North Dakota physician (MD and DO) CME requirements for license renewal

The North Dakota Board of Medicine licenses both allopathic (MD) and osteopathic (DO) physicians. Both follow the same statute, N.D. Century Code 43-17-27.1, and the same rules, N.D. Administrative Code chapter 50-04-01. This guide covers both degrees.

The short version

Requirement	Hours	How often	Who
Total CME	40	Every two years	Every MD and DO, unless excepted
Nutrition and metabolic health (new in 2026)	1	Each renewal cycle	Every MD and DO (Board has not yet said how it applies)
Board certification in lieu of hours	—	Current at the time of an audit	Physicians with current ABMS, AOA or Royal College (Canada) certification

How many hours, and what kind

Since April 1, 2024, N.D. Admin. Code 50-04-01-01 requires every licensed physician to "complete no less than forty hours of board-approved continuing medical education (CME) every two years," at one hour of credit per clock hour. This replaced the old rule of 60 hours every three years; older summaries still quote it.

Rule 50-04-01-03 lists what the Board accepts:

• AMA PRA Category 1 Credit™ from ACCME-accredited providers, or providers accredited by an ACCME-recognized accreditor;
• AOA Category 1 credit from AOA-accredited providers;
• AAFP Prescribed credit, and AAFP Elective credit that the AAFP has approved for Category 1;
• courses approved for Section 1 credit by the Royal College of Physicians and Surgeons of Canada;
• other courses the Board approves as equivalent to AMA or AOA Category 1.

The rule applies to every licensee, so MDs may count AOA Category 1 credit and DOs may count AMA PRA Category 1 Credit™. It says AOA "category 1" without separating 1-A and 1-B; Category 1-B is part of AOA Category 1, so it appears to count. The rule makes you, not the Board, responsible for checking a course's credit designation with its provider.

The rules say nothing about carrying extra hours into the next cycle, so plan on none.

Who is excepted

Rule 50-04-01-02 says these physicians do not have to meet the hours:

• residents and fellows in full-time ACGME- or AOA-accredited training;
• holders of a locum tenens permit or a special license;
• physicians who have not yet renewed for the first time since receiving a regular license;
• retired physicians who have completely withdrawn from practice and file the Board's affidavit;
• physicians who hold current certification, maintenance of certification or recertification from an ABMS member board, the AOA or the Royal College of Physicians and Surgeons of Canada "at the time of the CME audit."

The Board's CME page says that since August 1, 2023, physicians with such certification "will not need to submit proof of CME hours." The Board may also grant an extension or waiver for prolonged illness or other extenuating circumstances.

The mandatory topic

Nutrition and metabolic health: 1 hour each renewal cycle (new)

Senate Bill 2401, passed in the January 2026 special session and effective when filed, added a new subsection to N.D.C.C. 43-17-27.1: "The board shall require physicians to complete a minimum of one hour of continuing education on nutrition and metabolic health each renewal cycle."

As of October 7, 2026, the Board's CME page and rule chapter 50-04-01 do not yet mention the hour. It is not settled when the first cycle starts, whether the hour counts within the 40, or whether board certification in lieu of CME also covers it. A safe plan is one accredited hour on nutrition and metabolic health inside your 40 hours each cycle; confirm with the Board.

Not a renewal requirement: abortion law course

Under N.D.C.C. 14-02.1-04(4), a physician may not perform an abortion unless the physician has reviewed the Board's instructional course on North Dakota abortion law within the two years before, except in a medical emergency. The Board says this applies as of January 2026 and that you keep the completion certificate yourself. It applies only to physicians who perform abortions and is not part of the renewal CME.

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 North Dakota's rules.

When your license expires

Since August 1, 2023, physician licenses expire on your birthday every other year. A new license expires the second time your birthday comes around after the Board approves it. Renewal opens 59 days before expiration, and the Board emails reminders 59 and 14 days before, so keep your email address current.

You can renew an expired license within three years of expiration. If you practiced while it was expired, the fee can be up to three times the normal licensure fee (N.D.C.C. 43-17-26.1).

Your first renewal

The rules point two ways here. Rule 50-04-01-02(2) excepts physicians who "have not renewed their licenses for the first time" since receiving a regular license. But rule 50-04-01-04(1) and the Board's CME page prorate by time licensed when you report: under one year, no CME; one to two years, 20 hours; two to three years, 40 hours. Because a first license runs to your second birthday after approval, it is often more than a year old at first renewal. Confirm with the Board whether you need 20 hours at your first renewal; if you can, have them.

Reporting and audits

You certify compliance, or an exception, on the renewal form. You do not send documents unless the Board asks (rule 50-04-01-04(1)). The Board audits randomly selected physicians. If you are selected, you must show the accredited provider's name, the program name, the hours, the dates, the credit designation and proof of attendance.

The Board has joined the ACCME's reporting system. Ask your providers to report your participation to the ACCME; the Board can then verify it directly, and you can track it in the ACCME's CME Passport.

Keep a record of every CME activity for at least one year after you report it to the Board (rule 50-04-01-04(3)). A physician who fails to verify compliance owes a $500 fee and may face discipline. The Board may treat a late audit response as an admission of noncompliance (N.D.C.C. 43-17-27.1). False statements on the renewal form can also lead to discipline.

Checklist before you renew

1. Find your expiration date: your birthday, every other year.
2. If you hold current ABMS, AOA or Royal College certification, keep proof of it; that stands in for the 40 hours at an audit.
3. Otherwise count 40 hours of AMA PRA Category 1, AOA Category 1, AAFP Prescribed or Royal College Section 1 credit in the two-year cycle.
4. Include one hour on nutrition and metabolic health.
5. Ask providers to report to the ACCME, and keep certificates for at least a year after you renew.

Requirements change. This guide was checked against the sources below on October 7, 2026; confirm with the Board before you rely on it.