Continuing Medical Education - Medicine - Business & Professions - CA

Section § 2190

This law requires licensed physicians and surgeons to complete ongoing education to stay competent in their practice. The board in charge sets the education standards and can include content on preventing and treating chronic diseases through nutrition and lifestyle changes. Physicians and surgeons must demonstrate they've met these education requirements every four to six years.

In order to ensure the continuing competence of licensed physicians and surgeons, the board shall adopt and administer standards for the continuing education of those licensees. The board may also set content standards for any educational activity concerning a chronic disease that includes appropriate information on prevention of the chronic disease, and on treatment of patients with the chronic disease, by the application of changes in nutrition and lifestyle behavior. The board shall require each licensed physician and surgeon to demonstrate satisfaction of the continuing education requirements at intervals of not less than four nor more than six years.

physician continuing education licensed surgeons chronic disease education

Section § 2190.1

This law sets guidelines for continuing medical education (CME) for physicians in California. It emphasizes the importance of educational activities that enhance physicians' knowledge and skills in providing quality patient care, while also addressing public health and preventive medicine topics.

CME courses must include cultural and linguistic competency starting July 1, 2006, unless they are strictly research-focused or offered out of state. Accreditation agencies need to create standards with input from cultural experts, addressing demographics and language needs.

Starting January 1, 2022, CME must also include curriculum on implicit bias unless the course's focus does not involve direct patient care. The course content should cover cultural competency, linguistic skills, and understanding implicit biases to improve health outcomes.

Certain non-medical topics like office management don't count toward CME requirements. Courses that align with content standards from esteemed medical associations are eligible for CME credit.

(a) The continuing medical education standards of Section 2190 may be met by educational activities that meet the standards of the board and that serve to maintain, develop, or increase the knowledge, skills, and professional performance that a physician and surgeon uses to provide care, or to improve the quality of care provided to patients. These may include, but are not limited to, educational activities that meet any of the following criteria:

(1) Have a scientific or clinical content with a direct bearing on the quality or cost-effective provision of patient care, community or public health, or preventive medicine.

(2) Concern quality assurance or improvement, risk management, health facility standards, or the legal aspects of clinical medicine.

(3) Concern bioethics or professional ethics.

(4) Are designed to improve the physician-patient relationship and quality of physician-patient communication.

(b)

(1) On and after July 1, 2006, all continuing medical education courses shall contain curriculum that includes cultural and linguistic competency in the practice of medicine.

(2) Notwithstanding the provisions of paragraph (1), a continuing medical education course dedicated solely to research or other issues that does not include a direct patient care component or a course offered by a continuing medical education provider that is not located in this state is not required to contain curriculum that includes cultural and linguistic competency in the practice of medicine.

(3) Associations that accredit continuing medical education courses shall develop standards before July 1, 2006, for compliance with the requirements of paragraph (1). The associations may update these standards, as needed, in accordance with the following requirements:

(A) The standards shall be updated in conjunction with an advisory group that has expertise in cultural and linguistic competency issues and is informed of federal and state statutory threshold language requirements, with prioritization of languages in proportion to the state population’s most prevalent primary languages spoken by 10 percent or more of the state population.

(B) The standards shall be updated to ensure program standards meet the needs of California’s changing demographics and properly address language disparities, as they emerge.

(4) A physician and surgeon who completes a continuing education course meeting the standards developed pursuant to paragraph (3) satisfies the continuing education requirement for cultural and linguistic competency.

(c) In order to satisfy the requirements of subdivision (b), continuing medical education courses shall address at least one or a combination of the following:

(1) Cultural competency. For the purposes of this section, “cultural competency” means a set of integrated attitudes, knowledge, and skills that enables a health care professional or organization to care effectively for patients from diverse cultures, groups, and communities. At a minimum, cultural competency is recommended to include the following:

(A) Applying linguistic skills to communicate effectively with the target population.

(B) Utilizing cultural information to establish therapeutic relationships.

(C) Eliciting and incorporating pertinent cultural data in diagnosis and treatment.

(D)

(i) Understanding and applying culturally, ethnically, and sociologically inclusive data to the process of clinical care, including, as appropriate, information and evidence-based cultural competency training pertinent to the treatment of, and provision of care to, individuals who identify as lesbian, gay, bisexual, transgender, queer or questioning, asexual, intersex, or gender diverse. This includes processes specific to those seeking gender-affirming care services.

(ii) An evidence-based cultural competency training implemented pursuant to clause (i) may include all of the following:

(I) Information about the effects, including, but not limited to, ongoing personal effects of historical and contemporary exclusion and oppression of transgender, gender diverse, or intersex (TGI) communities.

