Earning CME Requirements: Different Types of CME Credits

The American Medical Association (AMA) and the American Osteopathic Association (AOA) assigns CME credit in different categories as highlighted below.

The AMA assigns CME credit to two categories:

1. AMA PRA Category 1 Credit™
2. AMA PRA Category 2 Credit™

AMA PRA Category 1 Credit

Category 1 Credits are the most commonly accepted form of CME credits for physicians and are also the basis for receiving the AMA Physician’s Recognition Award (PRA). Physicians must participate in activities that are certified and sponsored by US-based CME providers accredited by the Accreditation Council for Continuing Education (ACCME) or an ACCME-recognized state medical society.

This credit is earned through participation in sponsored events and completion of all requirements for the activity. You can ensure an activity has been certified for AMA PRA Category 1 Credit™ by locating the prescribed AMA credit designation Statement on promotional and activity materials.

Look for this statement:

“The [name of accredited CME provider] designates this [learning format] for a maximum of [number of credits] AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.”

Teaching medical students and residents requires a slightly different statement as the number of credits is not known in advance:

“The [name of accredited CME provider] designates this live activity for a maximum of 2 AMA PRA Category 1 Credit™ per 1 hour of interaction with medical student and/or residents/fellows. Physicians should claim only the credit commensurate with the extent of their participation in the activity.”

AMA PRA Category 2 Credit

AMA PRA Category 2 Credits™ are awarded for activities not certified for AMA PRA Category 1 Credit™. This is on the physician to self-claim and self-document the activity.

These activities must meet the AMA definition of CME, comply with AMA ethical opinions, and not be promotional in nature.

Unlike Category 1 Credit, which requires a designation statement, organizations may not advertise an activity as meeting requirements or being eligible for AMA PRA Category 2 Credit™. Physicians must document the activity description, subject, date(s) of participation, and the number of credits claimed. Credits should be claimed based on participation time with 60 minutes equal to (1) AMA PRA Category 1 Credit™. Credit is claimed in 15 minute or 0.25 credit increments, rounded to the nearest quarter.

This may seem obvious, but physicians may not claim AMA PRA Category 2 Credit™ for an activity which the physician has already claimed AMA PRA Category 1 Credit™.

AOA

The American Osteopathic Association assigns CME credit to four categories:

1. 1-A
2. 1-B
3. 2-A
4. 2-B

The AOA gets pretty specific as far as what qualifies for each category.  If you are an allopathic physician you may skip this part, for the osteopathic physicians, the breakdown is below.  Try not to get overwhelmed or bogged down by all the categories. In the end, the breakdown is similar to the AMA where live sponsored activities are the highest acclaim, self-study is at the bottom, and everything else is in between!

AOA Category 1-A Credit

Category 1-A Credit is granted to physicians who attend formal educational programs designed to enhance clinical competence and improve patient care. Category 1-A Credit is considered ‘formal osteopathic CME’ consisting of live programs or interactive online that meet the Category 1 quality guidelines, faculty requirements, and which are sponsored by AOA accredited Category 1 CME sponsors.

In addition to face-to-face activities, physicians can earn Category 1-A Credit for the following:

1. Osteopathic Medical Teaching – credit is given on an hour-for-hour basis for formal delivery of osteopathic medical education lectures in colleges of osteopathic medicine or Category 1 CME sponsoring hospital. Credit may also be given for speaking at specialty and divisional society conferences.
2. Federal Aviation Courses – standardized CME programs sponsored by the Federal Aviation Administration, Civil Aeronautic Institute, or the US Armed Services are eligible for Category 1-A credit.
3. Federal Programs – credit granted for formal CME programs to participants who are on active duty or employed by a uniformed service. Category 1-B will be given to all other federal CME activities.
4. Grand Rounds – must be submitted in a series of three and meet the requirements for Category 1-A credit.
5. Judging Osteopathic Clinical Case Presentations and Research Poster Presentations – serving as formal judges at a formal CME function will be awarded AOA Category 1-A credits. This credit is granted on an hour-for-hour basis and capped at ten credits per AOA 3-year cycle.

