DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS  
DIRECTOR'S OFFICE  
MEDICINE - GENERAL RULES  
(By authority conferred on the director of the department of licensing and regulatory  
affairs by sections 16145, 16148, 16174, 16204, 16215, 16287, 17031, 17033, 17048, and  
17076 of the public health code, 1978 PA 368, MCL 333.16145, 333.16148, 333.16174,  
333.16204, 333.16215, 333.16287, 333.17031, 333.17033, 333.17048, and 333.17076,  
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 338.2401 Definitions.  
Rule 101. (1) As used in these rules:  
(a) “Board” means the Michigan board of medicine created under section 17021 of the  
code, MCL 333.17021.  
(b) “CK” means clinical knowledge.  
(c) “Code” means the public health code, 1978 PA 368, MCL 333.1101 to 333.25211.  
(d) “Department” means the department of licensing and regulatory affairs.  
(e) “ECFMG” means the Educational Commission for Foreign Medical Graduates.  
(f) “FSMB” means the Federation of State Medical Boards.  
(g) “USMLE” means the United States Medical Licensing Examination.  
(2) A term defined in the code has the same meaning when used in these rules.  
History: 2016 AACS; 2021 AACS; 2023 MR 6, Eff. March 22, 2023.  
R 338.2403 Rescinded.  
History: 2016 AACS; 2021 AACS.  
R 338.2405 Rescinded.  
History: 2016 AACS; 2021 AACS.  
R 338.2407 Telehealth.  
Rule 107. (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 keep 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.  
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(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) If medically necessary, refers the patient to a provider who is geographically  
accessible to the patient.  
(b) Makes the licensee 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 a telehealth service shall do both of the following:  
(a) Act within the scope of the licensee’s 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 338.2409 Prescribing of drugs by physician’s assistants; procedures and  
protocols.  
Rule 109. (1) Under sections 17048(2) and 17076(2) of the code, MCL 333.17048 and  
333.17076, 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 Drug Enforcement Agency (DEA) registration number must be  
used, recorded, or otherwise indicated in connection with that prescription.  
(2) Under sections 17048(2) and 17076(3) of the code, MCL 333.17048 and 333.17076,  
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 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  
number must be used, recorded, or otherwise indicated in connection with that order,  
receipt, or dispensing.  
History: 2016 AACS; 2021 AACS.  
R 338.2411 Delegation of prescribing controlled substances to an advanced practice  
registered nurse; limitation.  
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Rule 111. (1) A physician may delegate the prescription of controlled substances listed  
in schedules 2 to 5 to a registered nurse who holds a 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 from 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 keep 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), (2), (3), and (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 338.2413 Training standards for identifying victims of human trafficking;  
requirements.  
Rule 113. (1) Under section 16148 of the code, MCL 333.16148, an individual seeking  
licensure or who 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 this state or 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.  
(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 for initial  
licensure, or by a college or university.  
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(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  
review 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 a sample of individuals and request  
documentation of proof of completion of training. If audited by the department, an  
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 an 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 article,  
author, publication name of peer review journal, health care journal, or professional or  
scientific journal, and 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 licensure beginning December 6, 2021.  
History: 2016 AACS; 2021 AACS; 2023 MR 6, Eff. March 22, 2023.  
PART 2. LICENSES  
R 338.2421 Accreditation standards for approval of medical schools and medical  
residency programs.  
Rule 121. (1) The standards for accrediting medical schools developed and adopted by  
the Liaison Committee on Medical Education, 655 K Street NW, Suite 100, Washington,  
District of Columbia 20001-2399, set forth in the publication entitled “Functions and  
Structure of a Medical School,” March 2021 edition, which are available at no cost on the  
committee’s website at https://lcme.org are approved and adopted by reference. A  
medical school accredited by the Liaison Committee on Medical Education is approved.  
(2) The standards for approval of a postgraduate training program developed and  
adopted by the Accreditation Council for Graduate Medical Education, 401 N. 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. A medical postgraduate training program accredited by the Accreditation  
Council for Graduate Medical Education is approved.  
