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 AACS.  
R 338.2403 Rescinded.  
History: 2016 AACS; 2021 AACS.  
R 338.2405 Rescinded.  
History: 2016 AACS; 2021 AACS.  
R 338.2407 Telehealth.  
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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 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 who is geographically accessible to the  
patient, if medically necessary.  
(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 any 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  
healthcare service.  
History: 2021 AACS; 2023 AACS; 2024 AACS.  
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.  
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R 338.2411 Delegation of prescribing controlled substances to an advanced  
practice registered nurse; limitation.  
Rule 111. (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 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.  
History: 2016 AACS; 2021 AACS; 2023 AACS; 2024 AACS.  
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 have completed training in identifying  
victims of human trafficking that satisfies the following standards:  
(a) Training content must cover all the following:  
(a) Understanding the types and venues of human trafficking in this state or the  
United States.  
(ii) Identifying victims of human trafficking in healthcare settings.  
(iii) Identifying the warning signs of human trafficking in healthcare 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:  
(it) 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.  
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(iii) Training obtained in an educational program that has been approved 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, healthcare 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-reviewed journal, healthcare journal,  
or professional or scientific journal, and the date, volume, and issue of publication,  
as applicable.  
History: 2016 AACS; 2021 AACS; 2023 AACS; 2024 AACS.  
PART 2. LICENSES  
R 338.2421 Accreditation standards for approval of medical schools and  
postgraduate training programs; adoption by reference.  
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 titled  
“Functions and Structure of a Medical School,” effective July 1, 2025, 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 accrediting medical schools developed and adopted by the  
Committee on Accreditation of Canadian Medical Schools, 10th FLR – 150 Elgin  
Street, Ottawa, ON K2P 1L4, set forth in the publication titled “CACMS Standards  
and Elements,” effective July 1, 2022, which are available at no cost on the  
committee’s website at https://cacms-cafmc.ca/, are approved and adopted by  
reference. A medical school accredited by the Committee on Accreditation of  
Canadian Medical Schools is approved.  
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(3) 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  
titled “ACGME Common Program Requirements,” effective July 1, 2023, 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.  
(4) 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 titled “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.  
(5) 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 titled “General Standards of Accreditation for  
Residency Programs,” July 2020 edition, which are available at no cost on the  
college’s website at https://royalcollege.ca/en, are approved and adopted by  
reference. A residency program accredited by the Royal College of Physicians  
and Surgeons is approved.  
(6) Copies of the standards adopted by reference in subrules (1) to (5) of this rule  
are available for inspection and distribution at a cost of 25 cents per page from the  
Board of Medicine, 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 AACS; 2024 AACS; 2026 MR 6, Eff. March 19, 2026.  
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, the rules promulgated under the code, and all the following  
requirements:  
(a) Provide the required fee and a completed application on a form provided by  
the department.  
(b) Provide proof, as directed by the department, verifying completion of a degree  
from a medical school that satisfies the standards under R 338.2421(1) or (2).  
(c) Provide proof, as directed by the department, verifying passing scores on all  
steps of the USMLE adopted under R 338.2431 and verifying satisfaction of all the  
requirements under R 338.2431.  
(d) Provide proof, as directed by the department, verifying completion of a  
minimum of 1 year of postgraduate clinical training in a program that satisfies the  
requirements under R 338.2421(3), (4), or (5).  
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(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 AACS; 2024 AACS; 2026 MR 6, Eff. March 19, 2026.  
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, the rules promulgated under the code, and all the following  
requirements:  
(a) Provide the required fee and a completed application on a form provided by  
the department.  
(b) Provide proof, as directed by the department, 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, as directed by the department, verifying passing scores on all  
steps of the USMLE adopted under R 338.2431 and verifying satisfaction of all the  
requirements under R 338.2431.  
(d) Provide proof, as directed by the department, verifying completion of a  
minimum of 1 year of postgraduate clinical training in a program that satisfies the  
requirements under R 338.2421(3), (4), or (5).  
(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 AACS; 2024 AACS; 2026 MR 6, Eff. March 19, 2026.  
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, the rules promulgated under the code, and  
all the following requirements:  
(a) Provide the required fee and a completed application on a form provided by  
the department.  
(b) Provide proof, as directed by the department, verifying a current and full  
doctor of medicine license in another state or province of Canada.  
(c) If the applicant is licensed as a doctor of medicine in a province in Canada,  
provide proof, as directed by the department, 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, as directed by the department, verifying passing scores on  
either of the following examinations for a doctor of medicine license in another  
state or province of Canada to obtain licensure as a doctor of medicine in another  
state or in a province of Canada:  
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(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.  
(e) Provide proof, as directed by the department, verifying completion of a  
minimum of 1 year of postgraduate clinical training in a program that satisfies the  
requirements under R 338.2421(3), (4), or (5).  
