Continuing Medical Education

The Chicago College of Osteopathic Medicine (CCOM), the founding college of Midwestern University, began in 1900 as a small medical school and grew through the years, graduating a loyal group of alumni. The financial support of the college came mainly from the alumni, and the college realized that it had a responsibility to support continuing medical education for the alumni. In 1947, the late Ward E. Perrin, D.O., began an annual program in the form of an alumni reunion and clinical refresher course (CRC), which he directed and guided for the next 53 years. 

An annual spring conference was developed in 1954 by the Department of Internal Medicine and has been presented annually since then. This is a traditional study conference originally intended for support of graduates needing advanced work for accreditation in Internal Medicine. Since 1978, it has provided an update for primary care.

CCOM has grown steadily and now has over 6,000 alumni. The CME program has continued to grow and diversify. Activities are directed toward physicians, but the Office of CME encourages participation by the other colleges of Midwestern University. The Colleges of Pharmacy in Downers Grove and Glendale each have their own continuing education programs for pharmacists, which are accredited by the American Council on Pharmaceutical Education (ACPE).

The strength of our CME programs lies in the close relationship between CCOM/MWU faculty and the audience. The confidence instilled by remembered professors is enhanced by the continuing addition of new teachers. New faculty members with varied backgrounds, as well as nationally recognized alumni and guest speakers when a special topic indicates a need, are continually added to the programs.

CCOM is accredited by the AOA to give CME programs for osteopathic physicians and by the ACCME to give CME credit for allopathic physicians.

The Office of Continuing Medical Education (OCME) is part of the Office of Postdoctoral Education of Midwestern University's Chicago College of Osteopathic Medicine (MWU/CCOM). The OCME is charged with carrying out the mission statement of the CME program, and ensuring that all sponsored activities meet the requirements set for CME providers by the American Osteopathic Association (AOA) and the Accreditation Council for Continuing Medical Education (ACCME). The OCME conducts and/or monitors the planning, implementation, evaluation, and documentation of all CME activities for which CME credit is awarded by MWU/CCOM. Sponsors of CME activities requesting CME credit from MWU/CCOM must submit an application form and related documents to the OCME at least one month in advance of the planned activity, or before any promotional materials are distributed, whichever comes first. The OCME will respond as quickly as possible, but within two weeks of the receipt of all required documentation. OCME approval is required before the release of any printed materials.

PRE-ACTIVITY PHASE
 

CME Mission Pledge – The activity must fit within the purview of MWU/CCOM's CME Mission. It must meet the standards for scientific validity, with content that would be accepted by the profession as being within the basic medical sciences, the discipline of clinical medicine, and the provision of health care to the public.

Course/Activity Description – The course or activity title, date/s, location, and credit hours to be awarded must be submitted at least one month in advance to the OCME.

Sponsorship/Accreditation – [Document B: Accreditation Statements]
A CME course or activity can be sponsored in one of three ways. The accreditation statement to be included on all promotional and documented materials must correspond to the appropriate type of sponsorship.

Direct Sponsorship – Activities which are planned and implemented through MWU/CCOM's OCME, such as the yearly Midwestern Study Conference, and the Ward E. Perrin Clinical Refresher Course.

Co-Sponsorship – Activities in which MWU/CCOM's OCME cooperates with one or more other accredited organizations to plan and execute an event. The organizations do not need to be accredited by the same accreditation agencies to be considered co-sponsors. In the case of co-sponsorship, each organization must be listed on the activity documents and materials as accredited sponsors of the activity. No letter of agreement between the organizations is required.

Joint Sponsorship – [Document C: JS Letter of Agreement]
Activities that are jointly sponsored by MWU/CCOM and a non-accredited organization, including other colleges of Midwestern University, as well as outside organizations. In this case, the non-accredited sponsor must sign a letter of agreement committing to abide by the following conditions:

