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Address correspondence to Delores J. Rodgers, BS, Director, Division of Continuing Medical Education, Department of Education, American Osteopathic Association, 142 E Ontario St, Chicago, IL 60611-2864. E-mail: drodgers{at}osteopathic.org

The current continuing medical education (CME) cycle began on January 1, 2007, and will end on December 31, 2009. Final statistics for the 2004-2006 CME cycle will not be available until May 31, 2008. The author provides an update on trends in osteopathic CME programs, details minor changes to the requirements for AOA-accredited Category 1 CME sponsors, and describes new online CME opportunities. In addition, the current article explains changes regarding the American Osteopathic Association's awarding and recording of CME credit hours for physicians who have specialty board certification.

View larger version (65K): [in this window] [in a new window]   Figure 1. Members of the American Osteopathic Association (AOA) exempted from the AOA's continuing medical education (CME) credit-hour requirements. Life members in active practice have a CME requirement. The AOA may grant exemptions, waivers, or reduction in credit hours only if due cause or inability to obtain hours is demonstrated to the Council on Continuing Medical Education (CCME).

This article provides an update of the AOA CME program for the current CME cycle, which began on January 1, 2007, and will end on December 31, 2009. Topic areas include earning CME for relicensure, recent changes in CME policies, and the continuing struggle with the awarding and recording of CME credit hours for physicians who are specialty-certified. The AOA staff continues to process CME credit hours for osteopathic physicians (DOs) who did not fulfill their AOA CME requirements for the 2004-2006 CME cycle. These individuals have until May 31, 2008, to fulfill this requirement. Statistics for members who did not fulfill the requirement for the 2004-2006 CME cycle will not be available until May 31, 2008.

Continuing medical education credit hours granted by the AOA are from one of four categories: 1-A, 1-B, 2-A, or 2-B (Figure 2). In general, CME credit from Category 1 is osteopathic (ie, AOA accredited); Category 2 credit is nonosteopathic; type A credit is granted for formal, didactic courses; and type B credit is for less formal CME activities, such as hospital committee work or reading the scientific content in JAOA—The Journal of the American Osteopathic Association in conjunction with completing a JAOA CME quiz.

View larger version (28K): [in this window] [in a new window]   Figure 2. The four categories of continuing medical education (CME) credits granted by the American Osteopathic Association (AOA).

At its February 2003 meeting, the AOA Board of Trustees (BOT) set the CME requirement for AOA membership to 120 credit hours with a minimum of 30 hours dedicated to earning Category 1-A credits.¹ The CCME considers exemptions, reductions, and waivers to its CME requirements on a case-by-case basis. However, no waiver for this 120-hour requirement will be granted unless due cause or inability to obtain hours is demonstrated to the CCME. The remaining 90 hours of the 120-hour requirement may be obtained by combining earned CME credits from any of the four credit categories (ie, 1-A, 1-B, 2-A, or 2-B). A maximum of 60 hours of Category 1-B credit for osteopathic preceptoring may be applied to the basic 120-hour requirement. In addition, the AOA, like the American Medical Association (AMA), awards a Certificate of Excellence to physicians who demonstrate exceptional commitments to CME.^2,3 A more detailed description of how CME credit is categorized by the AOA can be found in Figure 3.²

