DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS  
DIRECTOR'S OFFICE  
OSTEOPATHIC MEDICINE AND SURGERY - GENERAL RULES  
(By authority conferred on the director of the department of licensing and regulatory  
affairs by sections 16145, 16148, 16174, 16201, 16204, 16215, 16287, 17531, 17533, and  
17548 of the public health code, 1978 PA 368, MCL 333.16145, 333.16148, 333.16174,  
333.16201, 333.16204, 333.16215, 333.16287, 333.17531, 333.17533, and 333.17548,  
and Executive Reorganization Order Nos. 1991-9, 1996-2, 2003-1, and 2011-4, MCL  
338.3501, 445.2001, 445.2011, and 445.2030)  
PART 1. GENERAL PROVISIONS  
R 338.111 Definitions.  
Rule 11. (1) As used in these rules:  
(a) "Board" means the Michigan board of osteopathic medicine and surgery  
created under section 17521 of the code, MCL 333.17521.  
(b) "Code" means the public health code, 1978 PA 368, MCL 333.1101 to  
333.25211.  
(c) “Department” means the department of licensing and regulatory affairs.  
(2) A term defined in the code has the same meaning when used in these rules.  
History: 2016 AACS; 2021 AACS.  
R 338.113 Rescinded.  
History: 2016 AACS; 2021 AACS.  
R 338.114 Telehealth.  
Rule 14. (1) A licensee shall obtain consent for treatment before providing a  
telehealth service under section 16284 of the code, MCL 333.16284.  
(2) A licensee shall maintain proof of consent for telehealth treatment in the  
patient’s up-to-date medical record and satisfy section 16213 of the code, MCL  
333.16213.  
(3) A licensee providing a telehealth service may prescribe a drug if the licensee is a  
prescriber acting within the scope of the licensee’s practice and in compliance with  
section 16285 of the code, MCL 333.16285, and if the licensee does both of the  
following:  
(a) Refers the patient to a provider that is geographically accessible to the patient, if  
medically necessary.  
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(b) Makes himself or herself available to provide follow-up care services to the  
patient, or to refer the patient to another provider, for follow-up care.  
(4) A licensee providing any telehealth service shall do both of the following:  
(a) Act within the scope of his or her practice.  
(b) Exercise the same standard of care applicable to a traditional, in-person health  
care service.  
History: 2021 AACS; 2023 MR 6, Eff. March 22, 2023.  
R 338.115 Code of ethics.  
Rule 15. (1) The standards of the American Osteopathic Association, 142 E.  
Ontario Street, Chicago, IL 60611-2864 set forth in the “Code of Ethics,” dated July 24,  
2016, which are available at no cost on the association’s website at  
https://osteopathic.org, are approved and adopted by reference.  
(2) A licensee shall not violate the code of ethics.  
(3) Copies of the adopted standards referenced in subrule (1) of this rule are  
available for inspection and distribution at a cost of 10 cents per page from the Board of  
Osteopathic Medicine and Surgery, Bureau of Professional Licensing, Department of  
Licensing and Regulatory Affairs, 611 West Ottawa, P.O. Box 30670, Lansing, Michigan  
48909.  
History: 2016 AACS; 2021 AACS; 2023 MR 6, Eff. March 22, 2023.  
R 338.117 Prescribing of drugs by physician’s assistants; procedures and  
protocols.  
Rule 17. (1) Under section 17548(3) and (4) of the code, MCL 333.17548, and  
under the terms of a practice agreement, a physician’s assistant may prescribe a drug,  
including a controlled substance that is included in schedules 2 to 5 of part 72 of the  
code, MCL 333.7201 to 333.7231, subject to both of the following requirements:  
(a) If a physician’s assistant prescribes a drug, the physician’s assistant’s name  
must be used, recorded, or otherwise indicated in connection with that prescription.  
(b) If a physician’s assistant prescribes a drug that is included in schedules 2 to 5,  
the physician’s assistant’s DEA registration number must be used, recorded, or otherwise  
indicated in connection with that prescription.  