AOA Category 1-B Credit

Physicians may earn Category 1-B Credit for the following activities:

1. Publications – development and publication of scientific papers and online osteopathic educational programs.
2. Inspections – surveyor or consultant for an osteopathic healthcare facility, college accreditation, or graduate medical education program or Osteopathic Postdoctoral Training Institution (OPTI) site visit.
3. Examinations – development or proctoring of a board certification examination. A maximum of fifteen Category 1-B credits per CME cycle will be granted to AOA members who pass an AOA recertification examination or obtain a certification for an added qualification.
4. Committees – participation in osteopathic state licensing professional review board and healthcare committees/departmental meetings that review and evaluate patient care (osteopathic or allopathic institution). Credit will not be awarded for administrative meetings.
5. Teaching – serving as preceptors/GME faculty in any AOA approved osteopathic or ACGME-accredited graduate medical education program. A maximum 60 AOA Category 1-B credits for faculty/precepting may be applied to the 120-hour requirement per CME cycle. No credit is available for training of physician assistants or nurse practitioners.
6. Journal Reading – osteopathic physicians can earn two credit hours of AOA Category 1-B credit for each issue of the Journal of the American Osteopathic Association read and the passing of the respective CME quiz with a minimum grade of 70%.  
7. Non-Osteopathic CME Programs non-osteopathic programs may be recognized for Category 1-B credit when there is essentially no equivalent course content available within the osteopathic profession. Examples include courses provided by the ACCME accredited provider for AMA PRA Category 1 Credit, or the American Academy of Family Physicians credit, or provided by an international sponsor acceptable to the Council on Continuing Medical Education. You must make a request directly to the AOA Department of Client and Member Services at AOA Headquarters, provide a completed request form (available for download on AOA website), copy of printed program or syllabus outlining the lectures, length of the lecture, and the faculty presenting at the conference, along with official document verifying attendance. You basically have to prove that the program doesn’t exist in the AOA world.
8. Test Construction – Ten Category 1-B credits (per CME cycle) will be awarded for administering the oral practical examinations. Credit will also be awarded for test construction committee work including meetings of an AOA certifying board, in-service examination committee, or a meeting of the National Board of Osteopathic Medical Examiners. One Category 1-B credit will be awarded for each accepted test item written for a maximum of 10 credits per CME cycle. Two Category 1-B credits will be awarded, up to a maximum of 20 credits her CME cycle, for accepted clinical cases submitted to the NBOME and osteopathic board certification examinations.
9. Job Task Analysis (JTA’s) – self-assessment examinations conducted every 5-7 years as the basis for all board certification examinations. JTA’s require physicians to review a significant number of tasks that are done on a regular basis within their specialty. The tasks are ranked on frequency and importance and are then used to develop the content outline for the certification examination.  One-half Category 1-B credit will be awarded for each JTA for a maximum of five credits per CME cycle.

AOA Category 2-A Credit

Category 2-A Credit includes formal educational programs sponsored by an ACCME accredited provider for AMA PRA Category 1 Credit™, approved by the American Academy of Family Physicians, approved by an internationally known sponsor acceptable to the Council on CME, or an AOA-accredited Category 1 CME sponsor that does not meet the faculty/hours requirement for Category 1-A Credit.

AOA Category 2-B Credit

Category 2-B credit can be earned for the following:

1. Preparation and presentation of scientific exhibits at a county, regional, state, or national professional meeting. Limited to ten credits per scientific exhibit.
2. Home study courses and viewing non-osteopathic medical video, audio, or online CME courses.
3. Journal type CME on the internet
4. Faculty development, physician administration training, quality assessment programs, observations at medical centers, and CME courses in medical economics.
5. Preparation in recertification examinations or examinations for certificate(s) of added qualification sponsored by the American Board of Medical Specialties (ABMS). Credit it limited to 15 credit hours per CME cycle.
6. Five credit hours may be granted for each medical textbook(s) read. Credit documentation must be provided to the AOA Department of Client and Member Services providing the name of the medical text(s) read.
7. One-half credit hour may be granted for each medical journal read.

