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

This guide covers physicians licensed by the Iowa Board of Medicine, which licenses both MDs and DOs and is now part of the Department of Inspections, Appeals, and Licensing. Both degrees follow the same rules. In 2025 the Board's rules were rewritten and renumbered: the CME rule is now 481 Iowa Administrative Code chapter 654 (formerly 653 IAC chapter 11), and licensure and renewal are in 481 IAC chapter 652.

The short version

Requirement	Hours	How often	Who
Total CME (category 1)	40 (up to 20 may be carryover)	Every two-year license period	Every MD and DO with a permanent or administrative medicine license
Child abuse identification and reporting	2	Every 3 years	Physicians who regularly provide primary health care to children in Iowa
Dependent adult abuse identification and reporting	2	Every 3 years	Physicians who regularly provide primary health care to adults in Iowa
Chronic pain management (CDC opioid guidelines)	2	Every 5 years	Physicians who prescribed opioids in the prior license period
End-of-life care	2	Every 5 years	Physicians who regularly care for actively dying patients in Iowa
License expires	First day of your birth month	Every two years	Every MD and DO

Category 1 credit earned for the mandatory trainings counts toward the 40 hours.

How many hours, and what kind

481 IAC 654.3(1)(a) requires "a total of 40 hours of category 1 credit or board-approved equivalent … for biennial renewal of a permanent license or an administrative medicine license. This may include up to 20 hours of carryover credit." A special license needs 20 category 1 hours every year, with no carryover (654.3(1)(b)).

Rule 654.1 defines category 1 credit as "any formal education program that is sponsored by an accredited provider," meaning a provider accredited by the ACCME, the Iowa Medical Society or the AOA's Council on Continuing Medical Education. So MDs may count AOA-accredited programs and DOs may count AMA PRA Category 1 Credit™.

AAFP Prescribed credit counts by name. Rule 654.1 says credits "designated as formal cognates by the American College of Obstetricians and Gynecologists or as prescribed credits by the American Academy of Family Physicians are accepted as equivalent to category 1 credits." The Board's page says the same.

Other credit the Board accepts (654.2):

• Residency or board certification: participation in an approved residency, or ABMS or AOA board certification or recertification within the license period, equals 50 hours of category 1 credit.
• Board and peer review service: up to ten hours a year for serving on the Board or the Iowa Professional Health Committee, or performing peer reviews.

Category 2 credit is not accepted. Because the rule counts "formal" programs from accredited providers, AOA Category 1-B activities that are not formal accredited programs may not qualify; confirm with the Board if you rely on them.

Carryover: you may carry up to 20 category 1 hours earned beyond the requirement into the next license period, and you report the carryover on the renewal application (654.3(1)(a)(2)).

When your license expires

Your license expires on the first day of your birth month, every two years. Under 481 IAC 652.10(1), licenses of physicians born in even-numbered years expire in even-numbered years, and those born in odd-numbered years expire in odd-numbered years. Each renewal is "a two-year license that expires on the first day of the licensee's birth month" (652.12(3)).

Renew before the expiration date. A penalty fee applies after it (652.12(2)), and "the license will become inactive and invalid if the licensee fails to renew a license within two months following its expiration date" (652.12(4)).

The mandatory trainings

Child abuse identification and reporting — 2 hours every 3 years

Under 481 IAC 654.3(1)(c)(1), a physician "who regularly provides primary health care to children in Iowa must complete at least two hours of training … in child abuse identification and reporting every three years." The rule names all emergency physicians, family physicians, general practice physicians, pediatricians and psychiatrists, plus any other physician who regularly provides primary health care to children. Iowa Code § 232.69(3) also requires the training within six months of starting such practice.

Dependent adult abuse identification and reporting — 2 hours every 3 years

Under 654.3(1)(c)(2), a physician "who regularly provides primary health care to adults in Iowa" must complete at least two hours on dependent adult abuse identification and reporting every three years. The rule names all emergency physicians, family physicians, general practice physicians, internists, obstetricians, gynecologists and psychiatrists, plus any other physician who regularly provides primary health care to adults. Iowa Code § 235B.16(5) says the same and also requires the training within six months of starting such practice.

Which courses count. The statutes require the core training curriculum "developed by the department … and provided by the department" of Health and Human Services. The rule says the training may be taken "as part of a category 1 credit or an approved training program," and defines approved programs to include courses offered by hospitals, physician organizations and others using an HHS-approved curriculum. If your course is not the HHS core curriculum, confirm with the Board that it counts. The Board's web page still asks for training "within the last five years," but the current rule and both statutes say every three years. The current rule does not mention a combined child and adult course.

Chronic pain management — 2 hours every 5 years

Physicians "who prescribed opioids in the prior license period must complete two hours of category 1 credit on U.S. Centers for Disease Control and Prevention (CDC) guidelines for opioid prescribing every five years" (654.3(1)(d)(1)). You may opt out at renewal if you did not prescribe opioids in the previous cycle.

End-of-life care — 2 hours every 5 years

A physician "who regularly provides direct patient care to actively dying patients in Iowa must complete at least two hours of category 1 credit for end-of-life care every five years" (654.3(1)(e)(1)).

The chronic pain and end-of-life requirements are suspended for periods when you lived outside Iowa and did not practice in Iowa (654.3(2)(b)).

Federal requirement

The federal DEA requires a one-time 8-hour training on treating and managing patients with opioid or other substance use disorders (the MATE Act) when you first register or renew a DEA registration. It is a federal requirement, separate from Iowa's rules.

Your first renewal

Because licenses are lined up with your birth month, your first license may run for less than two years. If it was issued for less than 24 months, "the number of hours of category 1 credit required … shall be reduced on a pro-rata basis" (654.3(1)(a)(1)). The Board's page says the same. The mandatory trainings still apply on their own schedules.

Reporting and audits

You report CME and the mandatory trainings on the renewal application (652.12(2)); you do not send certificates unless audited. Keep documentation "including dates, subjects, duration of programs, and proof of participation" (654.3(6)).

"The board may audit continuing education and training documentation at any time," and you must provide what is requested within 30 days (654.3(7)). The Board's page says it audits a number of renewing physicians each month and may audit "at any time within four years," so keep records at least four years.

You are exempt from the CME and training requirements for periods of honorable active military duty, practice only in another state that has its own CME requirement (with no care, including telemedicine, for patients in Iowa), and government service abroad in your specialty (654.3(2)). For illness or disability, the Board may grant an extension or an exemption of up to one calendar year (654.3(3)).

Checklist before you renew

1. Find your expiration date: the first day of your birth month in your renewal year.
2. Count 40 category 1 hours (fewer, prorated, if your first license ran less than two years), including up to 20 carryover hours. AAFP Prescribed credit counts.
3. Check whether each mandatory training applies to you and is current: abuse training every 3 years, chronic pain and end-of-life every 5 years.
4. Keep certificates at least four years.
5. Renew before the expiration date.

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