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(3) The standards for approval of a resident training program by the College of Family  
Physicians of Canada, 2630 Skymark Avenue, Mississauga, Ontario, Canada L4W 5A4,  
set forth in the publication entitled “Standards of Accreditation for Residency Programs  
in Family Medicine,” July 2020 version, which are available at no cost on the college’s  
website at https://www.cfpc.ca/en/home are approved and adopted by reference. A  
residency program accredited by the College of Family Physicians of Canada is  
approved.  
(4) The standards for approval of a resident training program by the Royal College of  
Physicians and Surgeons of Canada, 774 Echo Drive, Ottawa, Ontario, Canada K1S 5N8,  
set forth in the publication entitled “General Standards of Accreditation for Residency  
Programs,” July 2020 edition, which are available at no cost on the college’s website at  
https://www.royalcollege.ca/rcsite/home-e are approved and adopted by reference. A  
residency program accredited by the Royal College of Physicians and Surgeons is  
approved.  
(5) Copies of the standards adopted by reference in subrules (1), (2), (3), and (4) of this  
rule are available for inspection and distribution at a cost of 10 cents per page from the  
Board of Medicine, Bureau of Professional Licensing, Department of Licensing and  
Regulatory Affairs, 611 W. Ottawa, P.O. Box 30670, Lansing, Michigan 48909.  
History: 2016 AACS; 2021 AACS; 2023 MR 6, Eff. March 22, 2023.  
R 338.2423 Doctor of medicine; license requirements; United States and Canadian  
graduates.  
Rule 123. An applicant for a doctor of medicine license who graduated from a medical  
school inside the United States or Canada shall satisfy the requirements of the code and  
the administrative 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 medical school that satisfies  
the standards under R 338.2421(1).  
(c) Provide proof verifying passing scores on all steps of the USMLE adopted under R  
338.2431 and proof verifying satisfaction of all the requirements under R 338.2431.  
(d) Provide proof verifying completion of a minimum of 1 year of postgraduate clinical  
training in a program that satisfies the requirements under R 338.2421(2), (3), or (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 338.2425 Doctor of medicine; license requirements; foreign graduates.  
Rule 125. An applicant for a doctor of medicine license who graduated from a medical  
school outside the United States or Canada shall satisfy the requirements of the code and  
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the administrative 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 certification from the ECFMG that the applicant has  
graduated from a medical school listed in the World Directory of Medical Schools.  
(c) Provide proof verifying passing scores on all steps of the USMLE adopted under R  
338.2431 and proof verifying satisfaction of all the requirements under R 338.2431.  
(d) Provide proof verifying completion of a minimum of 1 year of postgraduate clinical  
training in a program that satisfies the requirements under R 338.2421(2), (3), or (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 338.2427 Licensure by endorsement.  
Rule 127. (1) An applicant for a doctor of medicine license by endorsement shall satisfy  
the requirements of the code and the administrative 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 a current and full doctor of medicine license in another state  
or in a province of Canada.  
(c) If the applicant is licensed as a doctor of medicine in a province in Canada, provide  
proof verifying that the applicant completed the educational requirements in Canada or in  
the United States for licensure as a doctor of medicine in Canada or in the United States.  
(d) Provide proof verifying passing scores on either of the following examinations for a  
doctor of medicine license in another state or in a province of Canada to obtain licensure  
as a doctor of medicine in another state or in a province of Canada:  
(i) All steps of the USMLE adopted under R 338.2431 and provide proof verifying  
satisfaction of all the requirements under R 338.2431.  
(ii) Part I of the Medical Council of Canada Qualifying Examination (MCCQE).  
(e) Provide proof verifying completion of a minimum of 1 year of postgraduate clinical  
training in a program that satisfies the requirements under R 338.2421(2), (3), or (4).  