(2) An applicant who provides proof, as directed by the department, verifying a  
current and full license in good standing as a doctor of medicine in another state  
or 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 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 AACS; 2024 AACS; 2026 MR 6, Eff. March 19, 2026.  
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, the  
rules promulgated under the code, and all the following requirements:  
(a) Provide the required fee and a completed application on a form provided by  
the department.  
(b) Provide proof, as directed by the department, verifying that the applicant has  
graduated or is expected to graduate within 3 months after the date of the  
application from a medical school that satisfies the requirements under R  
338.2421(1).  
(c) Provide proof, as directed by the department, 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, the  
rules promulgated under the code, and all the following requirements:  
(a) Provide the required fee and a completed application on a form provided by  
the department.  
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(b) Provide proof, as directed by the department, 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, as directed by the department, 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 renewable for not more than 5 years.  
History: 2016 AACS; 2021 AACS; 2023 AACS; 2024 AACS; 2026 MR 6, Eff. March 19, 2026.  
R 338.2431 Examination; adoption; passing scores; limitation on attempts.  
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.  
(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.  
History: 2016 AACS; 2021 AACS; 2023 AACS; 2024 AACS.  
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, the rules promulgated under the code, and all the  
following requirements:  
(a) Provide the required fee and a completed application on a form provided by  
the department.  
(b) Provide proof, as directed by the department, verifying that the applicant has  
been appointed to a position in an academic institution.  
(c) Provide proof, as directed by the department, verifying 1 of the following:  
(i) The applicant has graduated from a medical school that satisfies the  
requirements under R 338.2421(1) or (2).  
(ii) Certification from the ECFMG that the applicant has satisfied both of the  
following requirements:  
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(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 AACS; 2026 MR 6, Eff. March 19, 2026.  
R 338.2437 Relicensure.  
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, the rules promulgated under the code, and all the  
following requirements:  
(a) Provides the required fee and a completed application on a form provided by  
the department.  
(b) Provides proof, as directed by the department, 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 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 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, as directed by the department, verifying that the applicant is  
currently licensed and in good standing as a doctor of medicine in another state or  
a province of Canada.  
(b) Provides proof, as directed by the department, 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(3), (4), or (5).  
(iii) Successfully completed a physician re-entry program that is an  
organizational member of the Coalition for Physician Enhancement (CPE) or a  
physician re-entry program affiliated with a medical school that satisfies the  
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requirements under R 338.2421(1) or (2). Proof of successful completion includes  
a certificate or letter of completion from the physician re-entry program that says  
that the applicant is competent and safe to practice, with no limitations or  
restrictions.  
(3) An applicant whose doctor of medicine license has 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, as directed by the department, verifying that the applicant is  
currently licensed and in good standing as a doctor of medicine in another state or  
a province of Canada.  
(b) Provides proof, as directed by the department, verifying completion of both  
of the following during the 3 years immediately preceding the date of the  
application for relicensure:  
(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(3), (4), or (5).  
(B) A physician re-entry program that is an organizational member of the CPE  
or a physician re-entry program affiliated with a medical school that satisfies the  
requirements under R 338.2421(1) or (2). Proof of successful completion includes  
a certificate or letter of completion from the physician re-entry program that says  
that the applicant is competent and safe to practice, with no limitations or  
restrictions.  
(4) If required to complete the requirements of subrule (2)(b)(ii) or (iii) or  
(3)(b)(ii)(A) or (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 the requirements under 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, including 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 AACS; 2024 AACS; 2026 MR 6, Eff. March 19, 2026.  
PART 3. CONTINUING EDUCATION  
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R 338.2441 License renewals.  
Rule 141. (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 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  
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, the licensee shall provide documentation as specified in R 338.2443.  
(5) An applicant must submit a request for a waiver of continuing education  
requirements to the department for the board’s consideration not less than 30 days  
before the last regularly scheduled board meeting before the expiration date of the  
license.  
History: 2016 AACS; 2021 AACS; 2023 AACS; 2024 AACS.  
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) 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.  
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(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.  
(e) Completion of implicit bias training under R 338.7004 during the 3 years  
immediately preceding the application for renewal may be used toward satisfaction  
of the requirements of R 338.2441(2) and subrule (1) of this rule.  
(2) The following activities are acceptable category 1 continuing education:  
Activity and Proof of Completion  
Number of Continuing Education  
Hours granted/allowed 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 related to the practice of activity is the number of hours  
medicine, including, but not limited approved by the sponsor or the  
to, live, in-person programs, approving organization for the  
interactive  
or  
monitored specific program. A maximum of 150  
teleconference, audio-conference, continuing education hours may be  
or web-based programs, online earned for this activity during the  
programs, and journal articles with renewal period.  
a self-study component or other  
self-study programs approved or  
offered by any of the following  
organizations:  
-
Accreditation  
Council  
for  
Continuing Medical Education  
(ACCME) including non-ACCME  
accredited providers engaging in  
joint providership with ACCME  
accredited providers.  