(2) Under section 17548(3) and (5) of the code, MCL 333.17548, and under the  
terms of a practice agreement, a physician’s assistant may order, receive, and dispense  
complimentary starter dose drugs, including controlled substances that are included in  
schedules 2 to 5 of part 72 of the code, MCL 333.7201 to MCL 333.7231, subject to both  
of the following requirements:  
(a) If a physician’s assistant orders, receives, or dispenses a complimentary starter  
dose drug, the physician’s assistant’s name must be used, recorded, or otherwise  
indicated in connection with that order, receipt, or dispensing.  
(b) If a physician’s assistant orders, receives, or dispenses a complimentary starter  
dose drug that is included in schedules 2 to 5, the physician’s assistant’s DEA registration  
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number must be used, recorded, or otherwise indicated in connection with that order,  
receipt, or dispensing.  
History: 2016 AACS; 2021 AACS.  
R 338.119 Delegation of prescribing controlled substances to an advanced  
practice registered nurse; limitation.  
Rule 19. (1) A physician may delegate the prescription of controlled substances  
listed in schedules 2 to 5 of part 72 of the code, MCL 333.7201 to MCL 333.7231, to a  
registered nurse who holds specialty certification under section 17210 of the code, MCL  
333.17210, except for a nurse anesthetist, if the delegating physician establishes a written  
authorization that has all the following information:  
(a) The name, license number, and signature of the delegating physician.  
(b) The name, license number, and signature of the nurse practitioner, nurse  
midwife, or clinical nurse specialist.  
(c) The limitations or exceptions to the delegation.  
(d) The effective date of the delegation.  
(2) The delegating physician shall review and update a written authorization on an  
annual basis after the original date or the date of amendment, if amended. The delegating  
physician shall note the review date on the written authorization.  
(3) The delegating physician shall maintain a written authorization at the delegating  
physician’s primary place of practice.  
(4) The delegating physician shall provide a copy of the signed, written  
authorization to the nurse practitioner, nurse midwife, or clinical nurse specialist.  
(5) The delegating physician shall ensure that an amendment to the written  
authorization satisfies subrules (1) to (4) of this rule.  
(6) A delegating physician may authorize a nurse practitioner, a nurse midwife, or a  
clinical nurse specialist to issue multiple prescriptions allowing the patient to receive a  
total of up to a 90-day supply of a schedule 2 controlled substance.  
(7) A delegating physician shall not delegate the prescription of a drug or device  
individually, in combination, or in succession, for a woman known to be pregnant with  
the intention of causing either a miscarriage or fetal death.  
History: 2016 AACS; 2021 AACS; 2023 MR 6, Eff. March 22, 2023.  
R 338.120 Training standards for identifying victims of human trafficking;  
requirements.  
Rule 20. (1) Under section 16148 of the code, MCL 333.16148, an individual  
seeking licensure or that is licensed shall complete training in identifying victims of  
human trafficking that satisfies the following standards:  
(a) Training content must cover all the following:  
(i) Understanding the types and venues of human trafficking in the United States.  
(ii) Identifying victims of human trafficking in health care settings.  
(iii) Identifying the warning signs of human trafficking in health care settings for  
adults and minors.  
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(iv) Identifying resources for reporting the suspected victims of human trafficking.  
(b) Acceptable providers or methods of training include any of the following:  
(i) Training offered by a nationally recognized or state recognized health-related  
organization.  
(ii) Training offered by, or in conjunction with, a state or federal agency.  
(iii) Training obtained in an educational program that has been approved under  
these rules for initial licensure, or by a college or university.  
(iv) Reading an article related to the identification of victims of human trafficking  
that satisfies the requirements of subdivision (a) of this subrule and is published in a peer-  
reviewed journal, health care journal, or professional or scientific journal.  
(c) Acceptable modalities of training include any of the following:  
(i) Teleconference or webinar.  
(ii) Online presentation.  
(iii) Live presentation.  
(iv) Printed or electronic media.  
(2) The department may select and audit an individual and request documentation of  
proof of completion of training. If audited by the department, the individual shall  
provide an acceptable proof of completion of training, including either of the following:  
(a) Proof of completion certificate issued by the training provider that includes the  
date, provider name, name of training, and individual’s name.  
(b) A self-certification statement by the individual. The certification statement  
must include the individual’s name and either of the following:  
(i) For training completed under subrule (1)(b)(i) to (iii) of this rule, the date,  
training provider name, and name of training.  