(2) An applicant who provides proof verifying a current and full license in good  
standing as a doctor of medicine in another state or in a province of Canada for not less  
than 10 years before the date of filing the application for a doctor of medicine license by  
endorsement is presumed to satisfy the requirements of subrule (1)(c), (d), and (e) of this  
rule.  
(3) An applicant who 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  
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17011(4) of the code, MCL 333.17011, sanctions are not in force when the application is  
submitted. 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.  
R 338.2429 Educational limited license.  
Rule 129. (1) An individual not eligible for a doctor of medicine license shall obtain an  
educational limited license before engaging in postgraduate training.  
(2) An applicant for an educational limited license who is from a medical school inside  
the United States or Canada shall satisfy the requirements of the code and the  
administrative 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 of the date of the application from a medical school that satisfies the  
requirements under R 338.2421(1).  
(c) Provide proof verifying that the applicant has been accepted into a postgraduate  
training program that satisfies the requirements under R 338.2421(2).  
(3) An applicant for an educational limited license who is from a medical school outside  
the United States or Canada shall satisfy the requirements of the code and the  
administrative 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 certification from the ECFMG and that the applicant has  
satisfied both of the following requirements:  
(i) Graduated from a medical school listed in the World Directory of Medical Schools.  
(ii) Received passing scores on step 1 and step 2 CK of the USMLE adopted under R  
338.2431.  
(c) Provide proof verifying that the applicant has been accepted into a postgraduate  
training program that satisfies the requirements under R 338.2421(2).  
(4) Under section 17012(2) of the code, MCL 333.17012, an educational limited license  
is not renewable for more than 5 years.  
History: 2016 AACS; 2021 AACS; 2023 MR 6, Eff. March 22, 2023.  
R 338.2431 Examination; adoption; passing scores; limitation on attempts; time  
limitations.  
Rule 131. (1) The USMLE, developed and administered by the FSMB, is approved and  
adopted, which consists of the following steps:  
(a) USMLE Step 1.  
(b) USMLE Step 2 CK.  
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(c) USMLE Step 3.  
(2) The passing score for each step of the USMLE accepted for licensure is the passing  
score established by the FSMB.  
(3) An applicant shall not make more than 4 attempts to pass any step of the USMLE.  
(4) An applicant shall successfully pass all steps of the USMLE within 7 years after the  
date that the applicant first passed a step of the USMLE. 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 has already passed all steps of the USMLE, but that the time  
taken to pass all steps is more than 7 years.  
(b) That the applicant has completed either of the following activities:  
(i) Graduation from an accredited graduate degree program in addition to 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 338.2433 Rescinded.  
History: 2016 AACS; 2021 AACS.  
R 338.2435 Clinical academic limited license.  
Rule 135. An applicant for a clinical academic limited license shall satisfy the  
requirements of the code and the administrative 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 been appointed to a position in an  
academic institution, as that term is defined in section 17001 of the code, MCL  
333.17001.  
(c) Provide proof verifying 1 of the following:  
(i) The applicant has graduated from a medical school that satisfies the requirements  
under R 338.2421(1).  
(ii) Certification from the ECFMG that the applicant has satisfied both of the  
following requirements:  
(A) Graduated from a medical school listed in the World Directory of Medical  
Schools.  
(B) Received passing scores on step 1 and step 2 CK of the USMLE adopted under R  
338.2431.  
History: 2016 AACS; 2021 AACS; 2023 MR 6, Eff. March 22, 2023.  
R 338.2437 Relicensure.  
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Rule 137. (1) An applicant whose doctor of medicine 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 administrative 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 of R 338.2443 during the 3 years immediately  
preceding the date of the application for relicensure.  
(c) Establishes good moral character, as that term is defined 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 medicine 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 the application is submitted.  
(iii) A previously held license was not surrendered or allowed to lapse to avoid  
discipline.  
(2) An applicant whose doctor of medicine 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 either of the  
following requirements:  
(a) Provides proof verifying that the applicant is currently licensed and in good standing  
as a doctor of medicine 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 Special Purpose Examination (SPEX) offered by the  
FSMB. The passing score is the passing score established by the FSMB.  
