medicine. Attendance at these sessions is reported to the Office of CME and uploaded to the our online CME retrieval system on a quarterly basis.
- Special programming has been developed to provide specific educational opportunities through live meetings and web-based modules (the latter are available to Jefferson physicians at http://jeffline.jefferson.edu/jeffcme/riskmgmt/.
- Sessions during Jefferson-approved conferences are identified and documented for patient safety or risk management credits, and documented as they occur. These credits are posted online.
Through self-declared attendance at qualified meetings.
- Morbidity and Mortality Conferences: While not all of these are currently certified for Category 1 credit, your documented attendance at an M&M conference that is not Category 1 certified can be counted towards your required patient safety / risk management credits as a Category 2 activity.
- Other Jefferson conferences that address topics as indicated by the State Board of Medicine that can be documented if audited can be counted toward these credits as well.
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Where else can I find Patient Safety / Risk Management Credits?
The JUP and TJUH Risk Management Offices, along with the JMC Office of CME have developed a listing of resources for patient safety and risk management credits. This is available from the JMC
Office of CME website (http://jeffline.jefferson.edu/jeffcme/). A copy can also be found below (Resources for Patient Safety/Risk Management CME Credits).
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How can I get CME credit?
In general, you can receive credit for the items listed below. Details pertaining to AMA credit for each activity below are provided.
| Activity | Type of credit | Amount of credit | Who gives the credit? |
|---|
| Attend a live activity that has been designated for credit | AMA Category 1 | Number of credits pre-designated | accredited provide |
| Publish an article as first or second lead author in journals indexed by the Index Medicus | AMA Category 1 | 10 credits per article | AMA |
| Teach at a live activity approved for AMA PRA category 1 credit | AMA Category 1 | 2 credits per lecture hour up to a maximum of 10 credits | As of July 2006, the accredited provider Prior to July 2006, the AMA |
| Prepare a poster presentation, which is also included in the published abstracts, for a live activity approved for AMA PRA category 1 credit | AMA Category 1 | 5 credits per poster | AMA |
| Complete American Board of Medical Specialties (ABMS) member board certification and recertification | AMA Category 1 | 25 credits | AMA |
| Complete medically related advanced degrees, such as a masters in public health | AMA Category 1 | 25 credits | AMA |
| Teach residents, medical students or other health professionals | AMA Category 2 | Actual time | Self designated |
| Utilize online study resources | AMA Category 2 | Actual time | Self designated |
| Read authoritative medical literature | AMA Category 2 | Actual time | Self designated |
| Complete approved enduring materials Complete non-designated enduring materials (ie, not designated by a provider for Category 1) | AMA Category 1
OR
AMA Category 2 | Number of credits pre-designated Actual time | Accredited provider Self designated |
| Conduct medical research | AMA Category 2 | Actual time | |
| Consult with peers | AMA Category 2 | Actual time | |
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How can I document and track my CME credits?
The JeffETC section of the OCME Website (http://jeffline.jefferson.edu/jeffcme/JeffETC/) allows physicians and other participants of JMC-CME accredited programs to receive their transcripts and/or certificates online. Transcripts and certificates are only available for JMC-CME accredited programs completed after July 1, 2003.
Currently, this service track Jefferson-certified activities. In order to retrieve credits online two things need to happen. First, you need to set up a "Web ID" by following the directions on the website. Second, your attendance as reported to the OCME must include your Web ID in order to match the records for retrieval. Attendance at grand rounds are updated quarterly throughout the year. In the absence of a Web-ID, paper certificates are produced per activity on an annual basis. Transcripts may be requested by calling the OCME at 888 JEFF CME or emailing jeffersoncme@jefferson.edu.
It is recommended that you keep a running list of activities in which you have participated as well as a folder for CME documentation. On your list, include the activity date and title, accredited provider, location, type of credit, and number of credits. You may also specify special content (i.e., patient safety) to help track specific requirements.
For activities designated for Category 1 credit by accredited providers, you will receive CME certificates. Keep these certificates in your CME folder as documentation. It is also a good idea to keep copies of your publications, agendas from Category 1 activities at which you presented, and any other non-designated activities for which you may request Category 1 credit in this folder. If you are applying for the AMA PRA, you will need to list your CME activities as well as provide documentation for non-designated Category 1 credits. Remember, the State Board of Medicine may audit your records to document your license renewal statements relating to continuing education.