1. MWU/CCOM OCME will be responsible that the activity meets the requirements of the AOA and the ACCME. MWU/CCOM OCME will have the final decision, including withdrawal of its accreditation for the activity up to and during the activity if the non-accredited sponsor fails to meet MWU/CCOM OCME guidelines.
2. Although the non-accredited sponsor may be responsible for the logistics of the activity, they must inform and provide the necessary documentation to the OCME within identified time frames.
3. The non-accredited sponsor must include a representative or designee of MWU/CCOM OCME in its activity planning process.
4. The non-accredited sponsor must provide documentation requested by MWU/CCOM OCME in the planning, implementation, and follow-up phases of the activity.
5. All commercial support for the activity is subject to the approval of MWU/CCOM OCME. Although written agreements of commercial support may be signed by the non-accredited sponsor, MWU/CCOM must be mentioned in those agreements as a joint sponsor of the activity.
6. Brochures for jointly sponsored activities shall contain the accreditation statement for joint sponsorship. [Document B: Accreditation Statements]
7. CME certificates for jointly sponsored activities may be provided by the non-accredited sponsor, but MWU/CCOM must be listed as the accredited sponsor on the certificate. The format for all jointly-sponsored event certificates must be approved in advance by the OCME. (See CME Certificates under Post-Activity Phase.)

Needs Assessment – Every CME activity must be planned and designed to meet a need for continuing medical education that is identified as a result of a needs assessment process. A statement of need must be developed for the activity based on the results of that process. This statement must be printed on course descriptions, promotional materials, and the activity syllabus. Needs assessment can be conducted in many different ways. Each activity should be based on at least two of the following methods:

• Previous participants' written evaluations (if applicable) [Document D: Evaluation Form]
• Expert opinion
• Faculty/Clinical Staff perception
• Literature review/reports
• Medical audits
• New techniques or materials
• Patient surveys; clinical or patient care indicators
• Physician surveys [Document E: Sample Needs Assessment Form]
• Industry sources
• Recent research; data from public health sources
• Self-assessment tests
• Other identified methods

Learning Objectives – Learning objectives for each activity must be developed that indicate how the identified needs will be addressed in the activity. These objectives should identify what the participant will be able to do or know following completion of the activity. They must also be listed in the course or activity description and appear in promotional material and the activity syllabus.

Example: Following this program, the participant should be able to differentiate acute (simple) pain from chronic (complicated) pain.

Faculty Communication – [Document F: Sample Faculty Letter]
The Course Coordinator must prepare a letter to the faculty that communicates the following:

• Learning objectives (see above)
• Intended audience
• The policy on faculty disclosure, disclosure of unlabeled/ unapproved uses, and fair-balance requirement [Document G: Faculty Disclosure Form], including notification that faculty must also disclose verbally before they begin their presentation
• Request for biographical information (curriculum vitae)

Commercial Support – [Document H: Letter of Agreement for Commercial Support]
CME activities are often supported by non-accredited commercial organizations. While this support can contribute significantly to the quality of CME activities, accredited CME providers are required to insure that CME activities are free of commercial bias for or against any product. The OCME follows the standards for commercial support of the AOA and the ACCME. If information about commercial products is presented in an activity, it must be done objectively, based on scientific methods generally accepted in the medical community. The standards for commercial support can be summarized as follows:

1. There must be a formal written letter of agreement between Midwestern University/Chicago College of Osteopathic Medicine and each commercial supporter reflecting that the program is educational and non-promotional. Letters of agreement from funding organizations are acceptable, as long as they contain all the information in [Document H: Letter of Agreement for Commercial Support]. In the case of jointly-sponsored activities, Midwestern University/Chicago College of Osteopathic Medicine MUST be included in the letter of agreement and sign the agreement. The non-accredited provider can also sign the letter of agreement and can be the delegated entity to receive and disburse the commercial support funds.
2. Acknowledgment of commercial support must appear in announcements and brochures.
3. Documentation must be provided that describes all funding arrangements, including how funds are received from commercial supporters were expended, how speakers were paid.
4. Disclosure information regarding each speaker must be given to participants.
5. Commercial exhibits must be separated from educational sessions and obligate pathways, in a separate room or arranged exhibit hall.
6. All commercial support must be in the form of a grant to the CME activity provider. The provider deals with all the activity expenses, including any meals and honoraria for individual sessions of regularly scheduled conferences. Grant monies are payable to Midwestern University / Chicago College of Osteopathic Medicine or the joint sponsor. Grants to MWU/CCOM must be processed by the Office of Business Affairs; phone 630/515-7184.
7. Additional information on the AOA and ACCME standards for commercial support can be obtained on their websites.