(ii) Successfully completed a postgraduate training program that satisfies the  
requirements under R 338.2421(2), (3), 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 a medical  
school that satisfies the requirements under R 338.2421(1).  
(3) An applicant whose doctor of medicine 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 either of the following  
requirements:  
(a) Provides proof verifying that the applicant is currently licensed and in good standing  
as a doctor of medicine 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:  
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(i) Successfully passed the SPEX offered by the FSMB. The passing score is the  
passing score established by the FSMB.  
(ii) Successfully completed 1 of the following training options:  
(A) A postgraduate training program that satisfies the requirements under R  
338.2421(2), (3), or (4).  
(B) A physician re-entry program that is an organizational member of the CPE.  
(C) A physician re-entry program affiliated with a medical school that satisfies the  
requirements under R 338.2421(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 338.2429.  
(6) An applicant who 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,  
which includes verification from the issuing entity showing that disciplinary proceedings  
are not pending against the applicant and sanctions are not in force when the application  
is submitted. 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 338.2441 License renewals.  
Rule 141. (1) An applicant for renewal shall satisfy the requirements of the code and  
the administrative 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 in activities approved under R 338.2443 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 keep 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 338.2443.  
History: 2016 AACS; 2021 AACS; 2023 MR 6, Eff. March 22, 2023.  
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R 338.2443 Acceptable continuing education; requirements; limitations.  
Rule 143. (1) The 150 hours of continuing education required under R 338.2441 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 must be earned in medical ethics.  
(c) For license renewals filed on December 6, 2017, or later, a minimum of 3 hours of  
continuing education must be earned in pain and symptom management under section  
17033(2) of the code, MCL 333.17033. 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 75 continuing education credits must be obtained through category 1  
programs listed in subrule (2) of this rule.  
(2) The following activities are acceptable category 1 continuing education:  
Activity and Proof of Completion  
Number of Continuing Education Hours  
granted/permitted for the activity  
(a) Attendance at or participation in a The number of continuing education  
continuing education program or hours for a specific program or activity is  
activity related to the practice of the number of hours approved by the  
medicine, which includes, but is not sponsor or the approving organization for  
limited to, live, in-person programs, the specific program. A maximum of  
interactive or monitored teleconference, 150 hours of continuing education may  
audio-conference,  
or  
web-based be earned for this activity during the  
programs, online programs, and journal renewal period.  
articles with a self-study component or  
other self-study programs approved or  
offered by any of the following  
organizations:  
- American Medical Association  
- Michigan State Medical Society  
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- Accreditation Council for Continuing  
Medical Education  
- American Osteopathic Association  
- Michigan Osteopathic Association  
If audited, the licensee must provide a  
copy of the letter or certificate of  
completion showing the licensee’s  
name, number of continuing education  
hours earned, sponsor name or the  
name of the organization that approved  
the program or activity for continuing  
education credit, and the date on which  
the program was held or the activity  
completed.  
(b) Taking and passing a specialty board A specialty board certification or  
certification  
or  
recertification recertification examination successfully  
examination for a specialty board passed during the renewal period is  
recognized by the American Board of granted 50 hours of continuing education.  
Medical Specialties, the American A maximum of 50 hours of continuing  
Board of Physician Specialties, or the education may be earned for this activity  
National Board of Physicians and in each renewal period.  
Surgeons.  
If audited, the licensee shall provide  
proof from the specialty board of the  
successful passing of the examination.  
(c) Successfully completing an activity that One hour of continuing education is  
is required for maintenance of a granted for every 60 minutes spent on the  
specialty certification for a board activity. A maximum of 30 hours may be  
recognized by the American Board of earned for this activity in each renewal  
Medical Specialties, the American period.  
Board of Physician Specialties, or the  
National Board of Physicians and  
Surgeons that does not satisfy the  
requirements of subrule 2(a) or 2(b) of  
this rule.  
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.  
