Continuing Medical Education

PURPOSE: This rule details the board’s minimum requirements for continuing education. (1) Each licensee shall complete and report at least fifty (50) hours of continuing medical education every two (2) years. A total of at least one (1) hour, within the required fifty (50) hours, must pertain to the topic of the health benefits of nutrition. The board shall not issue a renewal of a licensee’s certificate of registration unless the licensee demonstrates completion of fifty (50) hours of continuing medical education accredited by the American Osteopathic Association (AOA) as Category 1-A or 2-A, by the American Medical Association (AMA) as Category 1, or by the American Academy of Family Practice Prescribed Credit, in the two (2) immediately preceding reporting periods. A licensee is not required to complete any continuing medical education hours in the renewal period in which the licensee is initially licensed to practice the healing arts in Missouri if the licensee has not previously held a permanent license to prac tice the healing arts in Missouri or any other state in the United States of America. The period for completion of the continuing medical education requirements shall be the twenty-four- (24-) month period beginning January 1 of each even-numbered year and ending December 31 of each odd-numbered year. A licensee who has failed to obtain and report, in a timely fashion, fifty (50) hours of continuing medical education shall not engage in the practice of medicine unless an extension is obtained pursuant to section (4) of this rule. (A) A licensee shall be deemed to have complied with sec tion (1) of this rule if the licensee completes forty (40) hours of continuing medical education and each course, seminar or activity includes a post-test of the material covered in the forty (40) continuing medical education hours. The forty (40) hours must all be accredited by the AOA as Category 1-A or by the AMA as Category 1. (2) Each licensee shall certify by attestation, under penalty of perjury, that they have completed the required hours of con tinuing medical education on the renewal form (see 20 CSR 2150-2.040). (3) Each licensee shall retain records documenting their attendance at and completion of the required hours of continuing medical education for a minimum of three (3) years after the reporting period in which the continuing medical education was completed. The records shall document the titles of the courses taken, dates, locations, course sponsors, category of hours earned, and number of hours earned. The board may conduct an audit of licensees to verify compliance with the continuing medical education requirement. Licensees shall assist the board in its audit by providing timely and complete responses to the board’s inquiries. (4) A licensee who cannot complete the required hours of con tinuing medical education because of personal illness or other circumstances beyond the licensee’s control which the board deems to be sufficient to impose an insurmountable hardship may apply for an extension of time to complete the continuing medical education requirements. Any extension of time to complete the continuing medical education requirements will be granted solely in the discretion of the board. The licensee must make a written application for extension of time prior to the December 31 deadline for completion of the continuing medical education requirement. The application for exten sion shall be accompanied by a processing fee of fifty dollars ($50), together with the application for extension. The licensee shall provide full and complete written documentation of the grounds supporting the reasons for which an extension is sought. A licensee who requests an extension of time to complete the required hours of continuing medical education shall not engage in the active practice of the healing arts until the board grants the licensee’s request for extension and the licensee receives express written authorization to do so. (A) Illness extensions may be granted only to a licensee who has suffered a personal illness or personal disability of a nature as to prevent them from engaging in the active practice of medicine for at least a majority of the reporting period. At a minimum, the licensee shall provide the board with written documentation from the licensee’s treating physician stating the nature of the illness or disability, the period of the illness or disability, any limitations on the licensee’s activities which resulted from the illness or disability, the number of hours earned in the reporting period, and a plan for completing the balance of the requirement. (B) The board, solely in its discretion, may grant an extension based on unforeseeable circumstances beyond the licensee’s control which impose an insurmountable hardship precluding the licensee from obtaining the required continuing medical education. At a minimum, the licensee must provide written documentation explaining specifically and in detail the nature of the circumstances, why the circumstances were unfore seeable and beyond the licensee’s control, the period during which the circumstances were in existence, the number of continuing medical education credits earned in the reporting period, and the licensee’s plan for completing the balance of the requirements. The board, in its discretion, shall determine if the situation described in the licensee’s application con stitutes unforeseeable circumstances beyond the licensee’s control which impose an insurmountable hardship precluding the licensee from obtaining the required continuing medical education. (C) A licensee who is granted an extension of time shall complete the balance of his/her continuing medical education requirements no later than February 28 immediately following the end of the reporting period for which an extension was sought and shall provide the board with written documentation of their completion of