(II) Information about communicating more effectively across gender identities, including TGI-inclusive terminology, using people’s correct names and pronouns, even when they are not reflected in records or legal documents, avoiding language, whether verbal or nonverbal, that demeans, ridicules, or condemns TGI individuals, and avoiding making assumptions about gender identity by using gender-neutral language and avoiding language that presumes all individuals are heterosexual, cisgender, or gender conforming, or nonintersex.

(III) Discussion on health inequities within the TGI community, including family and community acceptance.

(IV) Perspectives of diverse, local constituency groups and TGI-serving organizations, including, but not limited to, the California Transgender Advisory Council.

(V) Recognition of the difference between personal values and professional responsibilities with regard to serving TGI people.

(VI) Recommendations on administrative changes to make health care facilities more inclusive.

(2) Linguistic competency. For the purposes of this section, “linguistic competency” means the ability of a physician and surgeon to provide patients who do not speak English or who have limited ability to speak English, direct communication in the patient’s primary language.

(3) A review and explanation of relevant federal and state laws and regulations regarding linguistic access, including, but not limited to, the federal Civil Rights Act of 1964 (42 U.S.C. Sec. 1981 et seq.), Executive Order 13166 of August 11, 2000, of the President of the United States, and the Dymally-Alatorre Bilingual Services Act (Chapter 17.5 (commencing with Section 7290) of Division 7 of Title 1 of the Government Code).

(d)

(1) On and after January 1, 2022, all continuing medical education courses shall contain curriculum that includes the understanding of implicit bias.

(2) Notwithstanding the provisions of paragraph (1), a continuing medical education course dedicated solely to research or other issues that does not include a direct patient care component or a course offered by a continuing medical education provider that is not located in this state is not required to contain curriculum that includes implicit bias in the practice of medicine.

(3) Associations that accredit continuing medical education courses shall develop standards before January 1, 2022, for compliance with the requirements of paragraph (1). The associations may update these standards, as needed, in conjunction with an advisory group established by the association that has expertise in the understanding of implicit bias.

(e) In order to satisfy the requirements of subdivision (d), continuing medical education courses shall address at least one or a combination of the following:

(1) Examples of how implicit bias affects perceptions and treatment decisions of physicians and surgeons, leading to disparities in health outcomes.

(2) Strategies to address how unintended biases in decisionmaking may contribute to health care disparities by shaping behavior and producing differences in medical treatment along lines of race, ethnicity, gender identity, sexual orientation, age, socioeconomic status, or other characteristics.

(f) Notwithstanding subdivision (a), educational activities that are not directed toward the practice of medicine, or are directed primarily toward the business aspects of medical practice, including, but not limited to, medical office management, billing and coding, and marketing shall not be deemed to meet the continuing medical education standards for licensed physicians and surgeons.

(g) Educational activities that meet the content standards set forth in this section and are accredited by the California Medical Association or the Accreditation Council for Continuing Medical Education may be deemed by the Division of Licensing to meet its continuing medical education standards.

(h) For the purposes of this section, the following definitions apply:

(1) “TGI” means transgender, gender diverse, or intersex.

(2) “TGI-serving organization” has the same meaning as set forth in paragraph (2) of subdivision (f) of Section 150900 of the Health and Safety Code.

continuing medical education cultural competency linguistic competency

Section § 2190.15

This law allows physicians and surgeons to count specific types of continuing medical education (CME) courses towards their required CME hours, but only up to 30% of the total required hours. These eligible courses include those focused on improving practice management to provide better patient service, managing healthcare facilities with topics like coding or reimbursement, and educational methods for those teaching at medical schools.

Notwithstanding Section 2190.1, a physician and surgeon may meet the continuing medical education standards in Section 2190 through continuing medical education courses that meet any of the criteria below, except that these courses shall not together comprise more than 30 percent of the total hours of continuing medical education completed by a licensee to satisfy the continuing educational requirement established by the board:

(a) Have practice management content designed to provide better service to patients, including, but not limited to, the use of technology or clinical office workflow.

(b) Have management content designed to support managing a health care facility, including, but not limited to, coding or reimbursement in a medical practice.

(c) Support educational methodology for physicians and surgeons teaching in a medical school.

continuing medical education physicians surgeons

Section § 2190.2

This law requires the Division of Licensing to set rules for continuing medical education (CME) providers to make sure that licensed medical professionals attend the full duration of their courses.

The Division of Licensing shall establish criteria that providers of continuing medical education shall follow to ensure attendance by licensees throughout the entire course.

