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Continuing Medical Education for MDs/DOs

As a prerequisite for physician registration, practitioners are required to complete continuing medical education.  Current requirements for physicians are summarized below. If you would like to review the current rule, these requirements are currently listed Board rule 166.2 available on our website at:

Physicians need to complete at least 48 credits of continuing medical education every 24 months (24 month timeline is in relation to the biennial registration period, not the calendar year). At least half of these hours must be in formal, category I or 1A courses. A physician must report during registration if she or he has completed the required CME.  However, newly licensed physicians are exempt from the CME requirement the first time they register.

Documentation of CE courses shall be made available to the Board upon request, but should not be submitted with the registration. Random audits will be made to assure compliance. 

** New CME Requirements – Rules pending**

New Opioid CME Requirements

During the 86th legislative session, in an effort to combat the opioid crisis in Texas, there were multiple bills passed requiring physicians, physician assistants and other licensees to complete certain specific opioid related continuing medical education.  These new CME requirements related to opioids will be part of the Opioid Workgroup being formed by TMB to address the on-going public health crisis in a comprehensive, multi-faceted approach. Please read the TMB's initial guidance regarding opioid-related CME:


New Human Trafficking Prevention CME Requirement

House Bill 2059 (86th Legislature) requires physicians, physician assistants, and any licensee of the TMB’s advisory boards or committees that provide direct patient care, to complete a human trafficking prevention course approved by the Texas Health and Human Services Commission (HHSC). This requirement applies to the renewal of a license on or after September 1, 2020.

HHSC is the approving body for the human trafficking prevention requirement. HB 2059 requires HHSC to approve training courses on human trafficking, including at least one that is free of charge, post a list of approved trainings on its website and update the list of approved trainings as necessary.

HHSC now has an approved course available, which is free of charge, that satisfies the requirements for all licensees impacted by HB 2059.


If you have any questions regarding continuing education requirements, please email us at .


Physician CME Requirements (per biennium)


24 Formal Category 1 or 1A hours:

  • courses designated for AMA/PRA Category 1 credit by a CME sponsor accredited by ACCME (Accreditation Council for CME) or state medical society recognized by ACCME;
  • approved for credit by American Academy of Family Physicians;
  • designated for AOA Category 1-A credit; or
  • approved by TMA based on standards established by AMA for its Physician's Recognition Award.


       Medical Ethics and/or Professional Responsibility

  • At least 2 of the formal hours must involve the study of medical ethics and/or professional responsibility. Professional responsibility includes but is not limited to courses in: Risk management, Domestic Abuse; or Child Abuse. Formal courses must be approved for ethics or professional responsibility credit by the accrediting agency.  
  • Please note that during the October 14, 2016 Full Board meeting, agenda item – 9.  Discussion, recommendation, and possible action regarding Board approval of CME for medical ethics”was considered.  After discussion, the Board approved to eliminate the process for board approval of CME for medical ethics.  This DID NOT eliminate the requirement for the 2 formal hours in medical ethics and/or personal development listed above.  This change eliminated only the process for TMB ethics designation of courses.  Those courses previously designated by the TMB for ethics credit were accepted through the expiration date of their approval.  Board meeting minutes are available for review in the Publications section of our website, located under “Agency” by Board and date of meeting.


24 Informal Hours:

  • Composed of informal self study, attendance at hospital lectures
  • or grand rounds not approved for formal CME or case conferences and shall be recorded in a manner easily transmitted to the board.


There is a maximum of 48 total excess credit hours that may be carried forward and a limit of two years from the date of the registration following the period during which the hours were earned. Excess hours are applied/reported according to their Category.   See Board Rule 166.2 for additional information.


For CME course listings contact:

Texas Medical Association: (512) 370-1300, (800) 880-1300 

Texas Osteopathic Medical Association: (512) 708-8662, (800) 444-8662


Additional requirements:

Forensic examinations

Per Board rule 166.2(a)(4), a physician who performs forensic examinations on sexual assault survivors must have basic forensic evidence collection training or the equivalent education. A physician who completes a CME course in forensic evidence collection that meet the requirements described in the formal category above, or is approved or recognized by the Texas Board of Nursing, is considered to have the basic forensic evidence training required by the Health and Safety Code, §323.0045.


Tick-Borne Diseases

Per Board rule 166.2(a)(6), a physician whose practice includes the treatment of tick-borne diseases should complete CME in the treatment of tick-borne diseases that meet the requirements described in the formal category above.


EMS Medical Director (also known as Off-Line Medical Director)

Per Board rule 197.3(a)(17), an off-line medical director shall be required to complete the following educational requirements:

  • within two years, either before or after initial notification to the board of holding the position as off-line medical director:

o   12 hours of formal continuing medical education (CME) as defined under Board rule §166.2 (relating to Continuing Medical Education) in the area of EMS medical direction;

o   board certification in Emergency Medical Services by the American Board of Medical Specialties or a Certificate of Added Qualification in EMS by the American Osteopathic Association Bureau of Osteopathic Specialists; or

o   a DSHS approved EMS medical director course; and

  • every two years after meeting the requirements of subparagraph (A) of this paragraph, one hour of formal CME in the area of EMS medical direction.

Additional information available at:


Pain Management Clinics

Per Board rule 195.4(e), the medical director of a pain management clinic must, on an annual basis, ensure that all personnel (including the medical director) are properly licensed, and if applicable, trained to include 10 hours of continuing medical education (CME) related to pain management.

Additional information available at:

  • Board Certification

    Per Board rule 166.2(c), a licensee shall be presumed to have complied with this section if in the preceding 36 months the licensee becomes board certified or recertified in a medical specialty and the medical specialty program meets the standards of the American Board of Medical Specialties, the American Medical Association, the Advisory Board for Osteopathic Specialists and Boards of Certification, or the American Osteopathic Association. This provision exempts the physician from all CME requirements, including the requirement involving the study of medical ethics and/or professional responsibility. This exemption is valid for a maximum of one registration.


    Maintenance of Certification (MOC)

    Per Board rule 166.2(d), a licensee shall be presumed to have complied with the formal and informal hours requirement of this section if the licensee:

    • is meeting the Maintenance of Certification (MOC) program requirements set forth by a specialty or subspecialty member board of the ABMS or the Osteopathic Continuous Certification (OCC) program requirements set forth by the AOA, and
    • the member board's MOC or OCC program mandates completion of CME credits that meet the minimum criteria set forth under the formal hours requirement.

     PLEASE NOTE: This provision does not exempt the physician from the requirement for two credits involving the study of medical ethics and/or professional responsibility, as outlined on the page above.


    Physicians in residency/fellowship training or who have completed such training within 6 months prior to their renewal application will satisfy the CME requirements by their residency or fellowship program.


    A physician may request in writing an exemption* for the following reasons:

    • catastrophic illness;
    • military service of longer than one year's duration outside the state;
    • medical practice and residence of longer than one year's duration outside the United States; or
    • good cause shown on written application of the licensee that gives satisfactory evidence to the board that the licensee is unable to comply with the requirement for continuing medical education.

    *Exemptions are reviewed on a case by case basis and must be requested in writing at least 30 days prior to the expiration date of the license.  An exemption may not exceed one registration period, but may be renewed, subject to approval.


    Continuing Education Exemption Request Form - Physician



    Physicians eligible for “retired” status and designated as such by the Board are exempt from CME requirements. “Voluntary charity care” status reduces informal CME requirements. For more information, visit License Retirement Options