Budget and OCME Administrative Fees – The CME sponsor must assure that a sound financial base is established for the planned activity. Budget planning should be clearly projected. The activity should not be presented for the sole purpose of profit. The application form contains space for a brief statement regarding all funding arrangements. Information must include:

1. How speakers are to be paid (if applicable)
2. A copy of all Letters of Agreement for commercial support [Document H: Letter of Agreement for Commercial Support]
3. Statement of responsibility for expenses, including staff time, materials, etc.
4. Statement of responsibility for the payment of OCME Activity fees for jointly sponsored events:

OCME Activity Fees    MWU College    Outside Sponsor
Joint Sponsorship Administrative Fee    $50    $100
Certificates of Participation in Category 1A Event    $5/participant    $10/participant

Activity fees are payable to Midwestern University Continuing Medical Education.

Promotion/Advertisement – Activity sponsors must have their application for CME credit approved before releasing any promotional or advertising materials. All such materials must be reviewed in advance by the OCME and by the MWU Office of Communications and must include the following:

• Activity/course title, dates, location, sponsor/s;
• Appropriate accreditation statement [Document B: Accreditation Statement];
• Intended audience;
• Objectives for the activity;
• Number of CME credits available;
• Faculty credentials;
• Acknowledgement of any commercial support confirmed through a signed letter of agreement when materials are printed;
• In accordance with the Americans With Disabilities Act, directions for participants requesting accommodation for special needs, with a date by which such requests must be submitted.

Three copies of all printed materials must be submitted to the OCME.

EVENT PHASE

Activity Brochure – The brochure or agenda distributed to participants at the event must be reviewed in advance by the OCME and by the MWU Office of Communications and must contain the following information:

• Activity/course title, dates, location, sponsor/s;
• Appropriate accreditation statement [Document B: Accreditation Statement];
• Intended audience;
• Objectives for the overall event;
• Number of CME credits hours available;
• Faculty credentials;
• Objectives for each presentation;
• Acknowledgement of any commercial support confirmed through a signed letter of agreement.

Three copies of all printed materials must be submitted to the OCME.

Attendance Roster – Verification of attendance must be provided for each CME activity. A sign-in sheet must be provided for individual sessions of Regularly Scheduled Conferences, which is used to award CME credits. Effective January 1, 2004, for one-time activities such as conferences, each physician must sign an individual form verifying the hours actually spent in the activity (signed evaluation forms or a separate form listing all sessions attended), to be submitted before leaving the conference. A sample sheet must be sent to the OCME, along with a list of participants and hours earned.

Grievance Policy – Activity sponsors must have a written policy dealing with procedures for the management of grievances and fee refunds. The grievance policy of the OCME is as follows:

Written evaluations of each CME activity are summarized and communicated to the activity's Program Director, the faculty of the activity, and the CME Committee. Grievances shared directly at the conference are handled by the program staff or, if the grievance involves content, by the Program Director. Issues raised are shared with the CME Committee and considered when planning future activities. Any grievances that cannot be resolved by the program staff or Director are referred to the CME Committee. If the CME Committee cannot resolve a grievance, it is referred to the Dean of Chicago College of Osteopathic Medicine.

On-site Evaluations – [Document D: Sample Evaluation Form]
A standard evaluation tool is attached, which should be customized for individual activities. Although this document does not need to be followed exactly, participant on-site activity evaluations must contain or measure the following standardized sections or statements: Attainment of Presenter's Objectives, Fair-Balance Question, Professional Effectiveness Question, Ideas on Future Activities Requested. If the activity is to have more than one presentation, an evaluation form should be distributed at the end of the entire event, with similar questions targeted to evaluating the event as a whole. [Document D2: Overall Activity Evaluation]

POST-ACTIVITY PHASE

On-Site Evaluation Summary – A sample of the on-site evaluation document/s, two evaluations filled out by participants, and a summarized report of all evaluations received, must be submitted to the OCME within one month of the completion of the activity.

Follow-Up (Outcomes) Evaluation – [Document I: Sample Follow-Up Evaluation]
Outcomes Evaluations should be used for all activities. Again, refer to the activity objectives as the basis for asking the questions, with the emphasis being whether or not the objective has been implemented in the physician's practice. Samples and summaries of follow-up evaluations should be submitted whenever they are completed.

CME Certificates – [Document J: CME Certificate Form]

Certificates of attendance must be provided to participants. For jointly sponsored events, the following conditions apply:

• The certificate may be provided by the non-accredited sponsor, but MWU/CCOM must be listed as the accredited sponsor on the certificate.
• Certificates may be signed by the non-accredited provider's CME activity director.
• The format for all jointly-sponsored event certificates must be approved in advance by the OCME.
• In cases where the non-accredited joint sponsor provides the certificate, the OCME certificate fee of $5/participant or $10/participant is waived.