Division of Licensing continuing medical education CME providers

Section § 2190.3

If you're a general internist or family physician and more than 25% of your patients are 65 or older, you need to dedicate at least 20% of your mandatory continuing education to geriatric medicine. This includes learning about the care needs of elderly patients, especially those with dementia.

All general internists and family physicians who have a patient population of which over 25 percent are 65 years of age or older shall complete at least 20 percent of all mandatory continuing education hours in a course in the field of geriatric medicine, the special care needs of patients with dementia, or the care of older patients.

geriatric medicine elderly patient care dementia care

Section § 2190.5

Physicians and surgeons in California must complete a one-time, 12-credit-hour course on pain management and treating terminally ill patients. Those licensed after January 1, 2019, must also learn about addiction risks from Schedule II drugs. This must be done by the second license renewal or within four years of getting their license. The board checks for course completion during license renewal.

Physicians not practicing direct patient care, not consulting with patients, or living outside California might be exempt. This rule does not apply to those in pathology or radiology.

(a)

(1) All physicians and surgeons shall complete a mandatory continuing education course in the subjects of pain management and the treatment of terminally ill and dying patients. For the purposes of this section, this course shall be a one-time requirement of 12 credit hours within the required minimum established by regulation, to be completed by December 31, 2006. All physicians and surgeons licensed on and after January 1, 2002, shall complete this requirement within four years of their initial license or by their second renewal date, whichever occurs first. The board may verify completion of this requirement on the renewal application form.

(2) For physicians and surgeons licensed on or after January 1, 2019, the course described in paragraph (1) shall also include the subject of the risks of addiction associated with the use of Schedule II drugs.

(b) By regulatory action, the board may exempt physicians and surgeons by practice status category from the requirement in subdivision (a) if the physician and surgeon does not engage in direct patient care, does not provide patient consultations, or does not reside in the State of California.

(c) This section shall not apply to physicians and surgeons practicing in pathology or radiology specialty areas.

pain management course terminally ill treatment addiction risks

Section § 2190.6

This law provides an alternative for physicians in California to meet continuing education requirements by allowing them to complete a one-time, 12-hour course focused on treating opioid-use disorders. This includes specific training in buprenorphine treatment. Physicians who already qualify under federal guidelines for treating opioid addiction are considered to meet this requirement automatically. Physicians need to complete this alternative course by their next license renewal if they choose this option. The medical board is responsible for verifying whether the requirements have been met.

(a) As an alternative to Section 2190.5, a physician and surgeon may complete a one-time continuing education course of 12 credit hours in the subject of treatment and management of opiate-dependent patients, including eight hours of training in buprenorphine treatment, or other similar medicinal treatment, for opioid use disorders.

(b) A physician and surgeon who meets the requirements, as determined by the board, of a “qualifying physician” under clause (ii) of subparagraph (G) of paragraph (2) of subsection (g) of Section 823 of Title 21 of the United States Code, the Comprehensive Addiction Recovery Act of 2016 (Public Law 114-198), as that clause read on January 1, 2018, shall be deemed to have met the requirements of subdivision (a).

(c) A physician and surgeon who chooses to comply with this section as an alternative to Section 2190.5 shall complete the requirements of this section by the physician and surgeon’s next license renewal date.

(d) The board shall determine whether a physician and surgeon has met the requirements of this section.

continuing education 12 credit hours opiate-dependent patients

Section § 2191

This law allows the board to consider various specialized courses as part of continuing education for licensees. These courses may include human sexuality, child abuse detection and treatment, acupuncture, nutrition, and elder abuse, among others. The board is encouraged to suggest these courses based on the specific needs of different practices. Special emphasis is given to pain management, spousal abuse detection, and geriatric and end-of-life care. If a course in spousal abuse detection is mandated, licensees must complete it within four years.

(a) In determining its continuing education requirements, the board shall consider including a course in human sexuality, defined as the study of a human being as a sexual being and how they function with respect thereto, and nutrition to be taken by those licensees whose practices may require knowledge in those areas.

(b) The board shall consider including a course in child abuse detection and treatment to be taken by those licensees whose practices are of a nature that there is a likelihood of contact with abused or neglected children.

(c) The board shall consider including a course in acupuncture to be taken by those licensees whose practices may require knowledge in the area of acupuncture and whose education has not included instruction in acupuncture.

(d) The board shall encourage every physician and surgeon to take nutrition as part of their continuing education, particularly a physician and surgeon involved in primary care.

(e) The board shall consider including a course in elder abuse detection and treatment to be taken by those licensees whose practices are of a nature that there is a likelihood of contact with abused or neglected persons 65 years of age and older.