AOA CME on the Internet

Osteopathic physicians may obtain up to 15 of their required 30 Category 1-A credits from interactive Internet CME programs.

Category 1-A credit will be awarded for interactive, live online CME conferences or case presentations, which includes both an online pre-test and post-test and allows the participant to ask questions of the presenter in either real-time or the presenter must respond to submitted questions within 48 hours of the presentation.  

Category 2-A credit will be awarded for real-time, interactive, live CME conferences not meeting the faculty hour requirements that are produced by CME providers accredited by ACCME for AMA PRA Category 1 Credit™ or approved by the American Academy of Family Physicians.

In order to receive credit for interactive Internet activities, osteopathic physicians must complete a post-test provided by the CME sponsor. A score of 70% is required to qualify for credit. The test may be retaken up to three times to achieve this score.

Non-Interactive CME programs include audio and video programs on the Internet that are available on an on-demand schedule, and are not real-time or interactive. Participants may be awarded Category 1-B credit for these programs as long as they meet the AOA quality guidelines and are sponsored by AOA-accredited Category 1 CME sponsors.  Physicians must successfully complete a post-test with a minimum score of 70%.

Category 2-B credit will be awarded to journal-type CME on the Internet that is produced by an AOA-accredited sponsor, ACCME accredited provider for AMA PRA Category 1 Credit™, or approved by the American Academy of Family Physicians.

Transferability

American Academy of Family Physicians’ prescribed credit and American College of Obstetricians and Gynecologists’ formal learning cognates may be submitted for the purpose of obtaining AMA PRA. These credits will be earned on a one-to-one basis for AMA PRA Category 1 Credit™. American Osteopathic Association credits may be claimed as AMA PRA Category 2 Credit™

International CME Activities

The American Medical Association (AMA) has an agreement of mutual recognition of CME credit with the European Union of Medical Specialties (UEMS). Under the terms of this agreement, most recently renewed in 2014, the AMA will convert CME credit for live and e-learning activities certified by the European Accreditation Council for Continuing Medical Education (EACCME), the accrediting arm of the UEMS, to AMA PRA Category 1 Credit™.

Physicians may earn AMA PRA Category 1 Credit™ for international conferences in the following situations:

1. The activity is certified for AMA PRA Category 1 Credit™ by a US-based CME provider accredited by the ACCME or an ACCME-recognized state medical society.  
2. The CME activity must be recognized through the AMA’s International Conference Recognition Program found on the AMA website.
3. The CME activity (live or e-learning) is approved by the European Union of Medical Specialists’ (UEMS) European Accreditation Council for Continuing Medical Education (EACCME) for European CME credit (ECMEC) and posted in the EACCME section of the UEMS website.

Physicians can apply to the AMA to have the EACCME credit converted to AMA PRA Category 1 Credit™.

Physicians may also apply to the AMA to have CME activity certified for Royal College of Physicians and Surgeons of Canada MOC credits converted to AMA PRA Category 1 Credit™.

More information about international conferences and converting international credit can be found on the AMA website. There are applications to EACCME credit conversion as well as Royal College Credit Conversion available for download.

In order to have credit converted, the activity must appear on the list of approved activities posted on the EACCME section of the UEMS website. The physician must apply to the AMA by downloading the Application for EACCME Credit Conversion and submitting the completed application, a copy of the UEMS-EACCME ECMEC® certificate, and the appropriate processing fee by fax, mail, or email. A certificate of AMA PRA Category 1 Credit™ will be emailed within four weeks.

Want to learn more about CME and MOC requirements? Download our Free eBook, Navigating Continuing Medical Education: A Guide to CME/MOC Requirements.