For physicians and other advanced medical practitioners, earning CME credit is an important part of the job. Meeting credit requirements is an integral part of maintaining licensure to satisfy regulatory requirements and continuing to practice. Understanding and ultimately meeting CME requirements means understanding the different CME categories and how they relate to earning credit.

CME Categories

According to the criteria set by the nation’s primary CME governing body, the Accreditation Council for Continuing Medical Education (ACCME), and professional associations such as the American Medical Association (AMA), there are four different categories of CME credit. Each category denotes an activity’s educational content and potential credit value.

Category 1

Category 1 credits are earned by physicians and other healthcare professionals by engaging in educational activities designed to build their knowledge and skills as medicine changes. Earning credits through Category 1 CME demonstrates to state licensing boards and professional organizations that a practitioner has met or exceeded the basic criteria to maintain their medical license.

To earn Category 1 credits, practitioners fully participate in certified CME activities that are created and distributed by an accredited CME provider sponsored by the ACCME and state medical authorities.

Category 1 credits are the most common category of credit and are weighted heavily in credit requirements. Examples of activities designated for AMA PRA Category 1 CreditTM include destination CME conferences, online courses including pre-recorded live events and point of care learning, blended learning, grand rounds, and medical journals. The number of credits awarded for each activity is based on the activity type, duration, and the practitioner’s degree of participation.

Accredited activities are typically designed for those seeking to earn Category 1 credit but may be helpful in earning other medical credentials. The exact role a Category 1 credit can play differs by the credential. While it was originally created for physicians, AMA PRA Category 1 Credit is considered a leading standard across medical disciplines and is accepted by all major professional organizations as a measure of competence and authority.

How can a practitioner can identify a legitimate AMA PRA Category 1 Credit opportunity offered by an accredited CME provider?

CME providers offering activities for AMA PRA Category 1 Credit must clearly display a formal statement of credit to demonstrate approval from the AMA. It must be italicized and in full. Activities should not list an abridged version of the statement or the name. For instance, the use of the phrase “Category 1 credit” in relation to a specific activity violates these rules.

Look for this statement to indicate an AMA-approved activity for Category 1 credit:

The [name of accredited CME provider] designates this [activity type] for a maximum of [# of credits] AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Category 2

Like Category 1 credits, Category 2 can comprise a substantial share of your annual or biannual credit requirements overall, depending on your state and medical profession. Practitioners may not claim Category 2 credits for activities for which they’ve already claimed Category 1 credits.

In contrast with Category 1 credits, physicians and other advanced practitioners self-designate and self-claim credit for appropriate AMA PRA Category 2 Credit activities. Category 2 activities are elective and therefore completed of the practitioner’s own volition. Accredited CME providers must not certify activities for AMA PRA Category 2 Credit and may not promote an activity eligible for Category 2 credit. It is up to individual physicians to claim and maintain a record of self-guided activities they have participated in for AMA PRA Category 2 Credit.

A wide range of activities can qualify for Category 2 credit but they must meet the following basic criteria. These criteria are not exclusive to Category 2 credits.

• Meet the AMA’s definition of CME
• Contain information that comports with applicable AMA ethical opinions
• Are non-promotional
• Relate to the physician’s practice, as determined by the physician

Examples of AMA PRA Category 2 Credit activities include:

• Teaching other healthcare professionals
• Unstructured online learning
• Reviewing recent and authoritative medical literature
• Consultation with peers
• Group discussions
• Self-assessment
• Conducting research
• Live medical conferences not designated for Category 1 credit

Keep in mind all activities are self-directed.

Category 3

Category 3 CME is required periodically as a part of the Maintenance of Certification. Credits are earned through teaching-related activities. Hours are approved for individual health facilities with an accredited residency program. The number of hours required to meet these criteria differs based on the institution. Documentation can include a letter from a sponsored provider offering a Category 1 program the physician is precepting or from a health institutional director overseeing a medical residency program.

In some states, Category 3 can refer to a recertification exam completed every five to 10 years.

Category 4

The need for Category 4 credits differs by medical professional and is typically reserved for physician specialists. Category 4 is designed to contribute to medical education in the form of materials such as original research, the presentation of scientific exhibits or a published study or article in a reputable medical journal or book. Completion should be documented with a copy of the activity agenda with descriptions of its educative value. A letter from the specialist’s professional organization is also acceptable.