(ii) For training completed under subrule (1)(b)(iv) of this rule, the title of the  
article, author, publication name of the peer-review journal, health care journal, or  
professional or scientific journal, and the date, volume, and issue of publication, as  
applicable.  
(3) Under section 16148 of the code, MCL 333.16148, the requirements specified in  
subrule (1) of this rule apply for license renewals beginning with the 2017 renewal cycle  
and for initial licenses beginning December 20, 2021.  
History: 2016 AACS; 2021 AACS; 2023 MR 6, Eff. March 22, 2023.  
PART 2. LICENSES  
R 338.121 Accreditation standards for approval of osteopathic medical schools,  
postgraduate training programs, and institutions; adoption by reference.  
Rule 21. (1) The standards for accrediting osteopathic medical schools developed  
and adopted by the American Osteopathic Association Commission on Osteopathic  
College Accreditation, 142 E. Ontario Street, Chicago, Illinois 60611-2864, set forth in  
the publication entitled “Accreditation of Colleges of Osteopathic Medicine: COM  
Accreditation Standards,” effective July 1, 2019, which are available at no cost on the  
association’s website at https://osteopathic.org, are approved and adopted by reference.  
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Any osteopathic school of medicine accredited by the Commission on Osteopathic  
College Accreditation is approved.  
(2) The standards of the American Osteopathic Association Council on Postdoctoral  
Training, 142 E. Ontario Street, Chicago, Illinois 60611-2864, set forth in the publication  
entitled “The Basic Documents for Postdoctoral Training,” effective July 1, 2020, which  
are available at no cost on the association’s website at https://osteopathic.org, are  
approved and adopted by reference. Any osteopathic postgraduate training program  
accredited by the American Osteopathic Association Council on Postdoctoral Training is  
approved.  
(3) The standards of the American Osteopathic Association Council on Osteopathic  
Postdoctoral Training Institutions, 142 E. Ontario Street, Chicago, Illinois 60611-2864,  
set forth in the publication entitled “OPTI Accreditation Handbook,” effective March  
2014, which are available at no cost on the association’s website at  
https://osteopathic.org, are approved and adopted by reference. Any osteopathic  
institution accredited by the American Osteopathic Association Council on Osteopathic  
Postdoctoral Training Institutions is approved.  
(4) The standards for approval of a postgraduate training program developed and  
adopted by the Accreditation Council for Graduate Medical Education, 401 North  
Michigan Avenue, Suite 2000, Chicago, Illinois 60611, set forth in the publication  
entitled “ACGME Common Program Requirements,” effective July 1, 2021, which are  
available at no cost on the council’s website at https://www.acgme.org, are approved and  
adopted by reference. Any medical postgraduate training program accredited by the  
Accreditation Council for Graduate Medical Education is approved.  
(5) Copies of the standards adopted by reference in this rule are available for  
inspection and distribution at a cost of 10 cents per page from the Board of Osteopathic  
Medicine and Surgery, Bureau of Professional Licensing, Licensing and Regulatory  
Affairs, 611 West Ottawa Street, P.O. Box 30670, Lansing, Michigan 48909.  
History: 2016 AACS; 2021 AACS; 2023 MR 6, Eff. March 22, 2023.  
R 338.123 Licensure by examination.  
Rule 23. An applicant for a doctor of osteopathic medicine and surgery license shall  
satisfy the requirements of the code and the rules promulgated under the code, as well as  
all the following requirements:  
(a) Provide the required fee and a completed application on a form provided by the  
department.  
(b) Provide proof verifying completion of a degree from a school of osteopathic  
medicine that satisfies the standards under R 338.121(1).  
(c) Provide proof verifying passing scores on all levels of the Comprehensive  
Osteopathic Medical Licensing Examination of the United States (COMLEX-USA)  
adopted under R 338.129 and provide proof verifying satisfaction of all the requirements  
under R 338.129.  
(d) Provide proof verifying completion of a minimum of 1 year of postgraduate  
clinical training in a program that satisfies either of the following requirements:  
(i) A postgraduate training program that satisfies the requirements under R  
338.121(2) at a training institution that satisfies the requirements under R 338.121(3).  