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RESOURCES FOR PATIENT SAFETY/RISK MANAGEMENT CME CREDITS
- Three CME certified activities that fulfill PA Board of Medicine requirements are available online at http://jeffline.jefferson.edu/jeffcme/riskmgmt/. The activities (each 1 CME credit) include:
Disclosure of Serious Events
Proactive Documentation
Learning from Closed Cases
- Medical Error Video (Rosemary Gibson lecture) 1 CME credit. www.jefferson.edu/jeffcme
- Attendance at Department M&M Conferences. 1 CME credit*. Requires formal sign- in sheet and log noting attendance and topic.
*while not all departmental M&M Conferences carry Category 1 CME credit, all can be used toward patient safety and risk management credit requirements
External Sources for CME Credit
| Topic | Source | Cost/Fee
CME credits | Description | Website |
|---|
- Medical Error Prevention and Patient Safety Parts 1 & 2
- Patient Safety & Risk Management- Mitigating Risks
| American Board of Quality Assurance and Utilization Review Physicians | $120.00
($40.00/credit hour)$30.00
1 hour category 1 AMA recognition award Total of 3 to 10 credit hours to complete all programs. | Comprehensive courses on patient safety and medical error. | http://www.abqaurp.org/course |
|---|
- "Morbidity and Mortality Rounds"
- Spotlight Cases
| AHRQ
Agency for Healthcare Research and Quality | Free of charge CME credit is available by registering, completing the module and taking the Spotlight quiz. | The online journal and forum on patient safety and health care quality. This site features "Morbidity and Mortality Rounds on the Web", expert analysis of medical errors reported anonymously by our readers, interactive learning modules on patient safety ("Spotlight Cases"), and forums for online discussion. | http://www.webmm.ahrq.gov |
|---|
| AHRQ features "Morbidity and Mortality Rounds on the Web", an online journal and forum on patient safety and health care quality. This site features expert analysis of medical errors (cases reported anonymously) in multiple specialties. Search for the interactive learning modules titled "Spotlight Cases". All qualify as patient safety topics for CME credit. AHRQ WebM&M offers continuing medical education (CME) credit for completion of Spotlight modules only. Each Spotlight Case has an expanded commentary by a national expert. After completion of a module, the user may choose to obtain credit for successful completion of the quiz. By completing each month's Spotlight quiz, users can obtain up to 12 CME credits per year. |
- Appropriate documentation: Your first (and best) defense
- Standard of Care: Does it exist in every malpractice case?
- Informed consent: Know rules and exceptions, when they apply
| Thomson's Free CME | Physicians will need to register for this site in order to take the course and receive CME credits. Free of charge 1.0 - 2.0 credit hour per AMA cert. course: | Site can be searched for Patient Safety or medico-legal courses including communication between physicians and patients. | http://freecme.com |
|---|
- System thinking
- Team Communication
- Physician-Patient Communication
- Learning from Mistakes
- Disclosure of Injuries and Errors
- Retrospective Analysis
- Technologies for Error Reduction
| Patient Safety for Physicians website Medical College of Wisconsin CME program | No fee. For CME credits, physicians must register on this site and log in to access learning modules. Each module equals 0.5 Category 1 credit per module toward AMA recognition award. | Developed by physicians and other healthcare professionals to provide information on patient safety to practicing physicians. This is a collaborative effort of the Agency for Health Research and Quality, the National Patient Safety Foundation and the College of Wisconsin. | http://npsf.disted.mcw.edu |
|---|
- Hand hygiene
- Informed consent
- Disclosure
| University of Pittsburgh | Accessed free of charge. Certificates can be printed out immediately following completion of the module. | Several web modules related to patient safety and risk management. | http://cme.health.pitt.edu |
|---|
- Topics include risk management and pt safety content.
| A team of medical editors and writers create Teaching Brief articles. Clinical content is reviewed and approved by a team of physicians under the direction of the University of Pennsylvania School of Medicine, Office of Continuing Medical Education (OCME). | Free of charge. 0.25 AMA PRA Category 1 credits for each Teaching Brief and post-test completed. Registration required. There is no charge to take the test, to receive credits or obtain your certificate. Clinicians can print a CME/CE certificate directly from the website. | MedPage Today physician-reviewed Teaching Brief® articles include news summaries and information regarding the latest medical news. | http://www.medpagetoday.com |
|---|
Other CME Sites
Content updated: December 6, 2006
Following are suggested sites for physicians who want to obtain CME credit hours online or who want information on national CME programs/events to attend:
Medscape from WebMD - Medscape offers continuously updated continuing education activities by specialty for physicians and other health professionals. There are over 100 courses to choose from that have been developed by ACCME-accredited organizations. It is recommended that you use the following guidelines for searching the site to identify courses that will qualify as patient safety topics.
http://www.medscape.com
CMEweb.com from PDRnet online education offers a selection of online CME activities in 23 specialties and 30 topic areas. Low cost to physicians who wish to obtain CME credit from this site. Symposiamedicus.com from Symposia Medicus provides physicians with a comprehensive offering of CME courses covering a variety of specialties.
http://cmelist.com/list.htm from Bernard Sklar, MD, MS - This is an annotated list of online CME. Links to, and descriptions of, more than 300 Online CME sites offering more than 12,500 courses and more than 22,000 hours of CME credit.