View larger version (65K): [in this window] [in a new window]   Figure 3 (above and right). Material that is new since the publication of the 2007 Osteopathic Medical Education issue of JAOA—The Journal of the American Osteopathic Association6 is indicated in boldface. *The optional Category 1-A requirements listed in this table are interchangeable. One may select 90 additional hours from any of the four continuing medical education (CME) credit types and in any combination, as long as the mandatory 30-hour requirement for Category 1 credit hours is met. Osteopathic physicians who exceed the maximum limit of 10 credit hours of Category 1-A CME credit for faculty development programs can apply those excess credit hours to Category 1-B CME credit if the programs were provided by an Category 1 CME sponsor accredited by the American Osteopathic Association (AOA). The JAOA grants 2 hours of Category 1-B CME credit to osteopathic physicians who complete quizzes on the scientific content in THE JOURNAL and its supplements. To apply for CME credit, AOA members who are registered users of DO-Online can take JAOA CME quizzes online (http://www.docmeonline.com). Alternatively, readers can complete the JAOA quiz and mail it with their AOA number to the Division of CME. Physicians who obtain 150 hours of CME credit in a 3-year CME cycle are recognized and awarded an AOA Certificate of Excellence in CME. Abbreviations: AAFP, American Academy of Family Physicians; ACCME, Accreditation Council for Continuing Medical Education; CCME, Council on Continuing Medical Education; COMLEX-USA Level 2-PE, Comprehensive Osteopathic Medical Licensing Examination-USA Level 2-Performance Evaluation; NBOME, National Board of Osteopathic Medical Examiners. Source: Continuing Medical Education Guide, 2007-2009: Guide for Osteopathic Physicians, December 2006.2

View larger version (155K): [in this window] [in a new window]   Figure 4 (above and right). Osteopathic physicians should verify the material reported here with their state licensing boards as listed in the appendix on pages 153-156. The information provided in this figure is reported annually to the American Osteopathic Association (AOA) directly from each state licensing board and is compiled here for the convenience of AOA members. The exact wording provided by the state licensing boards is preserved in this figure where possible. The AOA takes no responsibility for changes to state guidelines made immediately before publication or errors in reporting from state licensing boards. Material that is new since the publication of THE JOURNAL`s 2007 Osteopathic Medical Education issue6 is indicated in boldface. *The District of Columbia has no continuing medical education (CME) requirements for physicians in continuous practice. Florida limits the number of CME credit hours osteopathic physicians can obtain from sources approved by the American Medical Association (AMA) to 13. Wyoming added CME requirements for its licensed physicians as of the current 2007-2009 CME cycle. Previously, there were no state CME requirements in Wyoming. Abbreviations: ABMS, American Board of Medical Specialties; ACCME, Accreditation Council for Continuing Medical Education; CCME, Council on Continuing Medical Education; HIV/AIDS, human immunodeficiency virus/acquired immunodeficiency syndrome; OSHA, US Department of Labor Occupational Safety and Health Administration. Source: US Osteopathic Licensure Summary, August 2007.5

Physician-members have opportunities to earn CME credit from many osteopathic medical organizations. A brief summary of programs sponsored or cosponsored by AOA-accredited CME sponsors are provided in the The DO magazine's "Coming Events" department at the back of each issue. Additional information regarding such programs are available on the DO-Online calendar, accessible through the Calendar link on the navigation bar at the top of the Web page (http://www.do-online.org). In addition, more detailed information regarding CME guidelines for the current cycle is available on DO-Online at http://do-online.osteotech.org/index.cfm?PageID=cme_main.

	CME Requirements for State Licensure Renewal

Top CME Requirements for State... DO-Online's CME Center Recent Activities at the... CME on the Internet Clinical Assessment Program Guidelines for Osteopathic... AOA-Accredited Category 1 CME... Online Calendar National CME Sponsors Conference CME Program Trends and... Comment References

 
Forty-two state licensing boards require CME for license renewal (Figure 4).⁵ Although the AOA CME program is on a 3-year CME cycle, state licensure boards have either a 2- or 3-year CME cycle for their requirements. Medical licenses are granted to those physicians meeting all state requirements at the discretion of the state board.

Some states also mandate CME content, such as human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), risk management, or end-of-life palliative care. In addition, many states require that a certain percentage of CME credit hours be in Category 1. Readers are encouraged to review the US Osteopathic Licensure Summary, which is available in the members-only section of DO-Online.⁵ State licensure requirements are also available at http://www.cemedicus.com/common_state_requirements/index.htm. Physician-members who are interested in additional information about state licensing requirements are strongly encouraged to contact their individual state licensing boards, which are listed in the appendix on pages 153-156.