the continuing medical education requirements no later than March 10 immediately following the end of the reporting period for which an extension was sought. Failure to complete the continuing medical education requirements by February 28 or to file the documentation with the board by March 10 shall constitute a violation of section 334.075, RSMo and this rule. (D) An extension of time shall not be granted to any licensee who obtained an extension in the immediately preceding reporting period in which the licensee held an active license, except in the case of a licensee who is unable to complete the requirements due to military service commitment pursuant to a combat or national emergency assignment. (5) Licensees in the military will be granted an extension of time to complete the continuing medical education require ments if they are called to active duty under competent orders for any period of thirty (30) days or more during the reporting period in accordance with section 41.950(10), RSMo. If the licensee is called to active duty for a majority of the reporting period, they will be exempt from obtaining continuing med ical education. The licensee must submit written documen tation from the appropriate military authorities verifying the licensee’s military service commitment. (6) A licensee who has obtained American Specialty Board cer tification or recertification during the reporting period shall be deemed to have obtained the required hours of continuing medical education. The licensee shall provide the board with documentation evidencing the certification or recertification upon request. (7) A licensee who participated in an AMA or AOA-approved internship or residency program during the reporting period shall be deemed to have obtained the required hours of con tinuing medical education if at least sixty (60) days of the re porting period were spent in the internship or residency. (8) A licensee who participated in a fellowship program in an approved teaching institution shall be deemed to have ob tained the required hours of continuing medical education if at least sixty (60) days of the reporting period were spent in the fellowship and the fellowship is determined to be advanced training. Upon request, the licensee shall provide documenta tion from the fellowship program director verifying the num ber of days in the program and that the program is advanced training. (9) A licensee who holds a limited license to practice medicine in the state of Missouri shall obtain and report to the board ten (10) hours of AMA Category 1 or AOA Category 1-A or 2-A continuing medical education each reporting period. The period for completion of the continuing medical education requirements for a licensee who holds a limited license shall be the twenty-four (24)-month period beginning January 1 of each even-numbered year and ending December 31 of each odd-numbered year. (10) For purposes of section 334.075, RSMo concerning waiver of the continuing medical education requirements for retired physicians, a retired physician is one who has neither engaged in the active practice of medicine nor held themselves out as an active practicing physician and, pursuant to section 334.110, RSMo, has executed and filed with the board a retirement affidavit. A retired physician may keep their wall-hanging certificate after execution of a retirement affidavit but shall surrender, upon retirement, all other indicia of licensure. (11) To reinstate the license of a physician whose license has been in a noncurrent state for any reason, including retirement, for a period of two (2) years or less, that physician shall obtain, in addition to any other requirements of law, twenty-five (25) hours of continuing medical education for each calendar year in which the license was in a noncurrent state. To reinstate the license of any physician whose license has been in a noncurrent state for any reason, including retirement, for more than two (2) years, that physician shall comply with 20 CSR 2150-2.150 and any other requirements of law. No license of a physician whose license has been noncurrent shall be reinstated unless and until all required continuing medical education is obtained and reported to the board and all other requirements of law have been satisfied. (12) Violation of any provision of this rule shall be deemed by the board to constitute misconduct, fraud, misrepresentation, dishonesty, unethical conduct or unprofessional conduct in the performance of the functions or duties of a physician depend ing on the licensee’s conduct. In addition, a licensee who has failed to complete and report in a timely fashion the required hours of continuing medical education and engages in the active practice of the healing arts without the express written authority of the board shall be deemed to have engaged in the unauthorized practice of medicine. AUTHORITY: sections 41.950, 334.075, and 334.125, RSMo 2016.* This rule originally filed as 4 CSR 150-2.125. Original rule filed Oct. 16, 1991, effective March 9, 1992. Emergency amendment filed Sept. 22, 1992, effective Oct. 2, 1992, expired Jan. 29, 1993. Emergency amendment filed Jan. 19, 1993, effective Jan. 29, 1993, expired May 28, 1993. Amended: Filed Oct. 2, 1992, effective May 6, 1993. Amended: Filed May 3, 1994, effective Sept. 30, 1994. Amended: Filed April 16, 1996, effective Nov. 30, 1996. Amended: Filed Dec. 13, 1996, effective July 30, 1997. Amended: Filed April 13, 2001, effective Oct. 30, 2001. Amended: Filed April 15, 2004, effective Oct. 30, 2004. Amended: Filed March 18, 2005, effective Sept. 30, 2005. Moved to 20 CSR 2150-2.125, effective Aug. 28, 2006. Amended: Filed Aug. 11, 2006, effective March 30, 2007. Amended: Filed Dec. 14, 2007, effective June 30, 2008. Amended: Filed Nov. 14, 2025, effective June 30, 2026. *Original authority: 41.950, RSMo 1991, amended 2007, 2009, 2011; 334.075, RSMo 1987; and 334.125, RSMo 1959, amended 1993, 1995, 2014.