CME Reporting – The OCME will submit a report to the AOA of all participants who are D.O.s, along with the number of CME credit hours earned. Sponsors must provide the OCME with a printed list of D.O. participants, along with the copy of the activity's sign-in sheets.

Thank-You Letters – Thank-you letters should be sent to all faculty presenters after the event, along with their CME certificates, a summarization of the evaluations of their individual presentation, and any honorarium awarded.

Budget Resolution and OCME Fee Payment – A report reflecting final budget resolution should be submitted to the OCME, if applicable, along with the CME Activity Fee based on the appropriate administrative fee, and the number of CME certificates requested, if any.

Regularly Scheduled Conferences (RSCs) – RSCs are daily, weekly, or monthly CME activities (such as Grand Rounds, Tumor Boards, or Educational Lecture Series) that are planned and presented to the institution's professional staff for Category 1/1A credit. All the RSCs that an institution supports are considered one "activity," within which there may be several "series," each made up of several "sessions." Each session of a RSC series must be planned and presented to be in compliance with accreditation standards. Documentation requirements for accreditation apply to RSCs, as well as to one-time activities. However, documentation provided to the OCME for RSCs should include a sampling from each series, not of each individual session. RSC activity providers will be expected to:

• Describe the system they have implemented to monitor the effectiveness of the overall series, and provide a sample evaluation document.
• Document that the monitoring system has been implemented, with a sample evaluation summary.
• Explain and show how summaries are used to facilitate improvements.
• Verify the presence of appropriate recording of learner participation (i.e., with a sample sign-in sheet and description of records keeping).
• Verify the presence of Faculty Disclosure and Letters of Agreement for Commercial Support.
  NOTE: All commercial support must be in the form of a grant to the CME activity provider. The provider deals with all the activity expenses, including any meals and honoraria for individual sessions of regularly scheduled conferences. In the case of jointly-sponsored activities, Midwestern University/Chicago College of Osteopathic Medicine MUST be included in the letter of agreement and sign the agreement. The non-accredited provider can also sign the letter of agreement and can be the delegated entity to receive and disburse the commercial support funds.

Any CCOM faculty member of joint sponsor (college of MWU or outside organization) interested in CCOM accreditation for an RSC series must complete the Application for Continuing Medical Education Credit Approval [Document A]. Office of CME Activity fees will be assessed on an annual basis for each activity series. For example, a joint sponsor seeking accreditation for RSC activity consisting of three "series" (such as Grand Rounds, Lecture Series, and Journal Club) will pay three activity fees per year to the Office of CME.

Example of RSC Documentation – One of the colleges of MWU or an affiliated organization supports an Educational Lecture Series for practicing physicians and residents-in-training. Flyers for the series carry the appropriate MWU/CCOM accreditation statement. Each series is planned during a one- to two-month period for the entire year through meetings of department staff. Notes/minutes from these meetings document the identification of needs, analysis of evaluations (monitoring of effectiveness), and planning process for the coming series. These notes/minutes are sent to the Office of CME annually, along with the sample sign-in sheets, sample evaluation documents and summaries, sample Faculty Disclosure information, and any Letters of Agreement for Commercial Support.

OVERALL PROGRAM EVALUATION

The OCME uses several different methods to assess the overall educational needs of its CME audience.

• An overall Physician Needs Assessment Survey is distributed periodically to potential program participants [Document E: Sample Needs Assessment Survey].
• Results of this survey are used to plan activities developed and conducted by the OCME.
• Questions about needs for future activities are included on the evaluation sheets for each sponsored activity. The OCME reviews participants' responses to these questions in planning future events.
• The OCME consults regularly with the academic and clinical faculty of MWU/CCOM to identify issues and topics where new developments in the various fields of specialization can be presented thorough CME activities.
• The OCME requests that co-sponsors, joint sponsors, and those involved in directly sponsored events fill out an evaluation of the service provided by the OCME. [Document K: OCME Program Evaluation]

Some or all of the attached documents are required for CCOM sponsored or jointly sponsored, formally planned Category 1/1A educational activities only. The Office of Continuing Medical Education will determine which documents will be required for each specific jointly sponsored activity. (These documentation requirements do not apply to medical teaching lectures for students and/or interns and residents.) Required documents are available in Word format. Save copies locally to disk or your hard drive. Upon completion, you can resave your document and print a copy for submission.

