Provider questions:
- General Provider Questions
- AMA PRA Category 1 Credit™
- Designation statement and trademark
- Awarding credit to faculty
- Awarding credit for specific activities
- AMA PRA Category 2 credit™
General provider questions
1. What does an organization need to do in order to offer AMA PRA Category 1 Credit™ for a CME activity?
In order to offer AMA PRA Category 1 Credit™, the organization offering the activity must be accredited by either the Accreditation Council for Continuing Medical Education (ACCME) or an ACCME-recognized state medical society (SMS), or be a joint sponsor with an entity that is accredited. To learn more about becoming accredited and to find a list of accredited CME providers, please visit the ACCME Web site. An accredited provider must follow all of the ACCME and AMA requirements in order to designate a CME activity for AMA PRA Category 1 Credit™.
2. What are the basic AMA requirements to designate an activity for AMA PRA Category 1 Credit™?
All activities that are designated for AMA PRA Category 1 Credit™ (PDF, 200KB) must:
- Conform to the AMA definition of CME
- Present content appropriate in depth and scope for a physician audience
- Conform to both the relevant CEJA opinions, as well as the ACCME Standards for Commercial Support, and are non promotional in nature
- Address demonstrated educational needs
- Communicate a clearly identified educational purpose and/or objectives
- Use learning methodologies and format(s) appropriate to the activity’s educational purpose and/or objectives
- Use evaluation mechanisms to assess an activity’s quality and relevance to its purpose and/or objectives
- Include a means for the provider to record the actual credits claimed by each physician participant (physicians are ethically obligated to only claim credit consistent with the extent of their participation in a CME activity)
- Be designated for AMA PRA Category 1 Credit™ in advance; activities cannot be retroactively designated for AMA PRA Category 1 Credit™
- Include the Designation Statement in any activity materials that reference CME, with the exception of “save the date” or similar notices
In addition, for specific type of CME activities (i.e. enduring materials, performance improvement, etc.) there are additional requirements that must be met.
3. What are CME providers responsibilities with regard to record keeping?
You should check with your accreditor (either the ACCME or State Medical Society) for their record keeping requirements. The AMA requires that providers record the actual number of AMA PRA Category 1 Credit™ claimed by each of their physician participants and keep these records, for each of their certified activities, for a minimum of six years. Providers may choose any system to accomplish this.
4. How does the AMA monitor compliance with the AMA PRA Credit System requirements?
The AMA monitors compliance in cooperation with the ACCME, by investigating complaints, and by review of information in the public domain.
Who can be awarded AMA PRA Category 1 Credit™
5. May an accredited CME provider award AMA PRA Category 1 Credit™ to a non-US licensed physician?
Yes. Accredited CME providers may award AMA PRA Category 1 Credit™ to all physicians (defined by the AMA as MDs, DOs, or international physicians with equivalent degrees from other countries). The requirements (PDF, 200KB) for awarding AMA PRA Category 1 Credit™ to US and non-US licensed physicians are the same.
6. May an accredited CME provider award AMA PRA Category 1 Credit™ to non-physicians for participating in a CME activity?
No. AMA PRA Category 1 Credit™ can only be awarded to MDs or DOs (or physicians with equivalent degrees from other countries). Non-physicians may not be awarded AMA PRA Category 1 Credit™. Non-physicians may, however, receive a certificate of attendance/participation that acknowledges the activity was designated for AMA PRA Category 1 Credit™. The AMA has developed recommended language for certificates (PDF, 200KB) of credit and attendance.
Designation statement and trademark questions
7. May accredited CME providers modify the required designation statement?
No. Providers that designate activities for AMA PRA Category 1 Credit™ may not modify or insert other language into the AMA designation statement. The following required designation statement (PDF, 200KB) must be used in both announcements and activity materials:
The [name of accredited provider] designates this educational activity for a maximum of [number of credits] AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
The (s) at the end of AMA PRA Category 1 Credit(s)™ is intended to indicate that providers have the leeway to make the sentence grammatically correct. Therefore, as examples, activities would be designated for 1 AMA PRA Category 1 Credit™, 2.5 AMA PRA Category 1 Credit™, etc.
An exception to the designation statement requirement is a “save the date” announcement. Such announcements may indicate that AMA PRA Category 1 Credit™ will be provided without stating an exact amount, but only if the provider has already certified the activity for AMA PRA Category 1 Credit™. A “save the date” announcement may read, “This activity has been approved for AMA PRA Category 1 Credit™.” Providers may never publish or announce that “AMA PRA credit has been applied for,” nor may they use “TBD” or “To be determined” in place of the designated number of credits.
8. When is the trademark symbol required when using the term “AMA PRA Category 1 Credit™”?
AMA PRA Category 1 Credit™ is a trademark (PDF, 200KB) of the American Medical Association. Accredited CME providers are required to always required use the phrase “AMA PRA Category 1 Credit™” in its entirety. It should be italicized and the trademark symbol used (1) the first time in publications (e.g., brochure), (2) in every designation statement, and (3) on certificates of credit or attendance. You should never use “Category 1 Credit” , “Category 1 CMEs”, “ACCME Credit” etc. when referencing AMA PRA Category 1 Credit™.