- American Academy of Family  
Physicians.  
- American Medical Association.  
-
American  
Osteopathic  
Osteopathic  
Association.  
-
Michigan  
Association.  
- Michigan State Medical Society.  
If audited, the licensee shall 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  
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program or activity for continuing  
education credit, and the date the  
program was held or the activity  
completed.  
(b) Taking and passing a specialty Fifty continuing education hours are  
board certification or recertification granted for successfully passing a  
examination for a specialty board specialty board certification or  
recognized by the American Board recertification examination during the  
of  
Medical  
Specialties,  
the renewal period. A maximum of 50  
American Board of Physician continuing education hours may be  
Specialties, or the National Board of earned for this activity in each  
Physicians and Surgeons.  
renewal period.  
If audited, the licensee shall provide  
proof from the specialty board of the  
successful  
passing  
of  
the  
examination.  
(c) Successfully completing an activity One continuing education hour is  
that is required for maintenance of granted for every 60 minutes spent  
a specialty certification for a board on the activity. A maximum of 30  
recognized by the American Board continuing education hours may be  
of  
Medical  
Specialties,  
the earned for this activity in each  
American Board of Physician renewal period.  
Specialties, or the National Board of  
Physicians and Surgeons that does  
not satisfy the requirements of  
subdivision (a) or (b) of this subrule.  
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 continuing education hours per  
program that satisfies any of the year may be granted for this activity.  
requirements of R 338.2421(3), (4), A maximum of 150 continuing  
or (5) or is accredited by a board education hours may be earned per  
recognized by the American Board renewal period.  
of  
Medical  
Specialties,  
the  
American Board of Physician  
Specialties, or the National Board of  
Physicians and Surgeons.  
To  
receive credit, the licensee shall be  
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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/allowed for the activity  
(a) Serving as a clinical instructor for Two continuing education hours are  
medical students or residents granted for each 50 to 60 minutes of  
engaged in a postgraduate training scheduled instruction.  
Additional  
program that satisfies requirements credit for preparation of a lecture  
of R 338.2421(3), (4), or (5).  
cannot be granted. A maximum of 48  
continuing education hours may be  
To receive credit, the clinical earned for this activity in each  
instructorship must not be the renewal period.  
licensee’s primary employment  
function.  
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 continuing education hours are  
exhibit, poster, or paper to a granted for each presentation. No  
professional medical organization. additional credit is granted for  
preparation of the presentation. A  
If audited, the licensee shall provide maximum of 24 continuing education  
a copy of the document presented hours may be earned for this activity  
with proof of presentation or a letter in each renewal period.  
Under  
from the program sponsor verifying subrule (1)(a) of this rule, credit for a  
the date of the presentation.  
presentation is granted only once per  
renewal period.  
(c) Publication of a scientific article Six continuing education hours are  
relating to the practice of medicine granted for serving as the primary  
in a peer-reviewed journal or author. Three continuing education  
periodical.  
hours are granted for serving as a  
secondary author. A maximum of 24  
If audited, the licensee shall provide continuing education hours may be  
a copy of the publication that earned for this activity in each  
identifies the licensee as the author renewal period. Under subrule (1)(a)  
or a publication acceptance letter of this rule, credit for an article is  
granted once per renewal period.  
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and documentation of the peer-  
review process.  
(d) Initial publication of a chapter or a Five continuing education hours are  
part of a chapter related to the granted for serving as the primary  
practice of medicine in either of the author. Two continuing education  
following textbooks:  
hours are granted for serving as a  
secondary author. A maximum of 24  
-
A
professional  
textbook.  
- A peer-reviewed textbook.  
healthcare continuing education hours may be  
earned for this activity in each  
renewal period. Under subrule (1)(a)  
of this rule, credit for publication is  
If audited, the licensee shall provide granted once per renewal period.  
a copy of the publication that  
identifies the licensee as the author  
or a publication acceptance letter.  
(e) Participating on any of the following Eighteen continuing education hours  
committees:  
are granted for taking part on a  
committee. A maximum of 18  
- A peer-review committee dealing continuing education hours may be  
with quality of patient care as it earned for this activity in each  
relates to the practice of medicine. renewal period.  
-
A
committee dealing with  
utilization review as it relates to the  
practice of medicine.  
-
A
healthcare 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,  
considered  
enhances  
or  
association  
acceptable if  
the  
is  
it  
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 AACS; 2024 AACS; 2026 MR 6, Eff. March 19, 2026.  
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;