(d) Participation in a clinical training Fifty hours of continuing education per  
program that satisfies any of the year may be granted for this activity. A  
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requirements of R 338.2421(2), (3), or maximum of 150 hours of continuing  
(4) or is accredited by a board education may be earned per renewal  
recognized by the American Board of period.  
Medical Specialties, the American  
Board of Physician Specialties, or the  
National Board of Physicians and  
Surgeons.  
To receive credit, the  
licensee shall be enrolled for a  
minimum of 5 months in a 12-month  
period.  
If audited, the licensee shall provide a  
letter from the program director  
verifying the licensee took part in the  
program.  
(3) The following activities are acceptable category 2 continuing education:  
Activity and Proof of Completion  
Number of Continuing Education Hours  
granted/permitted for the activity  
(a) Serving as a clinical instructor for Two hours of continuing education is  
medical students or residents engaged granted for each 50 to 60 minutes of  
in a postgraduate training program that scheduled instruction. Additional credit  
satisfies  
338.2421(2), (3), or (4).  
requirements  
of  
R for preparation of a lecture cannot be  
granted. A maximum of 48 hours of  
continuing education may be earned for  
To receive credit, the clinical this activity in each renewal period.  
instructorship must not be the  
licensee’s  
function.  
primary  
employment  
If audited, the licensee shall provide  
proof of scheduled instructional hours  
and a letter from the program director  
verifying the licensee’s role.  
(b) Initial presentation of a scientific Two hours of continuing education is  
exhibit, poster, or paper to a granted for each presentation.  
professional medical organization. additional credit is granted for  
preparation of the presentation.  
No  
A
If audited, the licensee shall provide a maximum of 24 hours of continuing  
copy of the document presented with education may be earned in this activity  
proof of presentation or a letter from in each renewal period.  
the program sponsor verifying the date 338.2443(1)(a), credit for a presentation  
of the presentation. is granted only once per renewal period.  
Under R  
(c) Publication of a scientific article Six hours of continuing education is  
relating to the practice of medicine in a granted for serving as the primary author.  
peer-reviewed journal or periodical.  
Three hours of continuing education is  
granted for serving as a secondary author.  
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If audited, the licensee shall provide a A maximum of 24 hours of continuing  
copy of the publication that identifies education may be earned for this activity  
the licensee as the author or a in each renewal period.  
Under R  
publication acceptance letter and 338.2443(1)(a), credit for an article is  
documentation of the peer-review granted once per renewal period.  
process.  
(d) Initial publication of a chapter or a part Five hours of continuing education is  
of a chapter related to the practice of granted for serving as the primary author.  
medicine in either of the following Two hours of continuing education is  
textbooks:  
granted for serving as a secondary author.  
A maximum of 24 hours of continuing  
education may be earned for this activity  
- A professional health care textbook.  
- A peer-reviewed textbook.  
in each renewal period.  
Under R  
338.2443(1)(a), credit for publication is  
If audited, the licensee shall provide a granted once per renewal period.  
copy of the publication that identifies  
the licensee as the author or a  
publication acceptance letter.  
(e) Participating on any of the following Eighteen hours of continuing education is  
committees:  
granted for taking part on a committee.  
A maximum of 18 hours of continuing  
- A peer review committee dealing with education may be earned for this activity  
quality of patient care as it relates to the in each renewal period.  
practice of medicine.  
- A committee dealing with utilization  
review as it relates to the practice of  
medicine.  
- A health care organization committee  
dealing with patient care issues related  
to the practice of medicine.  
- A national or state committee, board,  
council, or association related to the  
practice of medicine.  
Participation in a committee, board,  
council, or association is considered  
acceptable if it enhances the  
participant’s  
knowledge  
and  
understanding of the field of medicine.  
If audited, the licensee shall provide a  
letter from an organization official  
verifying the licensee’s participation in  
not less than 50% of the regularly  
scheduled meetings of the committee,  
board, council, or association.  
History: 2016 AACS; 2021 AACS; 2023 MR 6, Eff. March 22, 2023.  
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