About CME Certification

• Continuing medical education consists of educational activities which serve to maintain, develop, or increase the knowledge, skills, and professional performance and relationships practitioners (MD, DO, ARNP, PA - and DC/ND in some states) use to provide services to patients, the public, or the profession. The content of CME is the body of knowledge and skills generally recognized and accepted by the profession as within the basic medical sciences, the discipline of clinical medicine, and the provision of health care to the public.
• ACCME Note: The ACCME definition of CME is broad, to encompass continuing educational activities that assist physicians in carrying out their professional responsibilities more effectively and efficiently. Examples of topics that are included in the ACCME definition of CME content include:
• Management, for physicians responsible for managing a health care facility
• Educational methodology, for physicians teaching in a medical school
• Practice management, for physicians interested in providing better service to patients
• Coding and reimbursement in a medical practice
• When physicians participate in continuing education activities not directly related to their professional work, these do not fall within the ACCME definition of CME content. Although they may be worthwhile for physicians, continuing education activities related to a physician's nonprofessional educational needs or interests, such as personal financial planning or appreciation of literature or music, are not considered CME content by the ACCME.
• ACCME-accredited providers must provide CME that contains content which falls within the definition of CME. The content of such CME must not promote recommendations, treatment or manners of practicing medicine that are known to have risks or dangers that outweigh the benefits or are known to be ineffective in the treatment of patients. Note that an organization whose program of CME is devoted to advocacy of unscientific modalities of diagnosis or therapy is not eligible to apply for ACCME accreditation.

The ACCME defines joint providership as the providership of a CME activity by one or more accredited (IBUM) and one or more nonaccredited organizations. Therefore, ACCME accredited providers that plan and present one or more activities with non-ACCME accredited providers are engaging in “joint providership.” Please note: the ACCME does not intend to imply that a joint providership relationship is an actual legal partnership. Therefore, the ACCME does not include the words partnership or partners in its definition of joint providership or description of joint providership requirements.

The accredited provider (IBUM) must take responsibility for a CME activity when it is presented in cooperation with a nonaccredited organization and must use the appropriate accreditation statement.

The ACCME expects all CME activities to be in compliance with the accreditation requirements. In cases of joint providership, it is the ACCME accredited provider’s responsibility to be able to demonstrate through written documentation this compliance to the ACCME. Materials submitted that demonstrate compliance may be from either the ACCME accredited provider’s files or those of the nonaccredited provider. An accredited provider puts their own accreditation at risk when they offer joint providership to another organization.

ACCME has noted that content validity is more challenging to assure with jointly provided activities. Organizations offering joint providership should ensure any contracts or agreements that are developed with a nonaccredited organization should allow immediate and last-minute revocation of accreditation without penalty to the accredited provider for any issues related to compliance with the accreditation standards including content validity.

Accredited providers should ensure that joint providers are contractually prohibited from engaging in any unapproved promotional or marketing activities. Gift cards and other high-value incentives are associated with particular expectations. The accredited provider should routinely and regularly review any website or promotional material that lists or advertises the activity to ensure it complies with accreditation expectations.

AMA PRA credit may only be claimed by, and awarded to, physicians, defined by the AMA as individuals who have completed an MD, DO, ARNP, and PA or an equivalent medical degree from another country. Non-physicians may be provided a certificate with the AMA PRA credit statement but are not eligible to be “awarded” this credit. 

• Credit for a live activity is determined by measuring formal interaction time between faculty and the physician audience; 60 minutes equals one (1) AMA PRA Category 1 Credit™; credit is designated in 15 minute or 0.25 credit increments and rounded to the nearest quarter hour.
• Physicians claim credit based on participation time, rounded to the nearest quarter hour; this is the number of credits awarded.
• When concurrent sessions are offered in a live activity the time is only counted once: i.e., the designated maximum amount of credit may not exceed that which could be claimed by an individual physician.
• Only segments of the activity complying with the AMA core requirements may be certified for AMA PRA Category 1 Credit™ and included in the designated maximum for the activity. Certified segments must be clearly identified in activity materials.
• For a live activity, if an exam is provided during or immediately at the conclusion of the activity, you can include it for CME credit. Exam review time during an educational activity with faculty to participant interaction can also be included for CME credit. 

