Continuing Medical Education Requirements for Physician License Renewal in Massachusetts

The information below provides physicians with licensing requirements, guidelines, and interpretations addressing continuing medical education in Massachusetts. For additional information go to the Board of Registration in Medicine's website at http://www.mass.gov/massmedboard. 

License renewal forms are available online at the Board of Registration in Medicine's website.

Documentation
CME Reporting Cycle
CME Requirements (Including new requirements effective Feb. 1, 2012)
Medically Related Degrees
Residency/Fellowship
Specialty Board Certification or Recertification
Volunteers for the Board
Medical Examiners
Waiver of CME Requirements
Category 1 Determination
Category 2 Determination

For More Information Contact:

MMS Department of Continuing Education and Certification 
860 Winter Street
Waltham, MA 02451-1411
(800) 322-2303, ext. 7306 or (781) 434-7306

Commonwealth of Massachusetts Continuing Medical Education Requirements for Physician License Renewal

Documentation

Physicians should maintain records of their continuing medical education (CME) activities, but are not required to submit documentation to the Massachusetts Board of Registration in Medicine with their renewal applications. The Board may conduct an audit and randomly select physicians to forward evidence of CME credits listed on their renewal form. Therefore, it is important to keep adequate records of all CME credits earned within the biennial renewal cycle. 

Maintain a list of category 1 CME programs and include the name of the sponsor of the activity, title, date(s) of attendance, and number of credits earned. Also record category 2 CME activities. Be sure to list the approximate number of credits spent in each type of CME activity. Maintain CME records for at least one full license cycle (2 years) after the cycle in which credits were earned.

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CME Reporting Cycle

To renew a medical license, physicians must certify compliance with state CME requirements. Licensees are required by law to renew their licenses biennially, on or before their birthdays. The Board will automatically forward a renewal application to each physician sixty days prior to his or her birthday. 

Physicians who receive an initial license within three months prior to their birthday will not be required to renew the registration until their birthday in the second year following the aforesaid birthday. The Massachusetts Board of Registration in Medicine will assign a renewal date to new licensees.

For more information about licensing requirements, and frequently asked questions, go to: http://www.mass.gov/massmedboard.

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CME Requirements

One hundred (100) CME credits during the two years immediately preceding the birthday license renewal date are required for physician license renewal. The majority of credits must be earned in study directly related to the physician's primary area(s) of practice.

Credits shall be earned as follows: 

• a minimum of forty (40) credits completed in category 1. (The entire 100-credit requirement may be completed in Category 1).     
• and, a maximum of sixty (60) credits completed in category 2. 

Also, required and included in the biennial 100 credits of CME: 

• two (2) credits of study of the MA Board of Registration in Medicine's regulations (243 CMR 1.00-5.00). A copy of the regulations may be obtained by going to http://www.mass.gov/massmedboard, and clicking on Regulations and Policies.  
• ten (10) credits total of risk management study with a minimum of four (4) credits in category 1. (The remaining six credits may be in category 1 or category 2). 

Risk management study must include instruction in medical malpractice prevention such as risk identification, patient safety, and loss prevention. In addition, it may include courses in medical ethics, quality assurance, medical-legal issues, patient relations, non-economic aspects of practice management, or courses designed to reduce the likelihood of medical malpractice through means other than increasing the licensee's medical education and technical competence. Risk management study also includes review of the Board's Patient Care Assessment regulations (234 CMR 3.01-3.16) and participation on designated peer review committees dealing with quality assurance. 

New Licensing Requirements Effective Feb. 1, 2012

Effective Pain Management

Effective Feb. 1, 2012, physicians applying to renew their license or obtain a new license must complete at least three (3) credits of education and training in pain management and opioid education. This requirement applies to all physicians who prescribe controlled substances (Schedules I through VI).  According to state regulations (pdf), such education includes training in effective pain management, identification of patients at high risk for substance abuse, counseling patients about side effects, and the addictive nature and proper storage and disposal of prescription drugs. These hours will qualify as either category 1 or category 2, and may be counted as risk management credits.

Recommended CME Activities 

• Managing Risk When Prescribing Narcotic Painkillers for Patients 
• Safe and Effective Opioid Prescribing for Chronic Pain

End of Life Care

Effective Feb. 1, 2012, physicians must also take two (2) CME credits in end of life care. The credits qualify as either category 1 or category 2, and may be counted as risk management credits.

Recommended CME Activities

• Legal Advisor: Advance Directives 
  

Future CME Requirements

In 2015, such applicants must also certify their competence in the use of electronic health records.

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Medically Related Degrees

Earning an advanced degree in an area related to medicine, such as a master's in public health, earns 25 category 1 credits following the award of the degree.

Residency/Fellowship

Enrollment in an ACGME-approved residency program within the year prior to the renewal date satisfies the CME requirement. Physicians earn 50 credits of category 1 credit per year for full- or part-time participation as residents or fellows in an ACGME-accredited residency program. A fellowship not exceeding two years also qualifies. If completing a residency or fellowship program, individuals need to earn CME credits beginning with the first full (i.e., two-year) license renewal cycle after the program has ended.

