MDCMEWhat is CME?
Continuing Medical Education (CME) refers to educational activities that help physicians, physician assistants, and other healthcare professionals maintain competence and learn about new developments in their field.
CME is required because medicine continuously evolves. State medical boards, specialty certification boards, and credentialing bodies mandate CME to ensure clinicians stay current, ultimately improving patient safety and outcomes.
Who Requires CME?
Multiple organizations enforce CME requirements:
| Entity | Purpose | Typical Cycle |
|---|---|---|
| State Medical Boards | License renewal | 1-3 years |
| ABMS Specialty Boards | Maintenance of Certification (MOC) | 10 years |
| NCCPA (for PAs) | PA-C certification maintenance | 2 years |
| Hospitals | Credentialing & privileging | Varies |
| Medical Societies | Membership requirements | Varies |
CME Credit Types
AMA PRA Category 1 Credit™
The most widely recognized CME credit in the United States.
- Awarded by ACCME-accredited providers
- Accepted by all state medical boards
- Accepted by ABMS specialty boards for MOC
- Accepted by NCCPA for PA certification
- One credit = one contact hour of instruction
AMA PRA Category 2 Credit™
For educational activities that don't meet Category 1 standards but still support professional development.
Qualifying activities include:
- Self-directed learning
- Teaching (when Category 1 wasn't awarded)
- Quality improvement activities
- Journal reading (non-accredited)
- Manuscript review and publishing
Limitations:
- Cannot exceed 50% of credits for AMA PRA awards
- Internet point-of-care learning: 20 credits/year maximum
- Teaching: 10 credits maximum per activity per year
AAFP Prescribed Credit
Specific to family medicine, awarded by the American Academy of Family Physicians.
- AAFP holds ACCME "Accreditation with Commendation" (highest status)
- One AAFP credit = one AMA PRA Category 1 Credit™
- Automatically accepted by state boards and ABFM
AOA Credits (Osteopathic)
For DO physicians, the American Osteopathic Association provides:
| Category | Description |
|---|---|
| 1-A | Live, interactive educational activities |
| 1-B | Enduring materials and online learning |
| 2-A | Self-directed learning, QI activities |
| 2-B | Teaching, publication, committee service |
AAPA Category 1 Credit
For physician assistants, awarded by the American Academy of Physician Associates.
- Accepted by NCCPA for certification maintenance
- Activities designed specifically for PA practice
CME vs. MOC: What's the Difference?
| CME (State Licensure) | MOC (Board Certification) | |
|---|---|---|
| Required by | State medical boards | ABMS specialty boards |
| Purpose | License renewal | Maintain board certification |
| Cycle | 1-3 years | 10 years (with annual requirements) |
| Scope | General competence | Specialty-specific |
| Components | CME credits only | CME + assessment + practice evaluation |
| Consequence of non-compliance | Cannot renew license | Lose board certification |
Can Credits Count for Both?
Yes. A single CME activity can satisfy both state licensure requirements AND specialty board MOC requirements, provided:
- The activity awards AMA PRA Category 1 Credit™
- Credits are earned within applicable time periods
- Content is relevant to your specialty (some boards require specialty-specific credits)
How to Earn CME
Live Conferences & Courses
- In-person or virtual synchronous events
- Typically 1 credit per contact hour
- Networking and interactive learning opportunities
Online / Enduring Materials
- Self-paced, web-based content
- Video presentations, case studies, interactive modules
- Flexible and convenient
Journal-Based CME
- Read peer-reviewed articles, complete assessment
- Offered by JAMA, NEJM, specialty journals
- Directly tied to current literature
Point-of-Care Learning
- Platforms like UpToDate, Medscape
- Learning integrated into clinical workflow
- Usually Category 2 credits (limited to 20/year)
Teaching & Precepting
- Earn credits for teaching at CME-accredited activities
- Up to 4 Category 1 credits per hour of presentation (as of 2023)
- Maximum 10 credits per teaching activity per year
Self-Assessment Modules
- Structured programs to evaluate knowledge gaps
- Often required or incentivized for MOC
- NCCPA awards 1.5x credit multiplier for PAs
Quality Improvement (QI) Activities
- Systematic activities to improve patient care
- Chart audits, performance measurement