9. Must accredited CME providers change CME materials that were developed using the previous designation statement and that do not have the trademark?
Accredited CME providers may continue to use CME materials which are already in circulation with the old designation statement and without the trademarked phrase, if changing such would be burdensome. The AMA began monitoring for the correct use of these statements in July 2006. Any materials for CME activities developed after July 2006 must utilize the current designation statement (PDF, 200KB) and trademark the credit statement.
10. What if the software an accredited CME provider uses does not allow for italics for the trademarked phrase?
Accredited CME providers are required to use the phrase “AMA PRA Category 1 Credit™” italicized with the trademark (PDF, 200KB) symbol. If the software an accredited provider is using does not allow for italics, then some other mechanism must be used to distinguish the trademarked phrase (i.e. bolding, underlining, quotes, etc.).
Awarding credit to faculty (Learning from Teaching)
11. How does an accredited CME provider award a faculty member AMA PRA Category 1 Credit™ for preparing and presenting at a live activity?
Accredited CME providers are allowed to award faculty (PDF, 200KB) AMA PRA Category 1 Credits™ for the learning that occurs in the preparation of an original presentation as part of an AMA PRA Category 1 Credit™ live activity. The formula for granting such credit is 2 AMA PRA Category 1 Credits™ per participant credit (or a 2:1 ratio). Like other AMA PRA Category 1 Credits™ based on time metrics, credit can be designated in 15 minute increments. No credits are awarded for repeat presentations of the same material. Credit may not be simultaneously earned as both a presenter and a learner.
Providers should calculate the participant credit first, then double it (as opposed to doubling the presentation time prior to calculating the credit). Physicians are awarded faculty credit based on the time of their presentation only, not based on the time of the session or activity. (Example: a one hour activity is designated for one AMA PRA Category 1 Credit™with three speakers who each present for 20 minutes. Each physician would receive .50 AMA PRA Category 1 Credit™ as faculty, .75 AMA PRA Category 1 Credit™ as a participant.)
If an accredited CME provider chooses not to award faculty credit, the physician may claim this credit directly from the AMA by submitting the Direct Credit Application (PDF, 150KB)
12. How does an accredited CME provider document faculty credit?
The AMA has not prescribed how faculty credits (PDF, 200KB) for teaching should be documented. The AMA recommends that accredited CME providers distinguish between the credit earned as faculty and as participant; otherwise, it could appear as though the physician was awarded more than the designated maximum for the activity. For additional documentation requirements, please consult your accreditor (ACCME and/or State Medical Society).
13. Are faculty eligible for AMA PRA Category 1 Credit™ for enduring materials or other formats of learning?
No. The AMA has only approved AMA PRA Category 1 Credit™ for the learning which occurs in preparation for teaching (PDF, 200KB) at live AMA PRA Category 1 Credit™ activities. (PRA booklet page 6) Physicians may choose to claim AMA PRA Category 2 Credit™ for other types of teaching (PDF, 200KB) .
14. May a physician be awarded AMA PRA Category 1 Credit™ for a presentation made internationally during a meeting sponsored by an accredited CME provider?
Yes. If the CME provider is accredited by the ACCME or an ACCME-recognized state medical society, the location of the activity has no bearing on the credit given to faculty or attendees. It is the same as if the activity took place within the United States.
15. May a physician be awarded credit if he prepares a presentation but does not actually do the presenting? If he presents but did not prepare the materials?
No. Faculty credit is a two-part process. The physician must prepare the material and present it in order to be awarded faculty credit.
16. If a physician gives the same one hour lecture more than once, how many credits may he claim?
Provided the lecture itself is designated for AMA PRA Category 1 Credit™, the physician may claim 2.0 AMA PRA Category 1 Credits™ as faculty. The credit is for the learning that occurs as the physician prepares the lecture, and may only be claimed once regardless of the number of times it is repeated.
Awarding credit for specific activities
17. Are there limits to the amount of credit an accredited CME provider may award for a CME activity?
There are no limits to the number of credits an accredited CME provider can designate and/or award to physician participants for a live activity or enduring material as long as these are based on real time or a legitimate estimate of the time to complete the activity. However, there are limitations for certain types (PDF, 200KB) of other activities. For example, a physician may receive a maximum of twenty (20) credits for completing a Performance Improvement activity and a maximum of one-half (0.5) credit for completing an Internet Point of Care activity. (PRA booklet pages 11-12) There are additional credit limits associated with the types and amount of credit a physician can claim for the Physician’s Recognition Award. (PDF, 200KB)
18. Are there limits to the amount of AMA PRA Category 1 Credit™ that physicians can earn during a year for specific learning formats, such as Journal-based CME or Manuscript Review?
The AMA places no limits on the amount of credit a physician can earn in any format. However, if the physician chooses to apply for the Physician’s Recognition Award, then there are limits to some of the learning format categories that may be used for this purpose. These limits (PDF, 200KB) may be found on page 21 of the AMA PRA booklet.