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(ii) A postgraduate training program approved under R 338.121(4).  
(e) Provide a certificate of completion of the postgraduate training required under  
subdivision (d) of this rule to the department no more than 15 days before the scheduled  
date of completion.  
History: 2016 AACS; 2021 AACS; 2023 MR 6, Eff. March 22, 2023.  
R 338.125 Licensure by endorsement.  
Rule 25. (1) An applicant for a doctor of osteopathic medicine and surgery license  
by endorsement shall satisfy the requirements of the code and the rules promulgated  
under the code, as well as all the following requirements:  
(a) Provide the required fee and a completed application on a form provided by the  
department.  
(b) Provide proof verifying the holding of a current and full doctor of osteopathic  
medicine and surgery license in another state or in a province of Canada.  
(c) If the applicant is licensed as a doctor of osteopathic medicine and surgery in a  
province in Canada, provide proof verifying that the applicant completed the educational  
requirements in Canada or in the United States at a school of osteopathic medicine that  
satisfies the standards under R 338.121(1) for licensure as a doctor of osteopathic  
medicine and surgery in Canada or in the United States.  
(d) Provide proof verifying passing scores on all levels of the COMLEX-USA  
adopted under R 338.129 and provide proof verifying satisfaction of all the requirements  
under R 338.129 for a doctor of osteopathic medicine and surgery license in another state  
or in a province of Canada to obtain licensure as a doctor of osteopathic medicine and  
surgery in another state or in a province of Canada.  
(e) Provide proof verifying completion of a minimum of 1 year of postgraduate  
clinical training in a program that satisfies either of the following requirements:  
(i) A postgraduate training program that satisfies the requirements under R  
338.121(2) at a training institution that satisfies the requirements under R 338.121(3).  
(ii) A postgraduate training program approved under R 338.121(4).  
(2) An applicant who provides proof verifying a current and full license in good  
standing as a doctor of osteopathic medicine and surgery in another state or in a province  
of Canada for not less than the last 5 years before the date of filing the application for a  
doctor of osteopathic medicine and surgery license by endorsement, and who provides  
proof verifying completion of the educational requirements in Canada or in the United  
States at a school of osteopathic medicine that satisfies the standards under R 338.121(1),  
is presumed to satisfy the requirements of subrule (1)(d) and (e) of this rule.  
(3) An applicant that is or has been licensed, registered, or certified in a health  
profession or specialty by another state, the United States military, the federal  
government, or another country shall disclose that fact on the application form. The  
applicant shall satisfy the requirements of section 16174(2) of the code, MCL 333.16174,  
including verification from the issuing entity showing that disciplinary proceedings are  
not pending against the applicant and, except as otherwise provided under section  
17511(2) of the code, MCL 333.17511, sanctions are not in force at the time of  
application. If licensure is granted and it is determined that sanctions have been imposed,  
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the disciplinary subcommittee may impose appropriate sanctions under section 16174(5)  
of the code, MCL 333.16174.  
History: 2016 AACS; 2021 AACS; 2023 MR 6, Eff. March 22, 2023.  
R 338.127 Educational limited license.  
Rule 27. (1) An individual not eligible for a doctor of osteopathic medicine and  
surgery license shall obtain an educational limited license before engaging in  
postgraduate training.  
(2) An applicant for an educational limited license shall satisfy the requirements of  
the code and the rules promulgated under the code, as well as all the following  
requirements:  
(a) Provide the required fee and a completed application on a form provided by the  
department.  
(b) Provide proof verifying that the applicant has graduated or is expected to  
graduate within 3 months after the date of the application from an osteopathic medical  
school that satisfies the requirements under R 338.121(1).  
(c) Provide proof verifying that the applicant has been accepted into a postgraduate  
training program that satisfies the requirements under R 338.121(2) or (4).  
(3) Under section 17512(2) of the code, MCL 333.17512, an educational limited  
license may be renewed not more than 5 years.  
History: 2016 AACS; 2021 AACS; 2023 MR 6, Eff. March 22, 2023.  
R 338.129 Examination; adoption; passing scores; limitation on attempts; time  
limitations.  