Document A: Application Form

Application forms must be typed and fully completed. Attach a course description, schedule of lectures, list of speakers with academic appointments/titles/affiliations and bios, complete addresses, as well as all supporting documentation, as indicated. Include actual brochures, flyers, registration forms, and copy of all surveys. Incomplete submissions, including signatures of course director, will be returned.

Completed application should be submitted to: 
Office of Continuing Medical Education 
Midwestern University 
20201 S. Crawford Avenue 
Olympia Fields, IL 60461 
708/747-4000, ext. 1097 phone
708/747-8532 fax

Document B: Accreditation Statement
Document C: Joint Sponsor Letter of Agreement
Document D: Sample Evaluation Form
Document D2: Overall Activity Evaluation
Document E: Sample Needs Assessment Form
Document F: Sample Faculty Letter
Document G: Faculty Disclosure Form
Document H: Letter of Agreement for Commercial Support
Document I: Sample Follow-Up Evaluation
Document J: CME Certificate Form
Document K: OCME Program Evaluation
Document L: CME Report Form

Midwestern University/Chicago College of Osteopathic Medicine (MWU/CCOM) is accredited by the American Osteopathic Association to present continuing medical education programs for D.O. physicians and by the Accreditation Council for Continuing Medical Education to present continuing medical education programs for M.D. physicians. MWU/CCOM follows all the standards and regulations of the AOA and ACCME governing the provision and documentation of CME programming.

The Chicago College of Osteopathic Medicine (CCOM) is accredited by the American Osteopathic Association (AOA) as an organization whose educational activities meet AOA standards, with authorization to award continuing medical education (CME) credit to United States licensed D.O. physicians. AOA accreditation requirements ensure the integrity and effectiveness of the osteopathic continuing medical education system.

PURPOSE AND MISSION
The CME provider must have a written statement of its CME mission, which includes the CME purpose, content areas, target audience, type of activities provided, and expected results of the program. [ACCME Essential Area 1, AOA Standard 2.2.2.1]

EDUCATIONAL PLANNING AND EVALUATION
The CME provider must use a planning process(es) that links identified educational needs with a desired result in its provision of all CME activities. [ACCME Essential Area 2.1] The objectives of an educational activity shall influence the educational design and be relevant to the practice needs of the audience. [AOA Standards 2.1.8, 2.2.3.3.1]

The provider must use needs assessment data to plan CME activities. [ACCME Essential Area 2.2, AOA Standards 2.1.2, 2.1.3, 2.2.3.1]

The provider must communicate the purpose or objectives of the activity so the learner is informed before participating in the activity. [ACCME Essential Area 2.3, AOA Standards 2.1.5, 2.2.3.2]

The provider must evaluate the effectiveness of its CME activities in meeting identified educational needs. [ACCME Essential Area 2.4, AOA Standards 2.1.9, 2.1.10, 2.1.11, 3.14]

The provider must evaluate the effectiveness of its overall CME program and make improvements to the program. [ACCME Essential Area 2.5, AOA Standard 2.1.6, 2.1.7]

ADMINISTRATION
The provider must have an organizational framework for the CME unit that provides the necessary resources to support its mission, including support by the parent organization, if a parent organization exists. [ACCME Essential Area 3.1, AOA Standards 2.1.1, 2.1.4, 2.1.12]

The provider must operate the business and management policies and procedures of its CME program (as they relate to human resources, financial affairs and legal obligations), so that its obligations are met. [ACCME Essential Area 3.2, AOA Standard 2.2.2.2]

If two or more sponsors act in association, the responsibility for complying with the standards for quality is held jointly. If an accredited sponsor acts in association with others in the development, distribution, and/or presentation of CME activities, it is mandatory that the identity of the AOA-accredited sponsor be identified in the title, advertising, and promotional materials, and the responsibility for adherence to the standards of quality must rest with the AOA-accredited sponsor. [AOA Standard 2.1.13, 2.2.2.3]

The provider must present CME activities in compliance with ACCME's policies for disclosure and commercial support. [ACCME Essential Area 3.2.] In conformance with the Uniform Guidelines for Accrediting Agencies of CME, the design and production of educational activities shall be the ultimate responsibility of the provider; commercial supporters shall not control the planning, content, or execution of sponsored activities. [AOA Standards 2.2.2.5, 2.2.3.3.3, 2.2.4]

CME REQUIREMENTS
All D.O. physicians, other than those exempted by the American Osteopathic Association (AOA), are required to participate in continued medical education activities and to meet specified CME credit hour requirements.

