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: http://www.tmb.state.tx.us/page/board-rules

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. 

If you have any questions regarding continuing education requirements, please email us at registrations@tmb.state.tx.us.

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 24 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

Pain Management and the Prescription of Opioids

• At least 2 of the 24 formal hours must involve the study of the following topics: 

• best practices, alternative treatment options, and multi-modal approaches to pain management that may include physical therapy, psychotherapy, and other treatments;

• safe and effective pain management related to the prescription of opioids and other controlled substances, including education regarding:

- standards of care;

- identification of drug-seeking behavior in patients; and

- effectively communicating with patients regarding the prescription of an opioid or other controlled substances; and

• prescribing and monitoring of controlled substances.

• These formal hours maybe credited towards

• the requirements for medical ethics or professional responsibility for any physician, or

• the 10 hours of pain management continuing education required for those physicians practicing in pain clinics (see info below under “Additional Requirements”.

• This requirement applies to the renewal of a license on or after September 1, 2020.

Human Trafficking

• As part of the 24 formal hrs required, a course in human trafficking prevention must be completed.

• The course must be approved by HHSC, and

• The course maybe credited towards the requirements for medical ethics or professional responsibility for any physician.

• See HHSC's Health Care Practitioner Human Trafficking Training page to access the free course that satisfies these requirements, and for more information about this requirement.
• This requirement applies to the renewal of a license on or after September 1, 2020.
• Senate Bill 415 (2023) requires physicians to complete at least 1 hour of CME in the identification and assistance of trafficked persons in their first renewal period after license issuance, and at least 1 hour every third renewal period thereafter. HHSC’s approved courses will fulfill this requirement.

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.  

Formal hrs in the following categories may NOT be carried forward at this time, and must be acquired each biennium:

• Medical Ethics and/or Professional Responsibility, and
• Pain Management and the Prescription of Opioids

See Board Rule 166.2 for additional information.

For CME course listings contact:

Texas Medical Association: (800) 880-7955

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

Additional requirements:

Forensic examinations

Per Board rule 166.2(a)(6), 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)(8), 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: http://www.tmb.state.tx.us/page/renewal-physician-EMS

Pain Management Clinics

Per Board rule 195.3(d), 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:http://www.tmb.state.tx.us/page/resources-cme-for-pain-managment-clinic