(f) In determining its continuing education requirements, the board shall consider including a course in the early detection and treatment of substance abusing pregnant women to be taken by those licensees whose practices are of a nature that there is a likelihood of contact with these women.

(g) In determining its continuing education requirements, the board shall consider including a course in the special care needs of drug-addicted infants to be taken by those licensees whose practices are of a nature that there is a likelihood of contact with these infants.

(h) In determining its continuing education requirements, the board shall consider including a course providing training and guidelines on how to routinely screen for signs exhibited by abused women, particularly for physicians and surgeons in emergency, surgical, primary care, pediatric, prenatal, and mental health settings. In the event the board establishes a requirement for continuing education coursework in spousal or partner abuse detection or treatment, that requirement shall be met by each licensee within no more than four years from the date the requirement is imposed.

(i) In determining its continuing education requirements, the board shall consider including a course in the special care needs of individuals and their families facing end-of-life issues, including, but not limited to, all of the following:

(1) Pain and symptom management.

(2) The psychosocial dynamics of death.

(3) Dying and bereavement.

(4) Hospice care.

(j) In determining its continuing education requirements, the board shall give its highest priority to considering a course on pain management and the risks of addiction associated with the use of Schedule II drugs.

(k) In determining its continuing education requirements, the board shall consider including a course in geriatric care for emergency room physicians and surgeons.

(l) In determining its continuing education requirements, the board shall consider including a course in menopausal mental or physical health.

continuing education human sexuality child abuse detection

Section § 2191.1

This law section encourages doctors in California to take ongoing education courses specifically in pharmacology and pharmaceuticals to stay informed about medications and their use.

The Division of Licensing shall encourage every physician and surgeon to take a course in pharmacology and pharmaceuticals as part of his or her continuing education.

physician continuing education surgeon education pharmacology course

Section § 2191.2

This law encourages all doctors and surgeons to include a course in geriatric medicine, focusing on the medical treatment of older adults, and geriatric pharmacology, which is about medication use in elderly patients, as part of their ongoing professional education.

The division shall encourage every physician and surgeon to take a course in geriatric medicine, including geriatric pharmacology, as part of his or her continuing education.

geriatric medicine geriatric pharmacology continuing education

Section § 2191.4

This law section suggests that when setting up continuing education requirements, the board should consider including a course on HIV/AIDS prevention and management. This would focus on medications like PrEP (pre-exposure prophylaxis) and PEP (post-exposure prophylaxis), and how these can be integrated into primary care. The course should also cover topics like HIV testing, care access, patient counseling, and making care and treatment referrals, especially for high-risk groups. The guidelines for the course content should align with the latest recommendations from the U.S. Public Health Service and the CDC.

The board, in determining its continuing education requirements, shall consider including a course in integrating HIV/AIDS pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) medication maintenance and counseling in primary care settings, especially as it pertains to HIV testing, access to care, counseling, high-risk communities, patient concerns, exposure to HIV/AIDS, and the appropriate care and treatment referrals. That course shall be consistent with the most recent guidelines on PrEP and PEP as published by the United States Public Health Service and the Centers for Disease Control and Prevention.

HIV/AIDS prevention PrEP medications PEP medications

Section § 2191.5

This section suggests that when setting continuing education requirements, the board should consider adding a course that focuses on combining mental and physical health care in primary health settings. Special emphasis should be placed on identifying mental health issues and trauma early in children and young adults and ensuring they receive suitable care and treatment.

In determining its continuing education requirements, the board shall consider including a course in integrating mental and physical health care in primary care settings, especially as it pertains to early identification of mental health issues and exposure to trauma in children and young adults and their appropriate care and treatment.

continuing education requirements mental health care physical health care

Section § 2191.6

This law section requires the board to think about adding courses on infection-associated chronic conditions, like long COVID, myalgic encephalomyelitis, and dysautonomia, when setting their continuing education requirements for medical professionals.

In determining its continuing education requirements, the board shall consider including a course in infection-associated chronic conditions, including, but not limited to, long COVID, as defined by the United States Department of Health and Human Services, myalgic encephalomyelitis, and dysautonomia.

continuing education infection-associated chronic conditions long COVID

Section § 2196

This law requires the board to regularly create and share information and educational materials about recognizing and treating child abuse and neglect. These materials must be sent to all licensed doctors and general acute care hospitals in California. To ensure the materials are effective, the board must work with the Office of Child Abuse Prevention.

