California physician (MD and DO) CME requirements for license renewal

California has two physician licensing boards. MDs are licensed by the Medical Board of California; DOs are licensed by the Osteopathic Medical Board of California. Both require 50 hours every two years, but they accept different credit.

The short version

Requirement	MD (Medical Board)	DO (Osteopathic Board)
Total CME	50 hours every two years	50 hours every two years
Credit minimum	None beyond approved credit	At least 20 hours AOA Category 1 (1-A or 1-B)
Pain management and terminally ill patients	12 hours, one time	12 hours, one time
Risks of addiction with Schedule II drugs	Part of the one-time 12 hours	At least 1 hour every cycle, plus the one-time 12
Geriatric medicine	20% of hours (10) for general internists and family physicians with over 25% of patients 65+	Same statute; confirm with the Board
License expires	Last day of the month the license was issued, every two years	Same

Mandated hours count within the 50; they are not added on top.

How many hours, and what kind

MDs

16 CCR 1336(a) requires at least 50 hours of approved CME in the two-year period immediately before your license expires. 16 CCR 1337(a) approves:

programs that qualify for Category I credit from the California Medical Association or the AMA (the Board's page describes these as CMA-, AMA- and ACCME-accredited programs that qualify for AMA PRA Category 1 Credit™);
programs that qualify for prescribed credit from the American Academy of Family Physicians;
programs from other organizations acceptable to the Board that meet 16 CCR 1337.5.

So AAFP Prescribed credit counts for California MDs. Other credit the Board allows:

Teaching: up to one-third of the hours by teaching or presenting an approved course (16 CCR 1337(c)).
Specialty boards: passing a certifying or recertifying exam earns 100 hours, covering four consecutive years (16 CCR 1337(d)).
Residency and fellowship: up to 6 hours for each month in an ACGME-accredited program (16 CCR 1337(f)).
Practice management: courses on practice management, facility management (including coding or reimbursement) or teaching method can be no more than 30% of your hours (Business and Professions Code 2190.15).

Courses aimed mainly at the business side of practice, such as office management, billing, coding and marketing, do not count unless they fall under that 30% allowance (section 2190.1(f)).

DOs

Business and Professions Code 2454.5 requires 50 hours each two-year cycle. At least 20 must be AOA Category 1, and the other 30 may be AOA- or AMA-accredited. The Osteopathic Board's CME document (effective October 1, 2025) says 1-A and 1-B both count toward the 20. Its chart puts ACCME-accredited and "AAFP approved" programs in Category 2A, up to 30 hours. The statute names only AOA and AMA credit, so confirm with the Board before you count AAFP Prescribed credit on its own. AMA PRA Category 1 credit counts toward the 30.

16 CCR 1635 still describes an older 150-hour, three-year period. The statute and the Board's current document set 50 hours every two years.

When your license expires

MD: Business and Professions Code 2423 sets a two-year term that ends on the last day of the month the license was issued. The Board says licenses expire "at 11:59 p.m. on the expiration date" and that "there is no grace period". The Board does not name a time zone. If it means California time, that is 2:59 a.m. Eastern the next day. Licenses issued on or after January 1, 2024 have a 26-month first term, then 24 months.
DO: Business and Professions Code 2456.1 says licenses "expire at midnight on the last day of the month in which the license was issued during the second year of the two-year term". If that is midnight California time, it is 3:00 a.m. Eastern the next day. Since January 1, 2022, the CME period matches your renewal period: the two years between your last expiration date and your next one.

Your expiration date is printed on your license and in BreEZe.

The mandated topics

Pain management and the treatment of terminally ill and dying patients: 12 hours, one time

Business and Professions Code 2190.5 requires a one-time 12 hours, due within four years of your initial license or by your second renewal, whichever comes first. You can split the 12 hours between the two topics in any way. For physicians licensed on or after January 1, 2019, the course must also cover "the risks of addiction associated with the use of Schedule II drugs". The Osteopathic Board's document gives January 1, 2020 for that change. Pathologists and radiologists are exempt. The 12 hours count toward the 50.