	DO-Online's CME Center

Top CME Requirements for State... DO-Online's CME Center Recent Activities at the... CME on the Internet Clinical Assessment Program Guidelines for Osteopathic... AOA-Accredited Category 1 CME... Online Calendar National CME Sponsors Conference CME Program Trends and... Comment References

 
The AOA's online CME center gives physician-members ready access to hundreds of hours of accredited online CME courses. With the help of this new feature, AOA members can search a catalog of online CME activities and quizzes, access and complete those activities and quizzes online, and receive a printable screen certificate immediately afterward. Credits for CME activities completed online are automatically applied to members' online CME activity reports (CARs).

Physician-members can view their current CARs at any time through DO-Online's CME Web site (see http://www.docmeonline.com). In addition, CARs from previous CME cycles are archived online for at least 6 full years after the end of a cycle (eg, reports for the 2004-2006 cycle will be archived on the site through 2012). However, only those physicians who are AOA members and registered DO-Online users can review their CARs online.

The AOA has always maintained member CARs as private documents. However, a physician-member can download his or her CAR or request that it be sent via e-mail to a third party. The AOA releases a member CAR to outside agencies (eg, state licensing boards, hospitals, attorneys, government agencies) only on written request by the physician-member. Through DO-Online, the AOA continues to maintain the confidentiality of this information, but individual physician-members have the added convenience of forwarding this information electronically at their discretion.

As previously noted,⁶ the AOA no longer routinely mails CARs to its physician-members. Members who do not have online access are asked to contact the AOA's Division of CME in writing to request an updated CAR, which can be sent by fax, mail, or e-mail.

The CCME continues to believe that all CME activity should be audited. Therefore, physician-members are not allowed to manually enter or update their CME records online. Physician-members should continue to submit their update requests for CME credit directly to the Association's Division of CME.

Physician-members are encouraged to send any correspondence regarding their CARs to the following address: American Osteopathic Association, Attn: Division of CME, 142 E Ontario St, Chicago, IL 60611-2864.

	Recent Activities at the AOA

Top CME Requirements for State... DO-Online's CME Center Recent Activities at the... CME on the Internet Clinical Assessment Program Guidelines for Osteopathic... AOA-Accredited Category 1 CME... Online Calendar National CME Sponsors Conference CME Program Trends and... Comment References

 
The CCME meets three times annually (ie, January, April, November) to address members' concerns and routine business related to CME programming. In addition, a standing subcommittee of the CCME, the Administrative Committee, meets in July as needed to perform any necessary duties of the CCME between the regularly scheduled meetings, including reviewing and taking final action on special consideration requests and reviewing policy items and basic documents before submission to the full Committee.

At its July 2007 meeting, the AOA BOT appointed Morton Morris, DO, JD, as the CCME's chairman. Dr Morris last held the position in 2005. He is currently the vice chancellor and deputy provost for the Health Professions Division of Nova Southeastern University in Fort Lauderdale, Fla. Dr Morris is also the executive director of the American Osteopathic Academy of Orthopedics, which is located in Davie, Fla.

At its November 2007 meeting, the CCME discussed at length various methods to assist subspecialists and "super subspecialists" so they may be able to obtain AOA Category 1-A CME credit hours. The CCME is concerned about the granting of subspecialty CME credit, which is not readily available within the osteopathic medical profession. The Council is also aware that this issue continues to present challenges to the whole profession and is taking steps to address those issues.

After some discussion, the Council determined that Dr Morris should appoint a subcommittee to examine how to recognize allopathic CME programs for specialties and subspecialties where CME credit hours are not available through osteopathic sponsors. The issue will be further discussed at the CCME's April 2008 meeting.

In addition, the CCME has revisited its policy regarding preceptoring physician assistant students on several occasions. The Council has taken a stand to uphold the current guidelines, namely that no CME credit hours will be awarded for this kind of preceptoring. Credit hours may be granted for preceptoring osteopathic medical students only.