Rule 29. (1) The COMLEX-USA, developed and administered by the National  
Board of Osteopathic Medical Examiners (NBOME), is approved and adopted, and  
consists of the following levels:  
(a) COMLEX-USA Level 1.  
(b) COMLEX-USA Level 2-Cognitive Evaluation (Level 2-CE).  
(c) COMLEX-USA Level 2-Performance Evaluation (Level 2-PE) or a temporary  
eligibility pathway approved by the NBOME.  
(d) COMLEX-USA Level 3.  
(2) The passing score for each level of the COMLEX-USA accepted for licensure is  
the passing score established by the NBOME.  
(3) An applicant cannot make more than 6 attempts to pass any level of the  
COMLEX-USA.  
(4) An applicant shall successfully pass all levels of the COMLEX-USA within 7  
years after the date that the applicant first passed any level of the COMLEX-USA. An  
applicant may request consideration of a variance of the 7-year requirement by providing,  
at a minimum, proof verifying both of the following requirements to the board:  
(a) That the applicant passed all levels of the COMLEX-USA, but that the time  
taken to pass all levels is more than 7 years.  
(b) That the applicant has completed either of the following activities:  
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(i) Graduation from an accredited graduate degree program in addition to  
osteopathic medical school.  
(ii) Completion of a residency or fellowship program with demonstrated consistent  
participation in the program.  
History: 2016 AACS; 2021 AACS; 2023 MR 6, Eff. March 22, 2023.  
R 338.131 Rescinded.  
History: 2016 AACS; 2021 AACS.  
R 338.133 Relicensure.  
Rule 33. (1) An applicant whose doctor of osteopathic medicine and surgery license  
has lapsed for less than 3 years preceding the date of application for relicensure may be  
relicensed under section 16201(3) of the code, MCL 333.16201, if the applicant satisfies  
the requirements of the code and the rules promulgated under the code, as well as all the  
following requirements:  
(a) Provides the required fee and a completed application on a form provided by the  
department.  
(b) Provides proof verifying the completion of not less than 150 hours of continuing  
education that satisfies the requirements under R 338.141 during the 3 years immediately  
preceding the date of the application for relicensure.  
(c) Establishes good moral character as that term is defined in, and determined  
under, 1974 PA 381, MCL 338.41 to 338.47.  
(d) An applicant who holds or has ever held a license to practice osteopathic  
medicine and surgery shall establish all the following requirements:  
(i) Disciplinary proceedings are not pending against the applicant.  
(ii) If sanctions have been imposed against the applicant, the sanctions are not in  
force when applying.  
(iii) A previously held license was not surrendered or allowed to lapse to avoid  
discipline.  
(2) An applicant whose doctor of osteopathic medicine and surgery license has been  
lapsed for 3 years but less than 5 years may be relicensed under section 16201(4) of the  
code, MCL 333.16201, if the applicant provides fingerprints as set forth in section  
16174(3) of the code, MCL 333.16174, and satisfies the requirements of subrule (1) of  
this rule and 1 of the following requirements:  
(a) Provides proof verifying that the applicant is currently licensed and in good  
standing as a doctor of osteopathic medicine and surgery in another state or in a province  
of Canada.  
(b) Provides proof verifying completion of 1 of the following during the 3 years  
immediately preceding the date of the application for relicensure:  
(i) Successfully passed the Comprehensive Osteopathic Medical Variable-Purpose  
Examination (COMVEX) offered by the NBOME. The passing score is the passing score  
established by the NBOME.  
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(ii) Successfully completed a postgraduate training program that satisfies the  
requirements under R 338.121(2) or (4).  
(iii) Successfully completed a physician re-entry program that is an organizational  
member of the Coalition for Physician Enhancement (CPE).  
(iv) Successfully completed a physician re-entry program affiliated with an  
osteopathic medical school that satisfies the requirements under R 338.121(1).  
(3) An applicant whose doctor of osteopathic medicine and surgery license has been  
lapsed for 5 years or more may be relicensed under section 16201(4) of the code, MCL  
333.16201, if the applicant provides fingerprints as set forth in section 16174(3) of the  
code, MCL 333.16174, and satisfies the requirements of subrule (1) of this rule and 1 of  
the following requirements:  
(a) Provides proof verifying that the applicant is currently licensed and in good  
standing as a doctor of osteopathic medicine and surgery in another state or in a province  
of Canada.  