19. Can a physician get credit for participating in the same educational activity more than once?
A physician shouldn’t claim credit for attending the same activity more than once unless there’s been a substantial change in the material that had been presented.
20. May committee work be designated for AMA PRA Category 1 Credit™?
Participation in the work of a committee does not in and of itself qualify for AMA PRA Category 1 Credit™. However, an accredited provider can choose to structure a committee meeting as a learning activity (PDF, 200KB) and designate that portion for AMA PRA Category 1 Credit™. Examples of this may include committees working on developing practice guidelines or performance improvement measures.
When designating committee education for AMA PRA Category 1 Credit™, a provider must comply with all of the basic requirements (PDF, 200KB) for an AMA PRA Category 1 Credit™ activity (i.e. programmatic needs assessment, learning objectives, appropriate design, evaluation, etc).
21. Can an accredited provider designate a prepared course (i.e. ACLS, PALS, etc) for AMA PRA Category 1 Credit™
ACLS and similar forms of training may be designated for AMA PRA Category 1 Credit™., but providers are still required to document that all of the basic requirements (PDF, 200KB) for designating an activity have been met (i.e. programmatic needs assessment, learning objectives, appropriate design, evaluation, etc.)
22. Can an accredited CME provider designate AMA PRA Category 1 Credit™ for poster session attendance?
Poster sessions may not be designated for AMA PRA Category 1 Credit™ unless they are planned and implemented in accordance with all of the basic requirements (PDF, 200KB) as other live activities which may be designated for AMA PRA Category 1 Credit™. The provider must ensure that credit is only awarded for the portion of the poster session during which the authors of the posters are available to discuss them. There must also be a mechanism for the learner to claim credit.
23. What is the difference between Journal-Based CME and journal clubs?
Journal-based CME (PDF, 200KB) describes a process by which accredited providers identify an article, within a peer-reviewed, professional journal, that serves as a planned learning activity. This is usually done through the publisher of the journal, in which an article or series of articles will be available for credit.
An accredited CME provider may choose to structure a learning activity around a journal article and designate that for credit, often called a journal-club. The key to remember here is that the CME provider must comply with the basic requirements (PDF, 200KB) for an AMA PRA Category 1 Credit™ activity in order to designate such an activity for AMA PRA Category 1 Credit™.
24. For Internet Point of Care, how are the resource databases determined?
The CME provider must have a system to vet databases and determine which one(s) are evidence-based and appropriate for physicians to access information.
25. Could interventions used in Stage B of a PI CME activity include practice improvement such as record-keeping in the office or a tickler system for tracking patients needing the flu vaccine?
Stage B of the PI CME activity can include a variety of different interventions depending on the evidence-based performance measure(s) addressed and identified gaps of the participants. A few examples of interventions are live didactic lectures or enduring materials if the reason for the gap is a lack of knowledge; reviewing case-based documents to help physicians develop their skills; a tickler file if the problem is forgetting to give the flu vaccine to appropriate patients during flu season, etc.
26. May providers award credit for time spent completing surveys/evaluations/commitments to change, etc., after a certified CME activity, e.g., at three or six months?
No. The completion of surveys, evaluations, commitments to change, etc. that are not included as part of an educational activity are not an approved AMA learning format and may not be designated for AMA PRA Category 1 Credit™.
AMA PRA Category 2 Credit™
27. May accredited CME providers designate activities for AMA PRA Category 2 Credit™?
No. Providers may not designate any CME activities for AMA PRA Category 2 Credit™ (PDF, 200KB) , nor may they provide documentation or otherwise indicate to a physician that an activity qualifies for such credit. AMA PRA Category 2 Credit™ activities are entirely self claimed and self documented by a physician.
28. What activities may a physician claim for AMA PRA Category 2 Credit™?
Activities that qualify for AMA PRA Category 2 Credit™ (PDF, 200KB) are defined as educational activities not designated for AMA PRA Category 1 Credit™ that: (1) comply with the AMA definition of CME; (2) comply with the AMA ethical opinions on Gifts to Physicians from Industry and on Ethical Issues in CME (i.e., are not promotional); (3) and a physician finds to be a worthwhile learning experience related to his/her practice.
The following are types of activities that may meet the definition of AMA PRA Category 2 Credit™:
- Teaching residents or medical students or other health professionals
- Unstructured online searching and learning (i.e., not Internet PoC)
- Reading authoritative medical literature
- Consultation with peers and medical experts
- Small group discussions
- Self assessment activities
- Medical writing
- Preceptorships
- Research
- Participating in live activities not designated for AMA PRA Category 1 Credit™
In each case, as with live activities, physicians may self claim one (1) AMA PRA Category 2 Credit™ for each 60-minute hour engaged in the learning activity. Physicians may claim credit in 15 minute, or 0.25 credit increments, and round to the nearest quarter hour.
If you have any other specific questions, please contact cme@ama-assn.org.
Content provided by: Division of CPPD