	CME on the Internet

Top CME Requirements for State... DO-Online's CME Center Recent Activities at the... CME on the Internet Clinical Assessment Program Guidelines for Osteopathic... AOA-Accredited Category 1 CME... Online Calendar National CME Sponsors Conference CME Program Trends and... Comment References

 
In February, the AOA BOT approved a resolution regarding Category 1-A CME opportunities available on the Internet (Resolution 6 [M/2008]—CME on the Internet). As dictated by the approved resolution, Category 1-A credit hours will only be awarded to real-time, interactive, simultaneous conferencing that includes both an online pre- and posttest and allows the participants to ask questions during or immediately after the presentation. This change was also approved for AOA Category 2-A CME credit for "CME on the Internet."

With the new change in policy, the CCME also approved two 1-hour lectures for AOA Category 1-A CME on the Internet titled, "A Comprehensive Review of Incretion Therapies for the Type II Diabetes," which took place in December 2007 and January 2008 and was sponsored by the American Osteopathic Academy of Medical Informatics and the Discovery Institute of Medical Education. A total of 64 physicians participated in these online lectures.

	Clinical Assessment Program

Top CME Requirements for State... DO-Online's CME Center Recent Activities at the... CME on the Internet Clinical Assessment Program Guidelines for Osteopathic... AOA-Accredited Category 1 CME... Online Calendar National CME Sponsors Conference CME Program Trends and... Comment References

 
The AOA's Clinical Assessment Program (CAP) was established in 1998 as a tool to improve DOs' clinical skills and to align those skills with the national movement toward pay-for-performance measures.⁷ Beginning in January 2006, a measure set on diabetes mellitus was made available to physicians, who, on completion of the module, are awarded 20 hours of Category 1-B CME credit. Two other measure sets—coronary artery disease and women's health—were made available in July 2006.

At the CCME's November 2007 meeting, two additional modules, focusing on asthma and chronic obstructive pulmonary disease, were approved for the AOA's CAP for physicians. Both modules were approved for 20 hours of AOA Category 1-B CME credit each. Additional information is available at http://cap.osteopathic.org.

	Guidelines for Osteopathic Specialty Board Certification

Top CME Requirements for State... DO-Online's CME Center Recent Activities at the... CME on the Internet Clinical Assessment Program Guidelines for Osteopathic... AOA-Accredited Category 1 CME... Online Calendar National CME Sponsors Conference CME Program Trends and... Comment References

 
Medical specialty certification in the United States is a voluntary process.⁸ Although general AOA CME requirements help physicians maintain their medical competence and their ability to diagnose and treat patients, they are not specialty specific. Board certification demonstrates a physician's commitment to and expertise in a particular specialty or subspecialty of medicine. As previously noted, DOs who wish to maintain specialty board certification through the AOA are required to earn a minimum of 50 hours of AOA Category 1 or 2 CME credit in their specialty areas during each 3-year CME cycle.

In February 2006, the AOA's BOT approved the recommended guidelines for academic and professional activities that allow specialty-board–certified DOs to satisfy the existing CME requirements (Resolution 45 [M/2006]—Specialty CME Reporting). These "templates," created by specialty boards, were designed to provide physician-members with a wide variety of options for earning CME credit hours while also maintaining overall consistency among the specialties.⁶ Figure 5 provides a summary of areas of divergence among specialties. For the activities noted in Figure 5 (ie, AOA specialty college seminars, Accreditation Council for Continuing Medical Education courses, formal teaching, and standardized/basic life support), the maximum number of CME credit hours accepted per 3-year CME cycle must be designated at the beginning of each new CME cycle. Although the number of credit hours accepted by each member board cannot change within a given cycle, some boards submitted their final recommendations for the 2007-2009 CME cycle after the publication of the 2007 Medical Education issue,⁶ as noted in Figure 5.

