Vol. 24 Annals of Health Law 302
censing examination for PAs.155 Most medical boards require continuing
medical education (“CME”) as a condition of license renewal.156 CME can
be earned in lecturer-learner format at conferences and seminars or
online.157 However, a wide range of alternatives for earning CME credits
emerged in recent years.158 For instance, CME may also be earned though
journal-based activities, like completing a set of questions derived from a
specific journal article.159 Most medical and osteopathic licensing boards
condition license renewal on a specific number of earned CME credits.160
The same is true for almost all PA licensing boards.161
By 2014, thirty-four states had abandoned the concept that a medical
board or other regulatory agency should micromanage PA-physician
teams.162 For example, regulations adopted by the Wyoming Board of Medicine specify that:
[T]he Board does not recognize or bestow any level of competency upon
a PA to carry out a specific task. Such recognition of skill is considered
the responsibility of the supervising physician. However, a PA is expected to perform with similar skill and competency and to be evaluated
by the same standards as the physician in the performance of assigned
The other sixteen states and D. C. require some degree of board approval
155. Id. at 6.
156. Continuing Medical Education: Board-by-Board Overview, FED’N OF STATE MED.
BDS. (last updated Mar. 2014), available at http://www.fsmb.org/Media/Default/PDF/
157. CME Content: Definition and Examples, ACCREDITATION COUNCIL FOR
CONTINUING MED. EDUC., http://www.accme.org/requirements/accreditation-requirements-cme-providers/policies-and-definitions/cme-content-definition-and-examples (last visited
Oct. 5, 2014). Continuing Medical Education, NAT’L COMM’N ON CERTIFICATION OF
PHYSICIAN ASSISTANTS, http://www.nccpa.net/ContinuingMedicalEducation (last visited Oct.
5, 2014). RUTH BALLWEG ET AL., supra note 30, at 58 (5th ed. 2013).
158. ACCREDITATION COUNCIL FOR CONTINUING MED. EDUC., 2013 ANNUAL REPORT
EXECUTIVE SUMMARY 1 (2013), available at http://www.accme.org/sites/default/
files/630_2013_Annual_Report_20140715.pdf (“The ACCME’s information on participation in activity types shows the growth of participation in individualized, self-directed CME
such as Internet searching and learning.”).
159. How Does the ACCME Define a Journal-based CME Activity?, ACCREDITATION
COUNCIL FOR CONTINUING MED. EDUC., http://www.accme.org/ask-accme/how-does-accme-define-journal-based-cme-activity (last visited Oct. 5, 2014).
160. Stephen H. Miller et al., Continuing Medical Education, Professional Development, and Requirements for Medical Licensure: A White Paper of the Conjoint Committee
on Continuing Medical Education, 28 J CONTINUING EDUC. HEALTH PROF. 95 (2008).
161. See STATE LAWS 14TH ED., supra note 101, at 6-7 (14th ed., Rev. 2014).
162. See generally STATE LAWS 14TH ED., supra note 101 (14th ed., Rev. 2014) (by adding up the individual states whose provisions qualify).
163. 5 WYO. CODE. R. §4(d) (2009), available at http://wyomedboard.state.