There is an alternative under section 2190.6: a one-time 12-hour course on treating and managing opiate-dependent patients. It must include 8 hours on buprenorphine or a similar treatment for opioid use disorder, and it is due by your next renewal. The Medical Board accepts these courses from organizations accredited by the ACCME, AMA, CMA or AAFP. The Osteopathic Board notes that this CME is usually AMA credit, which it counts as AOA Category 2 unless the activity is also AOA Category 1.

DOs only: risks of addiction with Schedule II drugs, every cycle

Business and Professions Code 2454.5 says osteopathic physicians "shall complete a course on the risks of addiction associated with the use of Schedule II drugs". The Osteopathic Board requires at least 1 of the 50 hours on addiction to Schedule II drugs or opioids in every renewal cycle. In the cycle when the one-time 12 hours are due, this hour can count toward them.

Geriatric medicine: 20% of your hours, for some physicians

Under Business and Professions Code 2190.3, "general internists and family physicians who have a patient population of which over 25 percent are 65 years of age or older" must complete at least 20% of their CME (10 of 50 hours) in geriatric medicine, the special care needs of patients with dementia, or the care of older patients. The dementia option was added from January 1, 2025 (SB 639). The Osteopathic Board's 2025 policy alert calls this a mandated CME for those physicians, but its CME document does not list it. DOs should confirm with the Board.

Content every California course must include

Section 2190.1 requires California CME courses with a patient-care component to include cultural and linguistic competency and implicit bias. Courses from providers located outside California, and research-only courses, are exempt. This is a rule for course providers, not an hour requirement you have to track.

Coming in 2027: menopause care

From July 1, 2027, some physicians earn double credit, up to 8 hours, for CME on perimenopause, menopause and postmenopausal care (Business and Professions Code 2190.4 for MDs, 2454.7 for DOs; SB 164, 2026). It applies to physicians certified in internal medicine, family medicine, obstetrics and gynecology, neurology, neurological surgery or psychiatry who treat adult women under 65. This is optional, not a requirement.

Federal requirement (not a California topic)

If you hold a DEA registration, federal law (the MATE Act) requires a one-time 8 hours of training on substance use disorders. This is a federal requirement, separate from California's.

Your first renewal

MD: the full 50 hours apply. 16 CCR 1336(a) reduces it to 25 hours only "if an initial license was issued for less than 13 months", but current first terms are 24 or 26 months. For licenses issued on or after January 1, 2022, the first renewal also needs proof of 36 months of Board-approved postgraduate training, or proof that you are enrolled in a program.
DO: nothing in the statute or the Board's document waives CME at the first renewal. The Board waives 50% or 100% of the hours for time spent in residency or fellowship during the cycle. Its sanctions text mentions a "prorated share", so confirm with the Board whether proration applies to you.

Reporting and audits

MD: at renewal you certify under penalty of perjury that you completed the CME. You send documentation only if you are audited. The Board audits a random sample each year (16 CCR 1338). The Board works with the ACCME's PARS system, so ACCME-accredited providers can report your credits directly. Ask the provider to report them, and you can see them in a free CME Passport transcript. Keep records for at least 4 years: course title, dates, hours, sponsor and accrediting organization (16 CCR 1338(e)). If you cannot finish because of health, military service or undue hardship, you can ask for a waiver (form CME-1W) about three months before expiration. Waivers are not available once you are audited.
DO: CME is checked by random audit after renewal. If you are selected, you send your AOA activity report or certificates, in PDF only. Missing hours can lead to a citation and fine, and you must make them up from current hours. Keep records for at least 4 years (16 CCR 1641(c)).

Checklist before you renew

Count 50 hours earned since your last expiration date.
MD: check that each course is AMA PRA Category 1, CMA Category I or AAFP Prescribed. DO: check that at least 20 hours are AOA Category 1-A or 1-B.
Check whether your one-time 12 hours of pain management and end-of-life care, or the opioid-dependence alternative, is done or due by this renewal.
DO: confirm you have at least 1 hour on Schedule II or opioid addiction this cycle.
General internists and family physicians with more than 25% of patients aged 65 or older: confirm 10 hours in geriatrics or dementia care.
Keep your certificates for at least 4 years, then renew in BreEZe before your expiration date.

Requirements change. This guide was checked against the sources below on October 6, 2026; confirm with the Board before you rely on it.