View larger version (47K): [in this window] [in a new window]   Figure 5. The maximum number of credit hours granted per cycle for each continuing medical education (CME) activity noted were specified in the Bureau of Osteopathic Specialists' "template" responses, approved by the American Osteopathic Association (AOA) Board of Trustees in February 2006 (Resolution 45 [M/2006]—Specialty CME Reporting). Although the number of credit hours accepted by each member board does not change within a given cycle, some boards finalized recommendations after the publication of the THE JOURNAL`s 2007 Osteopathic Medical Education issue.6 Changes are indicated in boldface. *All activities must be related to the specialty for continuing medical education (CME) credit. All of the specialty boards noted have set a maximum number of 50 credit hours for AOA specialty college seminars for the 2007-2009 CME cycle, except for the American Osteopathic Board of Nuclear Medicine, which has limited member credit hours for this activity to 25. The full name of this board is the American Osteopathic Boards of Ophthalmology and Otolaryngology. Abbreviation: ACCME, Accreditation Council for Continuing Medical Education.

View larger version (70K): [in this window] [in a new window]   Figure 6. Changes to the standards in the American Osteopathic Association (AOA) document on accreditation requirements for Category 1 continuing medical education (CME) sponsors. *Changes were approved by the AOA's Board of Trustees (BOT) during the July 2007 meeting in Chicago, Ill. Standard 5.2 was approved with Resolution 45 [A/2007]—Revision to the Accreditation Requirements for Category 1 CME Sponsors, Annual Minimum Programming Requirements; standard 5.4.1, Resolution 44 [A/2007]—Annual Registration Fee Increase for AOA Category 1 CME Sponsors—Accreditation; and standard 6.6, Resolution 43 [A/2007]—Extension of Document Surveys—AOA Category 1 CME Sponsors. Approved by the BOT in February 2002 (Resolution 42 [M/2002]—Record Retention of the CME and Accreditation Programs). Approved by the BOT in February 2007 (Resolution 19 [M/2007]—AOA Category 1-A CME Programs).

• Will the AOA specialty boards accept credit hours designated as specialty credit from state societies as being sufficient to satisfy the specialty credit hours requirement for meetings that are conducted by either society?
  
• Will the board require approval from the specialty affiliates to accept recommendations from the state societies?
  

The CCME reviewed the responses at its January 2008 meeting and asked the BOS to establish guidelines for processing osteopathic specialty credit hours. The BOS will be meeting in April 2008 to discuss and finalize the process. Osteopathic specialty board certification will also be revisited at this meeting.

	AOA-Accredited Category 1 CME Sponsors

Top CME Requirements for State... DO-Online's CME Center Recent Activities at the... CME on the Internet Clinical Assessment Program Guidelines for Osteopathic... AOA-Accredited Category 1 CME... Online Calendar National CME Sponsors Conference CME Program Trends and... Comment References

 
There are currently 159 AOA-accredited Category 1 CME sponsors (Table 1). A list of these sponsors is maintained on DO-Online (see http://do-online.osteotech.org/pdf/cme_sponscat1alist.pdf).

All AOA-accredited Category 1 CME sponsors are obligated to meet certain requirements to maintain their accreditation status. The CCME recently updated the AOA accreditation requirements for AOA Category 1 CME sponsors⁹ as approved by the BOT in previous years. Changes relating to the requirements appear in Figure 6.

On an ongoing schedule, the CCME and AOA staff monitor sponsor compliance ("spot monitoring") with AOA policies and the CCME-approved Uniform Guidelines for Accrediting Agencies of Continuing Medical Education.⁹ Once a sponsor has been selected for review, the AOA will request documentation of their CME activities and then use a checklist to determine whether all requirements have been met or whether certain major or minor deficiencies exist. In addition, AOA staff and the CCME investigate all written complaints or deviations from AOA policy using standard compliance-review procedures.^9,10

For AOA-accredited Category 1 CME sponsors, the AOA Division of CME provides the following information:

• Complete list of AOA CME credit hours awarded to physicians on a yearly basis for sponsors to verify that they have reported all their CME programs to the AOA
  
• AOA Speakers' Bureau Directory every 2 years as approved by the BOT to assist sponsors in obtaining speakers on unique topics
  
• List and mailing labels of DOs who have failed to submit their AOA CME credits for sponsors to contact those physicians and encourage them to fulfill the CME requirements
  

