Navigating the Accreditation Council for Continuing Medical Education (ACCME) Requirements

Continuing Medical Education (CME) is an essential part of maintaining the knowledge and skills of medical professionals. CME accreditation is the process by which continuing medical education providers are evaluated and granted approval to offer CME courses. In the United States, the Accreditation Council for Continuing Medical Education (ACCME) is the accrediting body for CME providers.

Understanding the Basics of CME and ACCME

CME, or continuing medical education, is an essential part of maintaining the knowledge and skills of medical professionals, helping them to practice medicine. The accreditation requirements for CME providers vary depending on the accrediting organization. However, there are some general requirements that most accrediting organizations have in common.

To ensure continuing competence as a licensed physician, a minimum number of approved Continuing Medical Education (CME) hours must be completed during each biennial renewal cycle. CME courses must have been completed during each two-year period immediately preceding the expiration of a license. To renew a license, a physician must certify under penalty of perjury that they have complied with the CME requirements, unless the Board has approved a CME waiver.

The Role of ACCME

The most prominent organization providing accreditation for CME providers in the US is the Accreditation Council for Continuing Medical Education (ACCME). Being accredited by the ACCME has several benefits for companies and their customers. For companies, it helps to establish credibility and reputation as a provider of high-quality CME courses. For medical professionals, taking CME courses that are accredited by the ACCME can help them to ensure that they are receiving education that is relevant, high-quality, and meets the standards set by the accrediting organization.

Specific CME Requirements and Regulations

Several specific requirements and regulations govern CME for physicians, including those related to pain management, treatment of terminally ill patients, and forensic examinations.

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Pain Management and Treatment of Terminally Ill Patients

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. A physician and surgeon may meet the requirement in one of the following methods:

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. 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.
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.

The courses or programs must be presented by an organization accredited to provide CME by the ACCME, the AMA, the CMA, or the AAFP.

Forensic Examinations

Per Texas Occupations Code 156.57, a physician who performs forensic examinations on sexual assault survivors must have basic forensic evidence collection training or the equivalent education. Physicians whose practice includes treating patients in an emergency room setting may complete two hours of continuing medical education relating to forensic evidence.

The Life of the Mother Act

Senate Bill 31 (also known as “The Life of the Mother Act”) requires physician applicants and licensees who provide obstetric care to complete a one-time, mandatory continuing education (CE) course on pregnancy-related medical emergencies.

Meeting CME Requirements for License Renewal

To be eligible for renewal, a physician must complete a minimum number of CME hours. Failure to meet this requirement will result in ineligibility unless they qualify for a waiver. However, waivers are not available if a physician has been audited.

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Documentation and Audits

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. 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.

CME Waivers

If a physician is unable to complete the minimum CME requirements due to health, military service, or undue hardship, they may request a CME waiver. If needed, a waiver should be requested approximately three months prior to license expiration.

Consequences of Non-Compliance

If a physician "declares under penalty of perjury" that they have completed the required CME hours during the renewal process but fail to provide the required verification of completion upon request by the Board, it is considered unprofessional conduct by the Board and may result in enforcement action.

Types of Activities that Qualify for CME Credit

There are a number of educational activities that meet the content standards for CME credit. This information is provided to assist physicians in finding those options that best meet their needs and should not be considered exhaustive.

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.
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.
Manuscript review (for journals) - CME activity in which a physician learns through the critical review of an assigned journal manuscript.
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.
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.

Joint Providership of CME Activities

The Federation of State Medical Boards (FSMB) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. As part of our ACCME accreditation, we are able to jointly provide CME activities for non-accredited, non-commercial organizations, and we welcome applications for the joint providership of continuing medical education (CME) activities. The ACCME defines joint providership as the providership of a CME activity by one accredited provider, such as the FSMB, and one non-accredited organization.

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The FSMB CME program targets a diverse audience of learners, both in terms of professional background and practice environment. FSMB CME activities include directly and jointly provided live courses, enduring materials, and internet programs. The education is delivered by lectures, concurrent sessions, question-and-answer sessions, group breakout sessions, roundtable discussions, webinars, seminars, symposia, and workshops.

Ensuring Quality and Addressing Conflicts of Interest

The ACCME has specific requirements regarding relevant financial relationships. All persons who influence the educational content are required to complete a Conflict of Interest Disclosure Form before any work on an educational activity begins.

Ineligible Company

The ACCME defines an “ineligible company” as any entity whose primary business is producing, marketing, re-selling, or distributing health care goods or services used by or on patients. Providers of clinical services (i.e., hospitals, medical groups, etc.) are not usually considered ineligible companies.

Financial Relationships

Financial Relationships are defined as those in which a person benefits by receiving a tangible financial benefit from an ineligible company (e.g., salary, royalty, consulting fee, honoraria, ownership interest such as stocks, stock options or other ownership interest, excluding diversified mutual funds).

Relevant Financial Relationships

Relevant Financial Relationships are defined as financial relationships in any amount occurring within the past 24 months that may create a CONFLICT OF INTEREST which potentially results when an individual has an opportunity to influence CME content that relates to the products or services of the ineligible company with which he/she has a financial relationship.

Additional Resources and Opportunities

The ACGME offers a variety of continuing education courses and activities designed to be informative, collaborative, and interactive. The ACGME Department of Education’s philosophy for continuing education can be summed up as: “Wherever learning occurs, reward it!” The Office of Continuing Education is committed to providing continuing professional development for physician-educators and other GME professionals in furtherance of the ACGME Mission. The Office of Continuing Education facilitates the development, implementation, and assessment of educational activities that comply with the Criteria and Standards of the Accreditation Council for Continuing Medical Education (ACCME).

Specific Board Requirements

In 2021, the Board added a requirement for collaborating/supervising physicians and assistants to physicians to obtain continuing medical education (CME) prescribed by the Board.

Board and Commission rules require (Q)ACSC holders to obtain certain CME credits for renewal. A random audit of physicians and assistants to physicians is completed annually. Chosen licensees will receive a letter requesting documentation of having met the requirement or of exemption. The Board has the authority to file formal charges with the Medical Licensure Commission for a rules violation and to seek penalties such as reprimands and fines.

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