Continuing Medical Education (CME)

There are resources to help physicians obtain the required credits in patient safety and risk management.

Main Line Health-approved category 1 CME activities:

• The program director of CME approved grand rounds and other regularly scheduled conferences can identify specific sessions that fall within the topics identified by the State Board of Medicine. Attendance at these sessions is reported to the Office of CME and uploaded to our CME tracking system. Sessions during other Main Line Health-approved conferences are identified and documented for patient safety or risk management credits, and documented as they occur. These credits are posted to our CME tracking system. You can also obtain credits through self-declared attendance at qualified meetings.
• Morbidity and mortality (M&M) conferences – ALL M&M conferences are considered patient safety credit for Pennsylvania licensing purposes. While not all of these are currently certified for category 1 credit, your documented attendance at an M&M conference that is not category 1 certified can be counted towards your required patient safety/risk management credits as a category 2 activity.
• Other Main Line Health non-CME approved conferences that address topics as indicated by the State Board of Medicine that can be documented if audited can be counted toward these credits as well.

Some of the Main Line Health required HealthStream courses can be counted as category 2 credit, and can be used to satisfy the patient safety/risk management requirements. HealthStream courses required annually can count for each year that they were completed. These courses include:

• Culture of safety training course
• Red Rules
• Universal protocol/surgical safety check list
• Conscious sedation
• Emergency preparedness
• Information security awareness training
• Shaping a reliable culture of safety and Error Prevention Toolkit review

Other Healthstream courses specific to your department that are related to the topics listed above in the What counts for patient safety/risk management requirement section.

Main Line Health is pleased to offer our medical staff a way to stay connected. MediaSite is a secure web portal that allows you to access recordings of Grand Rounds and other important educational meetings from any computer or mobile device. You can even claim AMA PRA category 2 credits™ for the time spent viewing activities on MediaSite.

Access MediaSite

• Look at the upper right corner for Welcome Guest
• Click the down arrow right next to Welcome Guest and click Login
• Use your Main Line Health login information
• When you are logged in; click CME in the left column
• You will find folders by campus and by meeting type (e.g., Grand Rounds in Medicine, Nuts & Bolts, Symposia)

Your AMA category 1 and patient safety credits received at Main Line Health-certified activities will be tracked in our CME Tracking system. You can print your transcript from our online data base or call one of the CME Coordinators for your transcript.

CME Transcripts: Go to mainlinehealth.org/cme/transcripts and sign in. If you don't know your password, click on "forgot password" and it will be emailed to you—don't create a new account. If you can't access your transcript via this method, call one of the Main Line Health campus CME offices:

• Lankenau Medical Center – Trish Levy, levyp@mlhs.org, 484.476.2559
• Bryn Mawr Hospital – Karen Kollias, kolliask@mlhs.org, 484.337.3050
• Paoli Hospital – Colleen Stanton, stantonc@mlhs.org, 484-565-8968
• Riddle Hospital – Annette Langston, langstona@mlhs.org, 484.227.6433

Physicians may also earn category 1 credit for activities that are not designated as such by providers. To receive credit for these activities, you must submit a request directly to AMA. A description of these activities and how to earn credits for them are outlined in the attached chart. They include:

• Presenting at a category 1 conference, seminar or symposium
• Publishing articles
• Poster presentations
• Obtaining a medically related advanced degree
• American Board of Medical Specialties (ABMS) member board certification and recertification
• ACGME accredited education
• International conference recognition

To obtain an application for AMA directly credited category 1 activities, go to edhub.ama-assn.org/pages/applications or call the AMA at 312.464.5296.

In general, you can receive credit for the items listed below. Details pertaining to AMA credit for each activity below are provided. Note that the AMA will provide 25 category 1 credits for your board recertification process.

The regulations state that category 2 credit hours must be documented in the form of a physician log or diary.

Documentation should include:

• The date the activity was completed
• A description of the activity (e.g., article title, resident teaching, consultation with peers)
• Location (e.g., name of journal, hospital, home study, website)
• The number of credits claimed (i.e., actual time spent in the activity)

View the Pennsylvania state form for category 2 reporting .

Yes. If any of the patient-safety credit hours that a physician has earned are category 1 credit hours, they can be counted toward both the category 1 requirement and the patient safety/risk management requirement.