	Online Calendar

Top CME Requirements for State... DO-Online's CME Center Recent Activities at the... CME on the Internet Clinical Assessment Program Guidelines for Osteopathic... AOA-Accredited Category 1 CME... Online Calendar National CME Sponsors Conference CME Program Trends and... Comment References

 
Changes are currently being made to the calendar on DO-Online, which will give Category 1 CME sponsors access to enter their own events listed in the calendar directly through a secure online interface. All calendar items will be reviewed by the American Osteopathic Information Association before being posted to the site. This information was presented by Mike Zarski, JD, at the CME Sponsors Conference in January, as indicated below.

	National CME Sponsors Conference

Top CME Requirements for State... DO-Online's CME Center Recent Activities at the... CME on the Internet Clinical Assessment Program Guidelines for Osteopathic... AOA-Accredited Category 1 CME... Online Calendar National CME Sponsors Conference CME Program Trends and... Comment References

 
The annual AOA National CME Sponsors Conference provides sponsors with up-to-date information regarding the latest requirements for maintaining their CME accreditation status (https://www.do-online.org/?PageID=cme_sponsmain). This conference is also intended to help sponsors understand the rationale of CCME directives, clarify those directives as necessary, and explain the trends and evolution of the CME environment.

The AOA's 14th Annual National CME Sponsors Conference was held Thursday, January 10, 2008, through Saturday, January 12, 2008, at the Westin Kierland Resort & Spa in Scottsdale, Ariz, in conjunction with the 18th Annual Osteopathic Medical Education Leadership Conference. In an effort to align the 2008 conference with the "Fit for Life" theme launched by 2007-2008 AOA President Peter B. Ajluni, DO, the sponsors conference theme was "Fit for Life—CME Programs."

A total of 65 individual registrants, including speakers, attended this year's National CME Sponsors Conference. The keynote address was delivered by Mark Quirk, EdD, Professor of Family Medicine and Community Health at the University of Massachusetts in Worcester. Dr Quirk's presentation was titled "On the Cutting Edge: Professional Development for Medical Education Faculty."

Conference topics and guest speakers consisted of the following:

• "CME in the Future," Sue Ann Capizzi, MBA, President, Alliance for CME; Associate Director, Division of Continuing Professional Development of Physicians, AMA (Chicago, Ill)
  
• "New Beginners Session," Delores J. Rodgers, BS, Director of CME, AOA; Secretary, CCME (Chicago, Ill)
  
• "Specialty Credits," Stephen M. Scheinthal, DO, Associate Director & Chief, Geriatric Behavioral Health, University of Medicine and Dentistry of New Jersey-School of Osteopathic Medicine (Stratford); Vice Chairman, Bureau of Osteopathic Specialists (Chicago, Ill)
  
• "Grant Application Overview," Mario E. J. Lanni, DSc, Executive Director, Pennsylvania Osteopathic Medical Association (Harrisburg); CCME member (Chicago, Ill)
  
• "Collaboration and Joint Sponsorship as a Vehicle for Innovation," Jennifer W. Jones, BS, Director of Affiliate Affairs, AOA (Chicago, Ill)
  
• "Develop a Needs Assessment for Your CME Program," Morton Morris, DO, JD, Vice Chancellor and Deputy Provost, Health Professions Division, Nova Southeastern University (Fort Lauderdale, Fla); Executive Director, American Osteopathic Academy of Orthopedics (Davie, Fla); Chairman, CCME (Chicago, Ill)
  
• "FSMB [Federation of State Medical Boards] Update: Physicians Accountability for Physician Competence," Frederick G. Meoli, DO, President, National Board of Osteopathic Medical Examiners (Chicago, Ill)
  
• "AOA CME Policy Update," Delores J. Rodgers, BS
  
• "FAQ's (Waivers and Exemptions)," William J. Burke, DO, CME Advisor, AOA, and James E. Preston, DO, CCME member (Chicago, Ill)
  