Individual articles are designated for, and physicians are awarded, one (1) AMA PRA Category 1 Credit™

• Credit is designated based on the average time it would take a small sample group of the target audience to complete the material. Accredited CME providers can use other mechanisms to establish credit if the result is the same. Credit is designated in 15 minute or 0.25 credit increments and rounded to the nearest quarter hour.
• Physicians who successfully complete the activity are awarded the number of credits for which the activity is designated.
• For enduring materials, you can include time for a post-test (done at the conclusion of the enduring material) in the credit calculation. Any exam time designated outside of the educational activity cannot be included in the credit calculation.
• Faculty credit for learning associated with preparing and presenting an original presentation:
• Accredited CME providers may also award AMA PRA Category 1 Credit™ to their physician faculty to recognize the learning associated with the preparation and teaching of an original presentation at the accredited CME provider’s live activities that are certified for AMA PRA Category 1 Credit™. 
• Credit for faculty is calculated on a 2-to-1 ratio to presentation time, rounded to the nearest quarter credit.
• Credit may only be claimed once for an original presentation; credit may not be claimed for subsequent presentations of the same material. Edits of any kind made to an original presentation are not eligible for faculty credit. 
• The host organization must have a process in place to ensure the presentation is an original and credit will not be claimed for subsequent presentations. An attestation from the faculty member would be appropriate. 
• Faculty credit may not be provided for ongoing presentations and should be considered a one-time offering for original presentations only.
• Physician faculty may not claim credit as a participant for their own presentation(s), but may claim credit for other segments they attend as a participant.
• Faculty claiming credit for original presentation(s) should be included on the host organizations participant list with the closing report and highlighted as such. An attestation should also be included that the credit claimed is for an original presentation, and faculty credit has not already been received for the content, and will not be claimed for subsequent presentations of the same material.

• The AMA Credit Designation Statement indicates to physicians that the activity has been certified by an accredited CME provider as being in compliance with AMA PRA Category 1 Credit™ requirements. The AMA Credit Designation Statement must be written without paraphrasing and must be listed separately from accreditation or other statements.
• The following AMA Credit Designation Statement must be included in relevant announcement and activity materials:
• The International Board of Undersea Medicine designates this <<learning format>> for a maximum of <<number of credits>> AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
• The learning format listed in the AMA Credit Designation Statement must be one of the following AMA approved learning formats (that IBUM also supports at the present time):

1. Live activity also includes live streaming)
2. Enduring material
3. Journal-based CME activity
4. Manuscript review activity

• The phrase “AMA PRA Category 1 Credit” is a trademark of the American Medical Association. Accredited CME providers must always use the complete italicized, trademarked phrase. The phrase “Category 1 Credit” cannot be used when referring to AMA PRA Category 1 Credit™.

• PROGRAM MATERIALS: The AMA Credit Designation Statement must be used in any program materials, in both print and electronic formats (e.g., a course syllabus, enduring material publication, landing page of an internet activity), that reference CME credit.
• ACTIVITY ANNOUNCEMENTS: Activity announcements include all materials, in both print and electronic formats, designed to build awareness of the activity’s educational content among the target physician audience. The complete AMA Credit Designation Statement must always be used on any document or publication referencing the number of AMA PRA Category 1 Credits™ designated for the activity.
•  SAVE THE DATE: A “Save the date” announcement (e.g.: a postal mailer with limited space) may indicate the activity has been approved for AMA PRA Category 1 Credit™ without stating an exact number of credits if the accredited CME provider has already certified the activity. This announcement may read, “This activity has been approved for AMA PRA Category 1 Credit™” or similar language. Accredited CME providers may never indicate that “AMA PRA Category 1 Credit™ has been applied for” or any similar wording.

Accredited CME providers must have a mechanism for physicians to claim credit and must award the actual number of AMA PRA Category 1 Credits™ claimed by each physician. The records documenting the credit awarded must be retained by accredited CME providers and host organization, for each certified activity, for a minimum of six years after the completion date of the activity.

• Only physicians (MDs, DOs and those with equivalent medical degrees from another country) may be awarded AMA PRA Category 1 Credit™ by accredited CME providers. Accredited CME providers must be able to provide documentation to participating physicians of the credit awarded upon the request of the physician. When an accredited CME provider issues a certificate, transcript or another means of documentation, it must reflect the actual number of credits claimed by the physician. An example of wording that might be used on certificates awarding AMA PRA Category 1 Credit™ to physicians follows:
• The International Board of Undersea Medicne certifies that <<name of physician>> <<degree>> has participated in the <<learning format>> titled <<title of activity>> on <<date>> and is awarded <<number of credits>> AMA PRA Category 1 Credit(s)™.
• Documentation provided to participating physicians must accurately reflect, at a minimum, the following:
• Physician’s name
• Name of accredited CME provider
• Title of activity
• Learning format
• Date(s) of live activity or date that physician completed the activity
• Number of AMA PRA Category 1 Credits™ awarded

• Non-physician health professionals and other participants may not be awarded AMA PRA Category 1 Credit™. However, accredited CME providers may choose to issue documentation of participation to non-physicians that states that the activity was certified for AMA PRA Category 1 Credit™. An example of wording that might be used on documentation for a non-physician participant follows: