Thursday, December 6, 2018

CME Inventory

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Pennsylvania medical licenses expire at the end of each even numbered year.  If you do not engage in heinous acts, most physicians just get processed through by some clerk near Harrisburg, the state capital, making sure that all the boxes are checked off and that the credit card payment goes through.  A sample gets audited, but that has never been me, not in Delaware, Massachusetts, or Pennsylvania where I have held licenses at one time or another.  Most of us are pretty good citizens and professionals that do not cause a lot of trouble. 

There are some very specific requirements above having a valid credit card and having the professional training that you claim.  The most intrusive is the Continuing Education standards, which are not difficult for us city folk, maybe a little harder for those taking care of people in rural Pennsylvania.  Every two years we need to show attendance at 100 hours of training, 40 of which need to be certified as Category I.  I just take the New England Journal article review courses, good for 50 credits per session.  Unlike showing up and sleeping through Grand Rounds, which most large institutions offer for free credit weekly or attending a national specialty meeting that would accrue 20 or so credits but at a high fee, the NEJM and most on-line courses care a little more about your learning something from the effort so they require a test of what was taught.  Not a big problem at all, and keeps me better engaged.  So I have my 100 credits, all Category 1.

As a practicing physician at the VA, I needed a license from any state, so I just continued my Massachusetts license.  The Board there can be a mixture of pompous and ornery.  They introduced a requirement in my early practice years that you needed 12 hours among the 100 related to risk management which could be defined rather broadly, but it was Category 1, the most difficult to acquire.  I did it, got a Delaware license, let the Massachusetts one lapse, and eventually took a position in Philadelphia for which I got a Pennsylvania license.  Initially they did not have this requirement, and I was in a training program which waives the CME anyway.  On returning to Delaware, I eventually let the Pennsylvania license expire, more for escalating costs than renewal requirements, but reactivated it when I started working in Philadelphia again, now with roughly the same 12 hour risk management requirement, though not limited to Category 1.  What qualifies has always been a little uncertain but as we get to the modern age of online learning, Medpage created a series of minicourses that would qualify for Type 1 credit, which I use to fill in the hours that my lecture attendance does not.

As of this morning I'm done.  5.25 hours on Medpage + 1.25 hours on Medscape where you can lose the credit since the questions seem harder and the articles more involved + six post-retirement Grand Rounds.  Let's see if I remember the subjects:

  1. Partnering with the VA for patient care.
  2. Documentation in patient encounters.
  3. Establishing a Medical Home
  4. Making hospital care more patient friendly
  5. Effects and policy challenges of Vaping
  6. Sickle Cell Diseases and Population Health Analysis
That's more than twelve.

Then we have a required course in Child Abuse Reporting Laws in both Pennsylvania and Delaware.  Since the laws differ, you have to take the three hours of online training separately in each state.  Then this cycle Pennsylvania added a 2 hour requirement for familiarity with the state's opioid prescribing laws.

All done.  Just need to figure out how to fill out the online form, provide payment, and I'm good to go for the last time unless I interrupt retirement by taking a job in Pennsylvania.

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