Most physicians earn CME credits through a mix of conferences, online courses, journal-based learning, and self-study, with requirements typically ranging from 20 to 100 hours every one to three years depending on your state. The process is straightforward once you understand the credit types, where to find accredited activities, and how your state and specialty board track what you’ve completed.
How Many Credits You Actually Need
Your CME requirement depends on where you’re licensed. Sixty-three of the 67 U.S. medical boards require substantial CME, generally 15 hours per year or more. Only a handful of states, including Indiana, Montana, New York, and South Dakota, have no set hour requirement.
The most common structure is 40 to 50 hours every two years. States like California, Connecticut, Maryland, Massachusetts, Ohio, and Missouri all fall in that range. Some states ask for more: New Hampshire and New Jersey require 100 hours every two years, Pennsylvania requires 100 hours every two years, and Illinois and Michigan each require 150 hours every three years. Washington state has the highest total at 200 hours every four years for MDs. On the lower end, Alabama requires 25 hours per year, and Louisiana and Arkansas require 20 hours per year.
If you hold licenses in multiple states, you’ll need to meet the requirements for each. Check your state medical board’s website for your specific renewal cycle and any mandated topics like opioid prescribing, pain management, or cultural competency, which many states now require as a portion of your total hours.
Category 1 vs. Category 2 Credits
The main distinction most physicians encounter is between AMA PRA Category 1 Credit and Category 2 Credit. Category 1 credits come from activities sponsored or jointly sponsored by providers accredited through the Accreditation Council for Continuing Medical Education (ACCME) or a state medical society. These are the credits most state boards and specialty boards specifically require, and they carry the most weight.
Category 2 credits cover less formal learning: independent reading, teaching preparation, online research you do on your own. These are self-claimed, meaning you log them yourself without completing a formal assessment. Many states accept a mix of both categories, but some require all or most hours to be Category 1. Your state board’s rules will specify the breakdown.
Ways to Earn Credits
Live Activities and Conferences
Medical conferences, grand rounds, and in-person workshops remain the most traditional route. These are typically pre-approved for Category 1 credit, and you receive a certificate of completion at the end. One hour of instruction generally equals one credit.
Online Courses and Enduring Materials
Enduring materials are self-study activities you complete on your own schedule: recorded webcasts, online modules, interactive case studies. They can be standalone courses or part of a series built around a theme. As long as the provider is ACCME-accredited, these carry the same Category 1 weight as live events. This is where most physicians pick up the bulk of their credits today.
Journal-Based Learning
Many medical journals offer CME credit for reading selected articles and completing a set of questions or reflective tasks afterward. The number of credits you can earn depends on how many eligible articles the journal publishes per issue. This is a practical way to earn credits while staying current in your field.
Point-of-Care Learning
Some clinical reference tools let you earn credits while looking up information during patient care. Platforms like UpToDate are accredited to offer CME, so searching for clinical answers you’d be looking up anyway can count toward your total. You typically need to log the search, reflect on what you learned, and answer a brief question to claim the credit.
Teaching and Presentations
Preparing and delivering lectures to medical students, residents, or peers can count as Category 2 credit. The hours you spend preparing the content, not just presenting it, are generally eligible.
Free CME Options
You don’t have to pay conference registration fees for every credit. The AAFP offers a library of free CME courses designed by subject-matter experts, open to physicians, nurses, and other clinicians. Many academic medical centers publish free online modules. Government agencies like the CDC and NIH also provide free accredited courses, particularly around infectious disease, public health, and prevention topics. The trade-off with free options is that the topic selection may be narrower, but the credit carries the same value as paid alternatives.
How CME Connects to Board Certification
State licensure and specialty board certification are separate requirements, and CME feeds into both. Beyond keeping your license active, your specialty board requires ongoing education as part of Maintenance of Certification (MOC), sometimes called Continuing Certification. The American Board of Internal Medicine, American Board of Pediatrics, American Board of Surgery, and several other boards participate in a system where accredited CME activities can count directly toward MOC requirements.
Not every CME activity automatically qualifies for MOC credit. Activities that do will carry a specific recognition statement from the relevant board, listing the type and number of MOC points available. Look for this statement in the activity description before you start, so you can choose courses that satisfy both your state CME requirement and your board’s MOC requirement at the same time.
Timing matters for MOC reporting. Most boards need your credit data submitted by December 31 of the relevant year. The American Board of Pediatrics has an earlier deadline of December 1. If you’re near the end of a certification cycle, submit credits promptly rather than waiting.
Credits for NPs and PAs
Nurse practitioners and physician assistants have their own credentialing bodies, but many of the same learning platforms work across professions. The National Commission on Certification of Physician Assistants (NCCPA) accepts credit from ACCME-accredited organizations, so PAs can often use the same courses physicians use. Nurse practitioners earn continuing education through providers approved by the American Association of Nurse Practitioners (AANP), and many large platforms like UpToDate carry dual accreditation for both physicians and NPs. NPs should confirm that courses meet their state’s pharmacology CE requirement, which is often a mandated subset of total hours.
Tracking and Reporting Your Credits
Keeping certificates organized is one of the most tedious parts of the CME process, but the infrastructure has improved significantly. The ACCME operates a system called PARS (Program and Activity Reporting System) that collects credit data from accredited providers and reports it directly to participating state licensing boards and specialty certifying boards. When a CME provider submits your completion data to PARS, it eliminates the need for you to manually report those credits yourself.
Not all providers report to PARS, though. For activities where you receive a PDF certificate, keep a digital folder organized by year. Many physicians use their state medical society’s online portal or their specialty board’s dashboard to verify which credits have been recorded and identify any gaps before renewal deadlines. The AMA also offers a physician profile where you can store and track credits across categories.
A practical approach: at the start of each renewal cycle, calculate how many credits you need per year to stay on pace, then set a quarterly check-in to make sure you’re not scrambling at the end. Spreading 50 credits over two years means roughly two credits per month, which is manageable with a single online module or journal article every few weeks.
What Makes a CME Activity Legitimate
Since 2022, all ACCME-accredited activities must follow updated Standards for Integrity and Independence. These rules require that content is evidence-based, free from commercial bias, and that any financial relationships between faculty and industry are identified, mitigated, and disclosed to learners before the activity begins. If a pharmaceutical or device company provides financial support for a CME activity, that support must be managed so it doesn’t influence the content.
Before investing time in any CME activity, confirm that the provider is accredited by the ACCME or a recognized state medical society. The accreditation statement will appear on the activity’s registration page or introductory materials. If you don’t see it, the credits may not count toward your license renewal or MOC requirements.