(b) Provides proof verifying completion of both of the following during the 3 years  
immediately preceding the date of the application for relicensure:  
(i) Successfully passed the COMVEX offered by the NBOME. The passing score  
is the passing score established by the NBOME.  
(ii) Successfully completed 1 of the following training options:  
(A) A postgraduate training program that satisfies the requirements under R  
338.121(2) or (4).  
(B) A physician re-entry program that is an organizational member of the CPE.  
(C) A physician re-entry program affiliated with an osteopathic medical school  
that satisfies the requirements under R 338.121(1).  
(4) If required to complete the requirements of subrule (2)(b) or (3)(b) of this rule,  
the applicant may obtain an educational limited license for the sole purpose of  
completing that training.  
(5) An applicant with an educational limited license may be relicensed under section  
16201(3) or (4) of the code, MCL 333.16201, if the applicant satisfies subrule (1) of this  
rule and R 338.127.  
(6) An applicant that is or has been licensed, registered, or certified in a health  
profession or specialty by another state, the United States military, the federal  
government, or another country shall disclose that fact on the application form. The  
applicant shall satisfy the requirements of section 16174(2) of the code, MCL 333.16174,  
including verification from the issuing entity showing that disciplinary proceedings are  
not pending against the applicant and sanctions are not in force at the time of application.  
If licensure is granted and it is determined that sanctions have been imposed, the  
disciplinary subcommittee may impose appropriate sanctions under section 16174(5) of  
the code, MCL 333.16174.  
History: 2016 AACS; 2021 AACS; 2023 MR 6, Eff. March 22, 2023.  
PART 3. CONTINUING EDUCATION  
R 338.141 License renewals.  
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Rule 41. (1) An applicant for renewal shall satisfy the requirements of the code and  
the rules promulgated under the code.  
(2) An applicant for license renewal who has been licensed in the 3-year period  
immediately preceding the application for renewal shall accumulate a minimum of 150  
hours of continuing education credit in activities approved under R 338.143 during the 3  
years immediately preceding the application for renewal.  
(3) Submission of an application for renewal constitutes the applicant’s certification  
of compliance with the requirements of this rule. The licensee shall maintain  
documentation of satisfying the requirements of this rule for 4 years after the date of  
applying for license renewal. Failure to satisfy this rule is a violation of section 16221(h)  
of the code, MCL 333.16221.  
(4) The department may select and audit a sample of licensees who have renewed  
their license and request proof of compliance with subrule (2) of this rule. If audited, a  
licensee shall provide documentation as specified in R 338.143.  
History: 2016 AACS; 2021 AACS; 2023 MR 6, Eff. March 22, 2023.  
R 338.143 Acceptable continuing education; requirements; limitations.  
Rule 43. (1) The 150 hours of continuing education credits required under R  
338.141 must satisfy the following requirements, as applicable:  
(a) Credit for a continuing education program or activity that is identical or  
substantially equivalent to a program or activity for which the licensee has already earned  
credit during the renewal period cannot be granted.  
(b) A minimum of 1 hour of continuing education credit must be earned in medical  
ethics.  
(c) For license renewals filed December 20, 2017 or later, a minimum of 3 hours of  
continuing education credit must be earned in pain and symptom management under  
section 17533(2) of the code, MCL 333.17533. At least 1 of the 3 hours must include  
controlled substances prescribing. Continuing education hours in pain and symptom  
management may include, but are not limited to, any of the following areas:  
(i) Public health burden of pain.  
(ii) Ethics and health policy related to pain.  
(iii) Michigan pain and controlled substance laws.  
(iv) Pain definitions.  
(v) Basic sciences related to pain including pharmacology.  
(vi) Clinical sciences related to pain.  
(vii) Specific pain conditions.  
(viii) Clinical physician communication related to pain.  
(ix) Management of pain, including evaluation and treatment and non-  
pharmacological and pharmacological management.  
(x) Ensuring quality pain care and controlled substances prescribing.  
(xi) Michigan programs and resources relevant to pain.  
(d) A minimum of 60 continuing education credits must be obtained through  
category 1 programs listed in subrule (2) of this rule.  