• "Posting of Live CME Meetings on DO-Online Calendar," Michael J. Zarski, JD, Executive Director, American Osteopathic Information Association (Chicago, Ill)
  
• "The Integration of Quality Improvement and Continuing Education for Healthcare Professionals," Nancy Davis, PhD, Executive Director, National Institute for Quality Improvement and Education (Homestead, Pa)
  
• "Outcomes Measurement," Morton Morris, DO, JD
  
• "Outcomes Survey Panel Discussion," Morton Morris, DO, JD
  
• "Negotiating Hotel Contracts for CME Programs," Cynthia Smith, CMP, Director of Continuing Education and Meetings, American College of Osteopathic Surgeons (Alexandria, Va)
  

Concerns addressed in networking sessions centered on current and proposed CME requirements and processes, particularly those related to healthcare facilities and state and specialty societies. Discussions included the following:

• Stark II Law and the potential effects of "free CME"
  
• benefits of CME awarded for grand rounds and hospital programs
  
• proposal to award Category 1-B CME credit for attending resident lectures
  
• credit requirements for the AOA Certificate of Excellence compared with the AMA Physician Recognition Award
  
• determination of hour assignment for specialty CME credits, including proposed changes to the processing of specialty credits
  
• potential sources of alternative funding for CME programs, including encouraging joint ventures for CME sponsorship
  
• assignment of attendant and exhibitor fees at conferences
  
• proposal that DOs must comprise 50% of faculty at healthcare facilities to receive status of an AOA-accredited Category 1 CME sponsor
  
• influence of pay-for-performance initiatives on CME
  
• proposed practice areas for CAP (eg, obstetrics/gynecology, pediatrics)
  
• improved methods for licensing and credentialing
  

In addition, the social networking sessions, which were broken into healthcare facilities, COMs and specialty colleges, and divisional societies, made the following recommendations to the CCME:

• beginner's session should be longer and divided into colleges, hospitals, and state and specialty societies
  
• more social networking sessions should be scheduled
  
• section 3.1.2 of the provider's manual needs to clarify that residents do not qualify as presenters for lectures approved for Category 1-A CME credit
  
• a CME primer should be available on DO-Online
  

The AOA's 15th Annual National CME Sponsors Conference will be held at the Hyatt Regency Pier 66 Resort in Fort Lauderdale, Fla, from Thursday, January 8, 2009, through Saturday, January 10, 2009. Additional information will be posted on DO-Online as it becomes available.

	CME Program Trends and Statistics

Top CME Requirements for State... DO-Online's CME Center Recent Activities at the... CME on the Internet Clinical Assessment Program Guidelines for Osteopathic... AOA-Accredited Category 1 CME... Online Calendar National CME Sponsors Conference CME Program Trends and... Comment References

 
The AOA's CME program continues to develop annually, as does the proportion of physician-members with a CME requirement from their state or specialty boards (Table 2). As of December 2007, the number of AOA members with a state- or specialty-board–mandated CME requirement was 28,812. As of January 23, 2008, AOA membership totaled 37,112; therefore, approximately 78% of AOA members now have a state-mandated CME requirement.

The type of CME credit recorded by the AOA has changed over time (Table 3). Earned Category 1-A credit in formal, osteopathic CME programs increased steadily but incrementally from 2.5 million hours in the 1995-1997 CME cycle to 2.9 million hours in the 2001-2003 CME cycle. However, earned Category 1-B credit, which is less formal, non-osteopathic CME credit, has experienced more dramatic growth, increasing from 5.7 million hours in the 1995-1997 CME cycle to 8.6 million hours in the 2001-2003 CME cycle.

The number of DOs whose AOA membership was dropped as a result of failure to complete the CME requirement has fluctuated between a high of 298 members in the 1983-1985 CME cycle and a low of 43 members in the 1986-1988 CME cycle (Table 2). Association members are given an 18-month grace period to fulfill requirements from the previous CME cycle. A total of 259 members were dropped from membership on May 31, 2005, for not meeting the 2001-2003 CME requirement. Statistics for the 2004-2006 CME cycle will not be available until May 31, 2008.