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Glossary of CME Terms
Accreditation: The decision by the ACCME, or a recognized state medical society, that an organization has met the requirements for a CME provider as outlined by the ACCME. The standard term of accreditation is four years.
AMA Physician's Recognition Award (PRA): An award issued by the AMA to physicians who have documented completion 50 hours of continuing medical education per year. The AMA offers one, two, and three-year certificates for the AMA PRA. Physicians must complete an application documenting the CME credits and submit a processing fee between $29 and $58 to apply for the award.
Cognates: Designation of CME offerings that have been reviewed and approved by the American College of Obstetrics and Gynecology (ACOG). The CME offerings that award COGNATES are directed toward OB/GYN physicians.
Elective Credit: CME credit for AAFP members that has not met the criteria for or may not have been submitted for review as Prescribed credit.
Enduring Materials: Enduring materials are printed, recorded or computer assisted instructional materials which may be used over time at various locations and which in themselves constitute a planned CME activity. Examples of such materials for independent physician learning include: programmed texts, audio-tapes, videotapes and computer assisted instructional materials which are used alone or in combination with written materials. Books, journals (unless specifically designated) and manuals are not classified as enduring materials.
Prescribed: CME credit from an activity that has been developed and submitted in accordance with AAFP requirements and that has subsequently been reviewed and approved by the appropriate section of the AAFP.
Self Directed Learning: Individual learner's initiative and responsibility to (with or without assistance) identify, assess, and set priorities for learning needs; define goals; select and organize learning activities; and evaluate outcomes in terms of performance.
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Additional Resources
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For More Information
There are many resources at Jefferson to help you:
If you have additional questions, please call the JUP Risk Management Office at extension 3-6486.
Jefferson Medical College Office of Continuing Medical Education
Phone: 1-888-JEFF-CME or 215-955 6992
Fax: 215-923-3212
Web: http://jeffline.jefferson.edu/jeffcme/
Email: jeffersoncme@jefferson.edu
Suggested Log Format for Licensing CME Documentation
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CME REQUIREMENTS
CME/CEU: Completion of a total of 100 hours of Continuing Education activity is required for the current 2-year licensing period running January 1, 2004 to December 31, 2006 and should relate to your practice specialty.
Please note that the Pennsylvania State Boards of Medicine and Nursing have specific CME/CEU requirements for allopathic physicians and certified registered nurse practitioners with prescriptive authority.
Evidence of fulfillment of the CME/CEU requirements is provided as follows:
___ Copy of AMA Physician Recognition Award, PMS Acknowledgement of Member's Continuing Education, or other specialty CME/CEU certificate. (attach copy)
___ Board certification or recertification during the last three years. Such evidence may be used to fulfill the CME requirement for one reappointment cycle only. (attach copy)
___ Individual courses or certificates for 100 hours. (please list below)
|
| Category 1 Credits obtained from an ACCME Approved Provider (Activity Title, Date, and Name of Accredited Sponsor) | Credit Hours | Description of Activity |
|---|
| | | |
| | | |
| | | |
| Category 1 Credits obtained from the AMA | Credit Hours | Description of Activity |
|---|
| Published Articles (10 credits per article, one per year). | | |
| Poster Presentation or Exhibit (5 credits each, one per year). Must be presented at a Category 1 activity. | | |
| Teaching at non-Category 1 activities for health care professionals (1 credit per hour of student contact). | | |
| Medically-Related Degree (25 credits), such as an MPH. | | |
| | | |
| Category 2 Credits (Self-designated) | Credit Hours | Description of Activity |
|---|
| Organized, non credit medical programs (1 credit per hour of participation), such as conferences, seminars, grand rounds, lectures attended. | | |
| Medical Staff Committee Meetings relating to patient care (1 credit per hour of participation), such as peer review, medical audit, case conferences. | | |
| Online or Journal Study (1 credit per hour of study). | | |
| Individual Study Program (1 credit per hour of study). | | |
| Consultation or Supervision (1 credit per contact hour). | | |
| ACLS (1 credit per hour of course) | | |
| Other Medical Activity (1 credit per hour) | | |
| | Total *__________
* MUST TOTAL 100 | |
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