The requirement for the AOA is 120 hours in a three-year period. Board certified physicians must earn a minimum of 50 of those credit hours (Category 1 or 2) in their primary specialty.

The 120 credits must be earned as follows:

• 30 CME hours must be earned in Category 1-A
• 90 CME hours must be earned in Category 1-A, 1-B, 2-A, or 2-B

Members obtaining 150 hour or more of AOA-approved CME in a three-year CME cycle will be given a certificate of excellence in CME from the AOA.

DEFINITIONS OF CATEGORIES
A complete explanation of AOA credit categories is listed on website of the American Osteopathic Association. The following categories apply to CCOM-sponsored and jointly sponsored activities.

Category 1-A Credits
Formally planned osteopathic CME events: face-to-face educational activities, approved for 1A credit. CME credits for presenters and participants in these events are submitted to the AOA, based on sign-in sheets. Presenters are awarded one credit for each hour presenting. Attendance earns one credit per hour. Examples include:

• Ward E. Perrin Clinical Refresher Course
• Midwestern Study Conference
• Other formal conferences
• Grand Rounds or Educational Lecture Series that are organized, approved, and documented as formal educational events for practicing physicians, as well as students, interns, and residents.

Osteopathic medical teaching lectures: 1A credit is awarded for presenters only; content must be didactic, not simply patient case reviews, and attendance documentation must be available in order for the presenter to receive credit. Examples include:

• Noon lectures
• Grand Rounds
• Journal Clubs organized for students, interns, and residents

Category 1-B Credits

• Serving as a preceptor in an AOA-approved medical education program (CCOM or AZCOM). Credit should be claimed only for actual teaching time, i.e., coaching a medical student in an office practice; bedside teaching of interns and residents in a hospital or clinical setting.
• Healthcare committee and departmental meetings which review and evaluate patient care.
• Faculty development programs with faculty of 50 percent D.O.s or osteopathic medical school faculty.

CME CREDIT REPORTING TO THE AOA

CCOM's Office of Continuing Medical Education (OCME) submits CME credit information for D.O.s to the AOA for the following activities:

• CCOM-sponsored or jointly sponsored, formally planned, Category 1A educational conferences and lectures; credits are submitted for D.O. presenters and attendees after each event, one credit for each hour presenting or attending, based on sign-in sheets;
• CCOM and AZCOM faculty members' CME credit reports are submitted twice yearly, in May and October, including credits earned in Categories 1A and 1B through teaching activities (lecturing and preceptorships) conducted through the medical schools and postdoctoral training programs. CCOM and AZCOM staff members collect information for these reports. D.O. faculty members can also provide the OCME with this information using [Document L: CME Report Form]. The OCME is not responsible for credit information not reported by a staff member or on this form.
  Physicians are responsible for reporting their own Category 2 credits and credits earned for activities outside the MWU/CCOM/AZCOM network. For a complete explanation of AOA report forms, visit the American Osteopathic Association website.

CME CREDITS FOR MEDICAL DOCTORS (M.D.)

The Chicago College of Osteopathic Medicine (CCOM) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) as an organization whose educational activities meet American Medical Association (AMA) standards, with authorization to award United States licensed M.D. physicians AMA PRA (Physicians Recognition Award) Category 1 credit. ACCME accreditation requirements ensure the integrity and effectiveness of the AMA PRA Category 1 credit system.

Category 1 Activities
CCOM designates AMA PRA Category 1 credit for formally planned educational activities. Attendance earns one credit per hour, which is reflected on the credit certificates CCOM awards after each event. Certificates reflect the physician's actual participation time, based on sign-in sheets. Examples include:

• Ward E. Perrin Clinical Refresher Course
• Midwestern Study Conference
• Other formal conference
• Grand Rounds or Educational Lecture Series that are organized, approved, and documented as formal educational events for practicing physicians

M.D.s who serve as presenters at these CME events may claim two Category 1 credits for each hour of teaching time. Application for these credits must be made directly to the American Medical Association (AMA) via e-mail to pra@ama-assn.org or by phone at 312/464-4672.

Category 2 Activities
M.D.s may claim Category 2 credit toward the PRA for the following activities by applying directly to the AMA (see above):

Serving as a preceptor for CCOM or AZCOM medical students, interns, and residents, i.e., coaching a medical student in an office practice; bedside teaching of interns and residents in a hospital or clinical setting.
Teaching at educational lectures, Grand Rounds, and Journal Clubs organized for students, interns, and residents.