The board shall periodically develop and disseminate information and educational material regarding the detection and treatment of child abuse and neglect to each licensed physician and surgeon and to each general acute care hospital in the state. The board shall consult with the Office of Child Abuse Prevention in developing the materials distributed pursuant to this section.

child abuse detection child neglect treatment educational materials

Section § 2196.1

This law requires the board to regularly create and share information on spotting and treating elder abuse and neglect with licensed physicians and general acute care hospitals in California. They must work with the Adult Protective Services Division to develop these materials.

The board shall periodically develop and disseminate information and educational material regarding the detection and treatment of elder abuse and neglect to each licensed physician and surgeon and to each general acute care hospital in this state. The board shall consult with the Adult Protective Services Division of the State Department of Social Services in developing the materials distributed pursuant to this section.

elder abuse detection elder neglect treatment educational materials

Section § 2196.2

The board is required to create and share educational materials about pain management techniques, including the potential for addiction to certain drugs, with doctors and general hospitals in California. These materials are developed with input from the State Department of Public Health.

The board shall periodically develop and disseminate information and educational material regarding pain management techniques and procedures, including the risks of addiction associated with the use of Schedule II drugs, to each licensed physician and surgeon and to each general acute care hospital in this state. The board shall consult with the State Department of Public Health in developing the materials to be distributed pursuant to this section.

pain management addiction risks Schedule II drugs

Section § 2196.5

This law requires that the board regularly provides information and educational materials about how to identify and treat spousal or partner abuse. This information must be sent to every licensed doctor and general acute care hospital in California.

The board shall periodically disseminate information and educational material regarding the detection and treatment of spousal or partner abuse to each licensed physician and surgeon and to each general acute care hospital in the state.

spousal abuse education partner abuse detection physician training

Section § 2196.6

This law requires that the board regularly provide doctors and hospitals with information and educational resources about preventing and treating chronic diseases through nutrition and lifestyle adjustments.

The board shall periodically disseminate information and educational material regarding the prevention and treatment of chronic disease by the application of changes in nutrition and lifestyle behavior to each licensed physician and surgeon and to each general acute care hospital in the state.

chronic disease prevention nutrition lifestyle changes

Section § 2196.7

This law requires that the board bring together a working group, including anyone interested, to talk about how nutrition and lifestyle choices can help prevent and treat chronic diseases. This discussion must happen at one of the board's quarterly meetings within three years of the law taking effect.

The board shall convene a working group of interested parties to discuss nutrition and lifestyle behavior for the prevention and treatment of chronic disease at one of its quarterly meetings within three years after the operative date of this section.

nutrition lifestyle behavior chronic disease prevention

Section § 2196.8

This law requires the board to regularly create and share educational materials about how to assess a patient's risk of misusing or illegally sharing controlled substances. These materials also provide information about CURES, a system that helps track controlled substance prescriptions. The board must work with various health and justice departments to develop these resources, ensuring they reach all licensed doctors and acute care hospitals in the state.

The board shall periodically develop and disseminate information and educational material regarding assessing a patient’s risk of abusing or diverting controlled substances and information relating to the Controlled Substance Utilization Review and Evaluation System (CURES), described in Section 11165 of the Health and Safety Code, to each licensed physician and surgeon and to each general acute care hospital in this state. The board shall consult with the State Department of Public Health, the boards and committees specified in subdivision (d) of Section 208, and the Department of Justice in developing the materials to be distributed pursuant to this section.

controlled substance risk assessment CURES information patient abuse prevention

Section § 2196.9

This law suggests that the board responsible for physician and surgeon education in California should consider including a course on maternal mental health. This course should cover best practices for screening these disorders while being mindful of cultural differences and reducing bias to build trust with mothers. It should also address different types of maternal mental health disorders and evidence-based treatments, emphasizing women's involvement in their treatment plans. The course should guide when specialists like psychiatrists should be consulted. Additionally, the curriculum should stay updated with new research and comply with specific health and safety regulations.

(a) In determining its continuing education requirements for physicians and surgeons, the board shall consider including a course in maternal mental health, which shall address the following:

(1) Best practices in screening for maternal mental health disorders, including cultural competency and unintended bias as a means to build trust with mothers.

(2) The range of maternal mental health disorders.

(3) The range of evidence-based treatment options, including the importance of allowing a mother to be involved in developing the treatment plan.

(4) When an obstetrician or a primary care doctor should consult with a psychiatrist versus making a referral.

(5) Applicable requirements under Sections 123640 and 123616.5 of the Health and Safety Code.

(b) Subject to Section 2001.1, the board shall periodically update any curriculum developed pursuant to this section to account for new research.

maternal mental health education screening best practices cultural competency

Medicine

Medicine 2000-2529.8.1Continuing Medical Education