ACT 31 OF 2014 Child abuse recognition and reporting continuing education providers

All health-related licensees/certificate holders and funeral directors are considered "mandatory reporters" under section 6311 of the Child Protective Services Law (23 P.S. § 6311). Therefore, all persons applying for issuance of an initial license or certificate from any of the health-related boards (except the State Board of Veterinary Medicine) or from the State Board of Funeral Directors are required to complete, as a condition of licensure, three hours of training approved by the Department of Human Services (DHS) on the topic of child abuse recognition and reporting.

As a condition of biennial renewal, you are required to complete two hours of approved training on the topic of child abuse recognition and reporting from an approved provider. If your license is close to expiration, we recommend that you check with the approved provider of your course to confirm the time-frame in which they plan to submit the results.

Read more frequently asked questions and the websites where you can obtain online approved training at dos.pa.gov.

The Pennsylvania Medical Society has new requirements for opioid continuing medical education for new licensees and for those wishing to renew their license beginning in the 2017–18 licensure period. There are currently two programs offered by the Pennsylvania Medical Society that will meet these requirements. One of the programs is only open to Pennsylvania Medical Society members, the other is open to everyone. The links to the online courses are listed below.

This activity is open to all:
Addressing PA's opioid crisis: What the health care team needs to know – Includes sessions on opioid prescribing guidelines for non-cancer pain, naloxone, referral to addiction treatment, the Pennsylvania Prescription Drug Monitoring Program (PDMP), and alternatives to opioid therapy.

This activity is for Pennsylvania Medical Society members only:
The use of opioids to treat chronic pain – Includes sessions on interdisciplinary pain, opioid therapy, patient monitoring during care, treatment failure, and managing pain in high risk patients.

Pennsylvania osteopathic licenses are due for renewal in even numbered years on Oct 31st and allopathic licenses are due by Dec 31st. There are several CME requirements that must be met:

1. One hundred (100) CME credit hours must be completed over the 24-month licensing period
2. At least 20 of those hours must be AMA PRA Category 1 or AOA Category 1-A for allopaths and osteopaths, respectively
3. Twelve (12) of those 100 hours must involve patient safety and risk. The determination of which activities meet this criterion is self-determined by the physician. Our M&M session meet this criterion as do many other activities you already participate in. These can be Category 1 or Category 2 – the latter are self-designated
4. Two (2) of the 100 hours must be in a state-approved child abuse recognition program. Here are some approved programs:
• University of Pittsburgh PA Child Welfare Resource Center – This is a free course. It no longer has the timer on each page but there are 3 to 4 embedded videos that you must sit through.
• NetCE – Course #97542; Cost: $24. You can also get MOC credit plus your CME.
• PA Medical Society – Available to members of the PA Medical Society.
5. 2 of the 100 hours must be in activities related to pain management, identification of addiction or the practices of dispensing and prescribing opioids. This can be addressed through Category 1 or 2 CME activities.
   
   The PA Medical Society states: "Q: Does the opioids continuing education need to be Category 1 or Category 2? A: PAMED has received confirmation from the Pennsylvania Department of State that both the State Board of Medicine and the State Board of Osteopathic Medicine will accept continuing education courses in either Category 1 or Category 2 for the purpose of compliance with the requirements of Act 124 as long as the content meets the Board-required subject matter noted above."
• PA Medical Society
• Train PA – from the PA DOH
• MLH Nuts and Bolts of Responsible Pain Management Symposium – Only requires a system ID to log in.
Use the PA Category 2 Recording Form to document your participation in category 2 activities.


6. The remaining credit hours shall be completed in AOA Category 1-A, 1-B, or Category 2, or AMA Category 1 or 2.

Finally, below are links to the PA State Board of Medicine and the State Board of Osteopathic Medicine regarding these requirements:

• MDs: Notice regarding State Board of Medicine Continuing Medical Education
• DOs: Notice regarding State Board of Medicine Continuing Medical Education

According to the regulations, the patient safety or risk management credit hours can be in either category 1 or category 2.