(2) The board considers any of the following activities as acceptable category 1  
continuing education:  
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Activity and Proof of Completion  
Number of Continuing Education  
Hours Granted/Allowed for the  
Activity  
(a)  
Attendance at or participating in a  
continuing education program or  
activity related to the practice of  
The number of continuing  
education hours for a specific  
program or activity is the number of  
osteopathic medicine, including, but is hours assigned by the sponsoring  
not limited to, live, in-person programs, organization for the specific program  
journal articles with a self-study  
component, interactive or monitored  
teleconferences, audio conferences,  
web-based programs, or online  
programs approved or offered by any  
of the following organizations:  
or activity. A minimum of 40 hours  
of continuing education credit must be  
earned in this activity. A maximum  
of 150 hours of continuing education  
credit may be earned for this activity  
in each renewal period.  
- American Osteopathic  
Association.  
- Michigan Osteopathic  
Association.  
If audited, a licensee shall provide a  
copy of a letter or certificate of  
completion showing the licensee’s  
name, number of credits earned,  
sponsor name or the name of the  
organization that approved the program  
or activity for continuing education  
credit, and the date or dates on which  
the program or activity was completed.  
Attendance at or participating in a  
continuing education program or  
activity related to the practice of  
(b)  
The number of continuing  
education hours for a specific  
program or activity is the number of  
osteopathic medicine including, but not hours assigned by the sponsoring  
limited to, live, in-person programs,  
journal articles with a self-study  
component, interactive or monitored  
teleconferences, audio conferences,  
web-based programs, or online  
organization for the specific program  
or activity. A maximum of 110 hours  
of continuing education credit may be  
earned for this activity in a renewal  
period.  
programs approved or offered by any  
of the following organizations:  
- American Medical Association.  
- Accreditation Council for  
Continuing Medical Education.  
- Michigan State Medical Society.  
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If audited, the licensee shall  
provide a copy of a letter or certificate  
of completion showing the licensee’s  
name, number of credits earned,  
sponsor name or the name of the  
organization that approved the program  
or activity for continuing education  
credit, and the date or dates on which  
the program or activity was completed.  
Taking and passing a specialty  
(c)  
A specialty board certification or  
recertification examination  
successfully passed during the  
renewal period is granted 50 hours of  
board certification or recertification  
examination for a specialty board  
recognized by the American  
Osteopathic Association, the American continuing education credit. A  
Board of Medical Specialties, or the  
American Board of Physician  
Specialties.  
maximum of 50 hours of continuing  
education credit may be earned for  
this activity in each renewal period.  
If audited, the licensee shall  
provide proof from the specialty board  
of the successful passing of the  
examination.  
(d)  
Successfully completing an activity  
that is required for maintenance of a  
specialty certification for a specialty  
board recognized by the American  
One hour of continuing education  
credit is granted for every 60 minutes  
spent on the activity. A maximum of  
30 hours of continuing education  
Osteopathic Association, the American credit may be earned for this activity  
Board of Medical Specialties, or the  
American Board of Physician  
Specialties that does not satisfy the  
requirements of subdivision (a) or (b)  
of this subrule.  
in each renewal period.  
If audited, the licensee shall  
provide proof from the specialty board  
that the activity was required for  
maintenance of certification, that the  
activity was successfully completed,  
and the date of completion.  
(e)  
Serving as a teacher, lecturer,  
Two hours of continuing  
preceptor, or moderator-participant in a education credit is granted for each  
medical education or training program  
that satisfies the standards adopted  
under R 338.121.  
scheduled lecture or clinical  
consultation. Additional credit for  
preparation of the lecture cannot be  
granted. A maximum of 90 hours of  
continuing education credit may be  
If audited, the licensee shall  
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provide a letter from the program  
director verifying the licensee’s role,  
length of lecture or lectures, and the  
date on which the lecture or lectures  
were held.  
earned for this activity in each  
renewal period.  
(f)  
Conducting a formal inspection of  
an osteopathic medical education or  
training program that satisfies the  
standards adopted under R 338.121 or  
conducting clinical examinations of  
Five hours of continuing  
education credit is granted per  
inspection. A maximum of 90 hours  
of continuing education credit may be  
earned for this activity in each  
osteopathic specialty boards recognized renewal period.  
by the American Osteopathic  
Association.  