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Specialty Board Certification or Recertification

Physicians becoming certified or recertified by a specialty board accredited by the American Board of Medical Specialties or American Osteopathic Board may claim the equivalent of 25 credits in category 1, exclusive of risk management study. Credits will only apply to the license renewal cycle in which the licensee receives notification from the specialty board of successful passage of the examination.

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Volunteers for the Board

A physician who serves as a volunteer for the Board of Registration in Medicine may claim the equivalent of a maximum of 20 credits in category 1 for each two-year renewal cycle. Four credits may be applied to category 1 risk management study. The Executive Director of the Board must certify such service.

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Medical Examiners

The Board will grant the equivalent of four credits of required category 1 credit in risk management study to medical examiners with active service or who can document attendance at appropriate professional society meetings, such as those conducted by the Massachusetts Medicolegal Society. Documentation must be submitted to and approved by the Board's Licensing Committee.

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Waiver of CME Requirements

In the event that a physician is unable to complete the CME requirements by date of license renewal, a CME Waiver Request Form must be completed and submitted with the license renewal form to the Board no later than 30 days prior to the renewal date. Visit the Board's website at http://www.mass.gov/massmedboard for specific details and the CME Waiver Request Form and instructions.

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Category 1 Determination

(Minimum of 40 credits)

CME activities are designated category 1 by an accredited sponsor or joint sponsor. Category 1 activities can take the form of lectures, seminars, use of self-study materials, self-assessment programs, mini-residencies, and use of audio-visual or computer-based materials, on-line courses, video-conferences, etc. 

Only an institution or organization accredited for continuing medical education can designate a CME activity as earning category 1 credit or category 2 credit. The Accreditation Council for Continuing Medical Education (ACCME) is responsible for CME accreditation of medical schools, state medical societies, and other institutions and organizations that provide CME activities for a national or regional audience. State medical societies accredit institutions and organizations that provide CME activities primarily for physicians within the state or bordering states. CME credit and accreditation information must be prominently printed on all promotional literature. 

The Physician's Recognition Award Information Booklet of the American Medical Association (version 3.0) has taken several actions regarding category 1 credits for the AMA Physician's Recognition Award (PRA). The following activities are now accepted on an application for the PRA in addition to previously mentioned activities:

1. Articles published in peer-reviewed journals (journals included in the Index Medicus): 10 category 1 credits for each article, 1 article per year. (For credit, attach a reprint of the first page of the article(s) to the application.)
   
2. Poster preparation for an exhibit at a medical meeting designated for AMA PRA category 1 credit, with a published abstract: 5 category 1 credits per poster, 1 presentation per year.  (For credit, attach a page from the program with the abstract and identification of the presenter.)
   
3. Teaching, e.g., presentations, in activities designated for AMA PRA category 1 credit: 2 category 1 credits for each hour to a maximum of 10 credits per year. (Two (2) AMA PRA category 1 credit hours for preparation and presentation of each hour of new and original material designated for category 1 credit by an accredited sponsor, to a maximum of 10 credits per year.  A program or announcement of an activity will be acceptable as proof of the teaching activity.)

For more information on these requirements,  visit the continuing education section of the AMA's website.

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Category 2 Determination

 (maximum of 60 credits)

Category 2 study includes any of the following: 

• Attendance at lectures and seminars designated category 2 by an accredited sponsor of CME
  
• Medical Teaching - Credits may be claimed for contact hours of teaching health professionals, including medical students, residents, practicing physicians, and allied health professionals. You must list type of education, subject, institution, address, and inclusive dates. Important: Teaching medical students and residents should not be reported by full-time faculty.
  
• Articles, Publications, Books, and Exhibits - A maximum of 10 credits may be claimed only once for the medical or educational content of a publication or exhibit regardless of whether it is reissued or changed in format. 

Non-supervised CME may include: 

• Use of database or other computer-based materials in connection with patient care activities.
  
• Use of self-instructive materials, such as audiovisual materials, teleconferences, programmed medical education materials, and computer assisted instruction.
  
• Clinical consultations that contribute to a physician's education. (Involvement in informal educational consultations about a patient should be estimated and reported in hour blocks.) Important:  Ordinary case consultation should not be reported.
  
• Discussion with colleagues about patient care and patient centered discussions with colleagues.
  
• Participation in patient care review activities such as peer review, case conference, chart audit, service on hospital medical staff committees for tissue review, infections, pharmacy, and morbidity and mortality.
  
• Journal club activities
  
• Self-Assessment - Physicians may earn credit for time spent taking self-assessment examinations not eligible for Category 1 credit. 

NOTE: Physicians must spend a minimum of 2 hours per licensing cycle studying the  Board of Registration in Medicine Regulations 243 CMR 1.00-5.00. Credit may be earned in category 2 or, when appropriate, in category 1.

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