The Pennsylvania State Board of Medicine has approved the following list of topics that will satisfy the patient safety/risk management requirement:

• Improving medical records and record keeping
• Reducing medical errors
• Professional conduct and ethics
• Improving communication among physicians and with other health care personnel
• Communication between physicians and patients
• Preventive medicine education
• Health care quality improvement

As long as the CME activity falls within these topics, you can count it toward the patient safety/risk management requirement. The course does not have to state, and very likely may not, that it is a patient safety or risk management course.

Examples of activities that you can use for patient safety/risk management credits include attendance at morbidity and mortality conferences, courses attended that include topics related to those listed above (count only those session that are related), completing online and print-based activities in the areas listed above, or those specifically targeting patient safety or risk management as the topic.

Do the patient safety or risk management credit hours need to be in category 1 or category 2?

According to the regulations, the patient safety or risk management credit hours can be in either category 1 or category 2.

Here are the directions to receive the registration code for medical license renewal online. Each physician is notified originally via mail of the registration code.

If a practitioner has no record of his registration code to renew his/her license online, the Pennsylvania State Board of Medicine will forward the number via email.

Email your request to the Pennsylvania State Board of Medicine at st-medicine@state.pa.us.State in the email:

• Your request for the registration code
• Provide the last digits of physicians' social security number
• Physician's date of birth
• Physicians' full name

The American Medical Association (AMA) defines a national standard of continuing medical education (CME): "...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. CME represents that 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" (ama-assn.org).

Not all continuing educational activities that physicians may engage in, however, are CME. Physicians may participate in worthwhile continuing educational activities that are not related directly to their professional work and these activities are not CME. Typically service on committees or direct patient care activities are not considered CME. Continuing educational activities that respond to a physician's non-professional educational need or interest, such as personal financial planning, and appreciation of literature or music, are not CME (accme.org).

AMA PRA category 1 credit™ is the most widely recognized term for physician CME. Category 1 activities have been formally planned and designated for credit toward the AMA Physicians Recognition Award (PRA) by an ACCME accredited provider. The following activities can be designated by an ACCME-approved provider for category 1 credit:

• Live activities
• Enduring materials (e.g., CD-Rom, videotape)
• Journal-based CME
• Web-based activities
• New procedures and skills courses that train and certify physicians to conduct new medical procedures

Ways that you can earn category 1 credits through an accredited provider*

• Test item writing
• Performance improvement CME
• Point of care CME
• Manuscript reviews

_{*these require specific designation for credit by a provider, and should not be claimed on your own}

The ACCME approved provider distributes certificates to the participants, and is required to maintain records of participation for six years.

Category 2 credit is the term used by AMA for activities physicians undertake on their own that should be beneficial to their practice. These activities are not formally planned and designated for category 1 credit by accredited providers. The AMA does not permit us to give you a certificate for a category 2 activity. See below for the Pennsylvania category 2 recording form. Examples include:

• Consultations with peers and experts
• Medical research and study online
• Using non-designated enduring materials
• Teaching residents, medical students or other health professionals
• Reading authoritative medical literature
• Self-assessment activities
• Medical writing
• Preceptorships

It is the physician's responsibility to identify and document category 2 activities. However, these activities must meet the AMA definition of CME (see above), and comply with the AMA ethical opinions on gifts to physicians and ethical issues in CME, and be a "worthwhile learning experience related to his/her practice."

View the AMA information about category 1 and category 2 credits.

The Pennsylvania State Board of Medicine is not requiring a report of CME at the time of license renewal. The license renewal form will contain an area for physicians to attest that they have completed the required hours. By attesting that the requirement is completed, a physician may be subject to a random audit by the Board of Medicine. If audited, a physician will need to show evidence of the completion of the required credit hours. Failure to produce the requested evidence will result in a fine and possible suspension of license.

Two organizations share the responsibility nationally for CME accreditation.

The Accreditation Council for Continuing Medical Education (ACCME), through the Pennsylvania Medical Society, accredits organizations like Main Line Health to provide AMA category 1 credit.
The American Medical Association (AMA) identifies the types of activities that can receive credit, and sets the rules for which whether an activity can be designated as category 1 or claimed as category 2. In addition, the AMA directly gives credit for some specific category 1 activities that not designated by an ACCME accredited provider (e.g., publishing an article).