If audited, the licensee shall  
provide documentation from the  
accrediting organization verifying the  
licensee’s role and participation in the  
inspection.  
(g)  
Participating in any of the  
following committees:  
Fifteen hours for each committee  
per year is granted. A maximum of  
90 hours of continuing education  
- A peer-review committee dealing credit may be earned for this activity  
with quality patient care as it relates to in each renewal period.  
the practice of osteopathic medicine  
and surgery.  
- A committee dealing with  
utilization review as it relates to the  
practice of osteopathic medicine.  
- A health care organization  
committee with patient care issues  
related to the practice of osteopathic  
medicine.  
- A national or state committee,  
board, council, or association related to  
the practice of osteopathic medicine.  
A committee, board, council, or  
association is considered acceptable  
under these rules if it enhances the  
participant’s knowledge and  
understanding of the practice of  
osteopathic medicine. If audited, the  
licensee shall provide a letter from an  
organization official verifying the  
licensee’s participation in not less than  
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50% of the regularly scheduled  
meetings.  
(h)  
Providing individual supervision  
for a disciplinary limited doctor of  
osteopathic medicine and surgery.  
One hour of continuing education  
credit is granted for each 60 minutes  
spent consulting or reviewing the  
disciplined licensee’s work. A  
If audited, the licensee shall  
provide an affidavit from the  
disciplinary limited doctor of  
maximum of 50 hours of continuing  
education credit may be earned for  
this activity per renewal period.  
osteopathic medicine and surgery who  
received the supervision. The affidavit  
must attest to the licensee’s role as  
supervisor and the number of hours  
spent providing supervision to the  
disciplinary limited doctor of  
osteopathic medicine and surgery.  
Participating in a postgraduate  
training program that satisfies the  
requirements under R 338.121(2) or  
(4). To receive credit the licensee shall earned for this activity in each  
enroll in the program a minimum of 5  
months per year.  
(i)  
(j)  
(k)  
Fifty continuing education credits  
per year are granted. A maximum of  
150 credits per renewal period may be  
renewal period.  
If audited, the licensee shall  
provide a letter from the program  
director verifying the dates that the  
licensee was enrolled in the program.  
Publication of a scientific article  
relating to the practice of osteopathic  
Ten hours of continuing education  
credit is granted for serving as the  
medicine in a peer-reviewed journal or primary author. Five hours of  
periodical.  
continuing education credit is granted  
for serving as a secondary author.  
Under subrule (1)(a) of this rule,  
credit for an article is granted only  
If audited, the licensee shall  
provide a copy of the publication that  
identifies the licensee as the author or a once per renewal period. A maximum  
publication acceptance letter and  
documentation  
of 90 hours of continuing education  
credit may be earned for this activity  
in a renewal period.  
Ten hours of continuing education  
credit is granted for serving as the  
primary author. Five hours of  
continuing education credit is granted  
for serving as a secondary author. A  
maximum of 90 hours of continuing  
education credit may be earned for  
this activity in each renewal period.  
Initial publication of a chapter or a  
portion of a chapter related to the  
practice of osteopathic medicine in  
either of the following textbooks:  
- A professional health care  
textbook.  
- A peer-reviewed textbook.  
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Under subrule (1)(a) of this rule,  
credit for publication is granted once  
per renewal period.  
If audited, the licensee shall  
provide a copy of the publication that  
identifies the licensee as the author or a  
publication acceptance letter.  
(3) The board considers initial presentation of a scientific exhibit, poster, or paper to  
a professional osteopathic medicine organization as acceptable category 2 continuing  
education. Ten hours of continuing education credit is granted for each presentation. No  
additional credit is granted for preparation of the presentation. A maximum of 90 hours  
of continuing education credit may be earned for this activity in each renewal period.  
Under subrule (1)(a) of this rule, credit for a presentation is granted once per renewal  
period. If audited, the licensee shall provide a copy of the document presented with proof  
of the presentation or a letter from the program sponsor verifying the date of presentation.  
History: 2016 AACS; 2021 AACS; 2023 MR 6, Eff. March 22, 2023.  
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