Similarly, the total number of CME credit hours recorded by the AOA has increased considerably during each successive 3-year CME cycle (Table 3). This growth is a reflection of the increasing number of AOA members who have a state- or specialty-board–mandated CME requirement and the steadily increasing average number of CME credit hours recorded per member.

	Comment

Top CME Requirements for State... DO-Online's CME Center Recent Activities at the... CME on the Internet Clinical Assessment Program Guidelines for Osteopathic... AOA-Accredited Category 1 CME... Online Calendar National CME Sponsors Conference CME Program Trends and... Comment References

 
Faced with an increasing amount of regulatory scrutiny, financial pressure, and technological change, the CME industry remains dynamic. The CCME continues to be committed to an agenda of progress in CME policies while maintaining the high standards for which the AOA is known. The Council continues to study the changing environment of osteopathic medicine, particularly as it relates to osteopathic specialty board certification, and to adjust the Association's CME program to respond to the needs of the public, physician-members, and the AOA.

	Footnotes

 
Editor's note: Although most articles in THE JOURNAL's annual Osteopathic Medical Education theme issue focus on recent changes to programming and updates to demographic data within the profession, the current article—though it also provides such summative information—is intended as an accessible and fairly comprehensive point of reference for the 84% of American Osteopathic Association members who have continuing medical education requirements.

Submitted December 12, 2007; revision received January 25, 2008; accepted January 31, 2008.

	References

Top CME Requirements for State... DO-Online's CME Center Recent Activities at the... CME on the Internet Clinical Assessment Program Guidelines for Osteopathic... AOA-Accredited Category 1 CME... Online Calendar National CME Sponsors Conference CME Program Trends and... Comment References

 
1. Rodgers DJ. AOA continuing medical education. J Am Osteopath Assoc. 2003;103:531-538. Available at: http://www.jaoa.org/cgi/reprint/103/11/531. Accessed February 19, 2008.

2. Division of Continuing Medical Education. Continuing Medical Education Guide, 2007-2009: Guide for Osteopathic Physicians, December 2006. Chicago, Ill: American Osteopathic Association; 2006. Available at: http://www.do-online.osteotech.org/pdf/cme_guidemain07-09.pdf. Accessed February 19, 2008.

3. Apply for your American Medical Association Physician's Recognition Award page. American Medical Association Web site. Available at: http://www.ama-assn.org/ama1/pub/upload/mm/455/praapplication.pdf. Accessed February 19, 2008.

4. American Osteopathic Board of Family Physicians. Verification and Maintenance of Certification. 2000. Available at: http://www.aobfp.org/verificationcert/index.html. Accessed February 19, 2008.

5. Division of State and Socioeconomic Affairs. US Osteopathic Licensure Summary, January 2007. Chicago, Ill: American Osteopathic Association; 2006.

6. Rodgers DJ. Osteopathic continuing medical education. J Am Osteopath Assoc. 2007;107:67-81. Available at: http://www.jaoa.org/cgi/content/full/107/2/67. Accessed February 19, 2008.

7. Schierhorn C. CAP for physicians now running [newsbrief]. The DO. February2006 :47;8 .

8. Ayres RE, Scheinthal S, Ramirez AF, Bell E. Osteopathic certification evolving into a continuous certification model. J Am Osteopath Assoc. 2008;108:159 -166.[Abstract/Free Full Text]

9. Division of Continuing Medical Education. Accreditation Requirements: Category 1 CME Sponsors. Chicago, Ill: American Osteopathic Association; 2007. Available at: http://do-online.org/pdf/acc_cmespo.pdf. Accessed February 19, 2008.

10. Rodgers DJ. AOA continuing medical education [published correction appears in J Am Osteopath Assoc. 2004;104:514]. J Am Osteopath Assoc. 2004;104:493-502. Available at: http://www.jaoa.org/cgi/content/full/104/11/493. Accessed February 19, 2008.

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