Board Approval of cpd activities Designed to Enhance Physician’s Maintenance of Competence




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Board Approval of CPD Activities Designed to Enhance

Physician’s Maintenance of Competence

Frequently Asked Questions

The American Medical Association (AMA) defines Continuing Medical Education as consisting of “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. The content of CME is the 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.” The Board requires each licensed physician to complete 100 continuing professional development (CPD) credits during each two year licensing period. CPD can consist of CME, continuing physician professional development (CPPD), or clinical training. See 243 CMR 2.01. The Board considers CPD/CME a vital part of each physician’s efforts to maintain competency and to provide the highest level of care to patients.


In order to help physicians maintain competency and meet their CPD requirements for relicensure, the Board may certify that any appropriate activity, course or training is the equivalent of Category 1 or Category 2 CPD credits. 243 CMR 2.06(6)(h)3. The Board may grant such approval for CPD activities that are designed to maintain or enhance physicians’ competency.
This FAQ is offered as guidance as to what the Board may expect to see in any proposal for CPD credits.
How many CPD credits are required for physicians seeking to renew their license?
In accordance with 243 CMR 2.06(6)(a), a licensee must complete 100 CPD credits during each two year licensing period. Forty of those credits must be in “Category 1” activities. There are several types of credit which comply with this requirement. 

  • The American Medical Association (AMA) permits accredited organizations to award AMA PRA Category 1 Credit™.  Before the sponsors of an educational activity can award AMA PRA Category 1 Credit™ the sponsoring organization must be accredited by the Accreditation Council for Continuing Medical Education (ACCME) or by a state medical society such as Massachusetts Medical Society (MMS).  See http://www.ama-assn.org/resources/doc/cme/pra-booklet.pdf.

  • Family Practice physicians may also seek CPD credits through an organization which is accredited by the American Academy of Family Physicians (AAFP) to award “Prescribed credits,” which are the equivalent of the AMA Category 1 credits. 

  • Osteopaths receive “Category 1-A credits” through an organization accredited by the American Osteopathic Association (AOA). 

Up to 60 CPD credits may be earned in Category 2 activities, as defined and adopted by the AMA or AOA.



  • AMA Category 2 credits are self-designated by physicians and are defined as CPD activities that comply with the AMA definition of CME; comply with the relevant AMA ethical opinions; are not promotional; and are worthwhile learning experiences related to the physician’s practice. See: http://www.ama-assn.org/resources/doc/cme/pra-booklet.pdf.

  • AOA Category 2-A credits include formal educational programs that are ACCME-accredited, AAFP-approved, an internationally known sponsor acceptable to the CCME, or sponsored by AOA-accredited Category 1 CME Sponsors that do not meet the 1-A faculty/hours requirement for Category 1-A credit; AOA Category 2-B credit is awarded for activities such as: the preparation and presentation of scientific exhibits; home study; reading medical journals; journal type CME on the Internet; faculty development; physician administrative training; quality assessment programs; observations at medical centers; courses in medical economics; CME programs on the Internet; risk management programs that are administrative in nature; programs dealing with experimental and investigative areas of medical practice, and ABMS recertification examination or a certificate of added certification (15 hours).  See: http://www.foma.org/AOA_CME_Guide.html.


What are the Board expectations for the content of CPD activities which are eligible for “Category 1” credit?
ACCME, the AAFP, the AOA, and MMS all have published extensive material on how an organization meets accreditation standards and what elements constitute an appropriate CME activity, course, or training.  The Board will only approve a learning activity for Category 1 credit if the Board determines that the learning activity would meet or be the equivalent of the standards set out by at least one of the accrediting organizations. It is the responsibility of the organization seeking approval for a learning activity to demonstrate to the Board that it meets one or more of these standards.
ACCME: The ACCME Accreditation Criteria: http://www.accme.org/requirements/accreditation-requirements-cme-providers/accreditation-criteria
AAFP: AAFP Prescribed Credit Eligibility Standards: http://www.aafp.org/online/en/home/cme/cmea/cmeapplying/requirements/prescribed.html
AOA: AOA Accreditation Requirements for Category 1 Sponsors:

http://www.osteopathic.org/inside-aoa/accreditation/Documents/cme-accreditation-requirements.pdf
MMS: MMS Essential Areas and Their Elements: http://www.massmed.org/AM/Template.cfm?Section=CME_accreditation_for_institutions&TEMPLATE=/CM/ContentDisplay.cfm&CONTENTID=31444
In addition, any sponsor seeking Board certification of an activity for CPD credit must demonstrate that the activity, course or training is independent and free of commercial bias. The Board considers the “2004 ACCME Standards for Commercial SupportSM Standards to Ensure Independence in CME Activities” to be a useful guide in making this determination. The Standards impose stringent restrictions on CME providers’ interactions with drug/device companies and other companies the ACCME defines as a commercial interest. The ACCME allows providers to accept company funding for CME activities, but prohibits any commercial influence, direct or indirect, over CME content. There are six standards: independence; resolution of personal conflicts of interest; appropriate use of commercial support; appropriate management of associated commercial promotion; content and format without commercial bias; and disclosures relevant to potential commercial bias. See: http://www.accme.org/requirements/accreditation-requirements-cme-providers/standards-for-commercial-support.
How does the Board determine how many credits to award for each activity, course, or training?
The Board calculates credits based upon the AMA’s credit designation for each of the seven AMA-approved learning formats:


Live Activity

1 CPD Category 1 credit per 60 minutes

Enduring Material

1 CPD Category 1 credit per 60 minutes

Journal-based CME

1 Category 1 credit per article

Test Item Writing

10 Category 1 credits per complete test item writing activity

Manuscript Review

3 Category 1 credits per accepted manuscript review

Performance Improvement CME

20 Category 1 credits per Performance Improvement Activity

Internet Point-of-Care

0.5 Category 1 credits per Point-of-Care cycle

See: www.ama-assn.org/go/prabooklet


If the Board determines that the proposed activity, course, or training does not qualify for Category 1 credits, the Board may approve the proposed activity, course, or training for Category 2 credits. To be eligible for Category 2 credits, the activity, course, or training must meet either the AMA Category 2, or the AOA Category 2-A or 2-B definition.
Will Board approval replace accreditation by ACCME, MMS, AOA, or AAFP?
The Board does not expect that its approval of an individual course will replace the extensive curricula of CME/CPD activities offered by educational organizations which are accredited by ACCME, MMS, AOA, or AAFP. The Board will approve individual courses or activities which the Board determines will further the goal of promoting the maintenance of competence among the Commonwealth’s physicians. If an educational organization wishes to create an extensive curriculum of CPD courses or activities, the organization may wish to seek accreditation from one of the above-mentioned organizations.
How should an organization seek Board approval of a proposed CPD activity, course, or training?
The organization should submit to the Board a description of the proposed CPD activity, course, or training that includes sufficient information for the Board to evaluate the activity. At a minimum, the proposal should include the following:

  • a description of the activity, course, or training;

  • the activity objectives;

  • the type of learning format;

  • a description of the evaluative tool that will be used to determine if improvements should be made to the activity;

  • a plan for documenting successful completion of the activity, including retention of that documentation for at least three years;

  • the number and type of credits sought;

  • the CV of any presenters or developers of the activity, course, or training; and

  • an affirmation that the activity, course, or training is independent and free of commercial bias.





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