- Category 2 credits; increasingly integrated with MOC
Physician CME Requirements by State
Requirements vary significantly by state:
| Requirement Level | Hours | Example States |
|---|---|---|
| None | 0 | CO, MT, SD |
| Low | 20-40 | IN (opioids only), NY (infection control only) |
| Moderate | 40-60 | FL (40), CA (50), TX (48) |
| High | 100-200 | IL (150), MI (150), WA (200) |
Common Cycle Lengths
- Annual: ~12-20 states
- Biennial (2 years): Most common
- Triennial (3 years): Common; allows flexibility
Special Topic Mandates
Many states require CME in specific topics:
- Opioid management — Most common; 1-8 hours
- Ethics — Required in several states
- Infection control — Growing post-COVID
- Cultural competency — Emerging requirement
- Mandatory reporting — Abuse, impaired physicians
PA Certification & CME Requirements
NCCPA Certification
| Requirement | Details |
|---|---|
| Certifying body | NCCPA |
| Credential | PA-C (Physician Assistant-Certified) |
| Certification cycle | 10 years |
| CME cycle | 2 years (5 cycles per certification) |
| CME required | 100 credits per 2-year cycle |
| Category 1 minimum | 50 credits |
| Category 2 maximum | 50 credits |
Credit Bonuses for PAs
NCCPA incentivizes high-quality learning:
- Self-assessment CME: 1.5x multiplier (10 credits → 15 credits)
- PI-CME: First 20 credits doubled per cycle
Accepted Credits for PAs
PAs can earn Category 1 credit from:
- AAPA Category 1
- AMA PRA Category 1 (ACCME-accredited)
- AAFP Prescribed Credit
- AOA Category 1-A
- Royal College MOC credits
- EACCME credits
PANRE vs. PANRE-LA
PAs must pass a recertification exam by year 10:
| PANRE | PANRE-LA | |
|---|---|---|
| Format | Proctored, 240 questions | Online, 25 questions/quarter |
| Duration | 4 hours, single sitting | 12 quarters (3 years) |
| Resources | Closed book | Open book allowed |
| CME credit | No | 2 credits per quarter |
| Fee | $350 | $350 |
State Licensure for PAs
State requirements may exceed NCCPA minimums:
- Some states accept NCCPA compliance as sufficient
- Some require additional hours or specific topics
- Always check your state PA licensing board
Tracking & Reporting CME
For Physicians
ACCME PARS (Physician Activity Recording System)
- Official transcript system for ACCME-accredited activities
- Free access with ACCME account
- Cumulative record of CME credits
CE Broker
- Third-party tracking service
- Required in some states (CA, FL, others)
- Physicians must ensure CME is properly reported
Board-Specific Portals
- ABIM, ABP, ABS each have separate MOC tracking systems
- Credits must be entered into the specific board's system
For PAs
NCCPA Portal (portal.nccpa.net)
- Online CME logging
- Mobile app available for iOS/Android
- Automatic uploads from preapproved conferences
- Transcript download and printing
Best Practices
- Maintain records — Keep certificates for at least 5 years
- Report promptly — Log CME within 30-60 days of completion
- Verify accreditation — Confirm provider is ACCME-accredited
- Track separately — MOC and state CME may need separate reporting
- Review before renewal — Check requirements 30 days before deadline
- Keep backups — Digital and physical copies of key certificates
ACCME Accreditation
ACCME (Accreditation Council for Continuing Medical Education) is the gold standard for CME accreditation.
What ACCME Accreditation Means
- Provider is authorized to award AMA PRA Category 1 Credit™
- Activities meet rigorous standards for content and disclosure
- Credits are universally recognized
Accreditation Levels
| Level | Description |
|---|---|
| Accreditation | Meets all ACCME requirements |
| Accreditation with Commendation | Highest status; demonstrates excellence |
| Provisional Accreditation | New providers building track record |
Verify Accreditation
Before claiming credits, confirm the provider is ACCME-accredited at accme.org
Quick Reference: Credit Equivalencies
| Credit Type | Accepted By |
|---|---|
| AMA PRA Category 1 | All state boards, ABMS boards, NCCPA, hospitals |
| AAFP Prescribed | Equivalent to AMA Category 1; accepted universally |
| AOA Category 1-A/1-B | Required for DOs; accepted by most state boards |
| AAPA Category 1 | NCCPA, state PA boards |
| AMA PRA Category 2 | Limited acceptance; check requirements |
Official Resources
For Physicians
- ACCME — Accreditation Council for CME
- AMA Ed Hub — CME tracking and courses
- AAFP — Family medicine CME
- ABMS — Board certification and MOC
- FSMB — State medical board requirements