California CME Requirements for MDs and DOs

California CME requirements depend on which board licenses you. MDs renew with the Medical Board of California, DOs with the Osteopathic Medical Board of California, and the two boards set different rules on top of a shared 50-hour baseline.

We checked these requirements against the Medical Board of California and Osteopathic Medical Board of California websites, and the California Business and Professions Code, in October 2026. Rules change, so confirm with your board before your renewal. For other states, see our CME requirements by state hub.

The short answer

MDs need 50 hours of approved CME in each two-year renewal cycle, completed in the two years before the license expires.
Most MDs must complete a one-time 12-hour requirement in pain management and care of terminally ill and dying patients, which also has to cover the risks of addiction tied to Schedule II drugs.
General internists and family physicians whose patients are more than 25 percent age 65 or older must put at least 20 percent of their CME hours toward geriatric topics.
California law requires CME courses themselves to include implicit bias content, so this is a rule for course providers, not a separate hour count for physicians.
DOs also need 50 hours every two years, but at least 20 must be AOA Category 1A or 1B, and at least 1 hour each cycle must cover addiction to Schedule II drugs or opioids.

California CME requirements for MDs

The Medical Board of California requires 50 hours of approved CME in each biennial renewal cycle. The hours must be completed in the two-year period immediately before your license expiration date, and they must come from a provider the board recognizes.

You certify compliance on your renewal. You don’t send certificates with it, but the board audits a sample of physicians every year, and anyone selected must produce documentation. The board treats misrepresenting CME compliance as unprofessional conduct.

Accepted credit types

The board accepts programs that qualify for AMA PRA Category 1 Credit™ and are accredited by the California Medical Association, the AMA, or the ACCME. It also accepts programs that qualify for prescribed credit from the American Academy of Family Physicians, and other programs the board’s Licensing Program finds acceptable. If you want a refresher on how Category 1 credit works, see our AMA PRA Category 1 Credit™ explainer.

A few other activities count, with limits. The board credits ACGME-accredited residency or fellowship training at 6 hours per month, and teaching or presenting a CME course for up to one-third of the required hours. Passing a recognized specialty board exam counts as 100 hours for four consecutive years.

State law also caps certain nonclinical content. Under Business and Professions Code section 2190.15, courses on practice management, health care facility management (such as coding or reimbursement), and teaching methods for medical school faculty can count, but together they can’t make up more than 30 percent of your total CME hours.

Pain management and end-of-life care

This is a one-time requirement, and the 12 hours count toward your 50-hour total. Pathologists and radiologists are exempt. The board allows two ways to meet it.

You can complete 12 hours in pain management and the treatment of terminally ill and dying patients, split between the two topics in any way that fits your practice. Every course used must also cover the risks of addiction associated with Schedule II drugs.
You can complete a one-time 12-hour course on treating and managing opiate-dependent patients, with 8 of those hours on buprenorphine or similar treatment for opioid use disorders.

Under section 2190.5, physicians licensed on or after January 1, 2002, must finish the pain management requirement within four years of initial licensure or by their second renewal date, whichever comes first. The board’s page describes the deadline as the second license renewal after licensure, so check your own date with the board if you’re close.

Geriatric requirement

Section 2190.3 applies to general internists and family physicians only. If more than 25 percent of your patients are 65 or older, at least 20 percent of your mandatory CME hours must be in geriatric medicine, the special care needs of patients with dementia, or the care of older patients. On a 50-hour cycle, that works out to at least 10 hours. Physicians in other specialties are encouraged, but not required, to take geriatric coursework, including geriatric pharmacology.

Implicit bias and cultural competency

California puts this requirement on the courses, not on your hour count. Under section 2190.1, all CME courses must include curriculum on cultural and linguistic competency, a rule in place since July 1, 2006. Since January 1, 2022, all CME courses must also include curriculum on understanding implicit bias.

The statute exempts two kinds of courses from the implicit bias rule. One is a course dedicated solely to research or other issues with no direct patient care component. The other is a course offered by a CME provider not located in California. Because of that second exemption, an out-of-state course can still count toward your 50 hours even if it doesn’t include implicit bias content.

Records, waivers, and audits

Keep your CME records for at least four years. Each record should show your name, the course title, attendance dates, credit hours, and the sponsoring or accrediting organization.

The board reviews waiver requests case by case for health reasons, military service, or undue hardship, and suggests applying about three months before your license expires. Its page says a waiver isn’t available once you’ve been selected for audit.

Requirements at a glance

Requirement	MDs (Medical Board of California)	DOs (Osteopathic Medical Board of California)
Total hours	50 per two-year cycle	50 per two-year cycle
Category requirement	Approved credit, such as AMA PRA Category 1 Credit™ or AAFP prescribed credit	At least 20 hours AOA Category 1A or 1B
Pain management or end-of-life	One-time, 12 hours (pathology and radiology exempt)	One-time, 12 hours (pathology and radiology exempt)
Schedule II or opioid addiction	Included in the one-time 12-hour course	At least 1 hour every cycle
Geriatric	20 percent of hours for qualifying internists and family physicians	Not addressed in the board’s CME summary
Implicit bias	Built into course curriculum (provider obligation)	Built into course curriculum (provider obligation)
Record retention	4 years	4 years

California CME rules for DOs

Osteopathic physicians are licensed by the Osteopathic Medical Board of California, which publishes its own CME summary (effective October 1, 2025). Here is what that document states.

DOs must complete 50 credit hours within each two-year period, and since January 1, 2022, the CME cycle matches the license renewal period.
At least 20 of the 50 hours must be AOA Category 1A or 1B.
At least 1 hour each renewal cycle must cover addiction to Schedule II drugs or opioids. The board notes it can count toward the one-time pain management course if taken in the cycle when that course is due.
The same one-time 12-hour pain management and end-of-life requirement applies, with the opiate-dependent patient course as an alternative, and pathology and radiology specialists are exempt.
Practice management content counts, capped at 30 percent of total hours, and records must be kept for at least four years.

The board’s summary also covers residency and fellowship waivers and inactive licenses, so read the full document if either applies to you.

Planning your hours

Start by checking which one-time and specialty rules apply to you, then fill the rest of the 50 hours with courses in your field. Family physicians and internists with an older patient panel should plan for the geriatric share early. Our family practice and internal medicine courses are a starting point, and if you’re working on the pain management requirement, check whether a specific course is approved for it before you count it.

Travel Medical Seminars offers Audio-Digest self-study courses in a 10-credit short course and a 20-credit full course, each designated for AMA PRA Category 1 Credit™. Audio-Digest lectures are individually designated for credit by the Lippincott Continuing Medical Education Institute, which is accredited by the ACCME. You study at your own pace and complete testing online. You can browse all courses by specialty.

California CME requirements for physicians (MD and DO)