LICENSING AND REGULATORY AFFAIRS  
DIRECTOR'S OFFICE  
OPTOMETRY - GENERAL RULES  
Filed with the Secretary of State on November 19, 2019  
These rules become effective immediately upon filing with the Secretary of State unless  
adopted under section 33, 44, or 45(a)(6) of the administrative procedures act of 1969,  
1969 PA 306, MCL 24.333, 24.244, or 24.245a. Rules adopted under these sections  
become effective 7 days after filing with the Secretary of State.  
(By authority conferred on the director of the department of licensing and regulatory  
affairs by sections 16145, 16148, 16174, 16287, and 17431 of the public health code,  
1978 PA 368, MCL 333.16145, 333.16148, 333.16174, 333.16287, and 333.17431 and  
Executive Reorganization Order Nos. 1991-9, 1996-2, 2003-1, and 2011-4, MCL  
338.3501, 445.2001, 445.2011, and 445.2030)  
R 338.301, R 338.303, R 338.305, R 338.309, R 338.313, R 338.319, and R 338.321 are  
amended, R 338.302, R 338.304, R 338.306, R 338.320 are added, and R 338.323 is  
rescinded, as follows:  
PART 1. GENERAL PROVISIONS  
R 338.301 Definitions.  
Rule 1. As used in these rules:  
(a) “Adverse drug reaction" means an adverse physical or psychological reaction that  
is experienced by a person resulting from diagnostic therapeutic agents administered by  
an optometrist and that occurs within 24 hours after the drug is administered. An adverse  
drug reaction may be indicated by symptoms that include any of the following:  
(i) Red eye.  
(ii) Painful eye.  
(iii) Decrease in vision.  
(iv) Pale or red swelling of the periocular or periorbital tissues.  
(v) Nausea.  
(vi) Vomiting.  
(vii) Fainting.  
(viii) Mental confusion.  
(ix) Cessation of respiration.  
(b) "Board" means the Michigan board of optometry.  
(c) "Classroom hour," for the purpose of determining whether a course of study meets  
the requirements of section 17412(2)(a) or 17435(2)(b) of the code, MCL  
333.17412(2)(a) or MCL 333.17435(2)(b), means a 50 to 60 minute period of lecture,  
group discussion, or laboratory directly associated with a course in pharmacology. Time  
spent working in a clinic other than as part of a laboratory directly associated with a  
course in pharmacology does not qualify as a “classroom hour.”  
April 24, 2019  
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(d) “Code" means the public health code, 1978 PA 368, MCL 333.1101 to 333.25211  
(e) "Course of study in general and clinical pharmacology" means a course of study  
that is completed in a board-approved school or college, in general and clinical  
pharmacology as it relates to optometry, with the characteristics described in section  
17412(2)(a) of the code, MCL 333.17412(2)(a). Not less than 30 of the 60 classroom  
hours of the course of study must be allocated to ocular pharmacology and must  
emphasize the systemic effects of, and reactions to, topical ocular diagnostic  
pharmaceutical agents, including the emergency management and referral of any adverse  
reactions that may occur.  
(f) "Course of study relating to the didactic and clinical use of therapeutic  
pharmaceutical agents" means a course of study that is comprised of a minimum of 10  
quarter hours or 7 semester hours of credit or 100 classroom hours of study, is completed  
in a board-approved school or college and is in subjects relating to the didactic and  
clinical use of therapeutic pharmaceutical agents related to optometry.  
(g) "Department" means the Michigan department of licensing and regulatory affairs.  
(h) “Established patient” means a person who has received a professional service from a  
provider within the optometrist’s practice group within the preceding 3 years and 1 day of the  
last professional service received.  
(i) "Examination and evaluation,” means that term as defined in section 5553 of the  
code, MCL 333.5553.  
(j) “Informed consent for an established patient” means consent by a patient or his or her  
legal representative for treatment, medication, or services after there has been full disclosure  
of the facts needed for a patient or his or her legal representative to make a voluntary  
decision based on the elements of knowledge, comprehension, and willingness to receive the  
treatment, medication, or service.  
(k) “Informed consent for a new patient” means a written agreement or documentation of  
a verbal agreement by a patient or his or her legal representative for treatment, medication, or  
services after there has been full disclosure of the facts needed for a patient or his or her legal  
representative to make a voluntary decision based on the elements of knowledge,  
comprehension, and willingness to receive the treatment, medication, or service.  
(l) “New patient” means a patient who has not received a professional service from a  
provider in the optometrist’s practice group within the preceding 3 years and 1 day of the last  
professional service received.  
(m)“Telehealth,” means that term as defined in section 16283 of the code, MCL  
333.16283.  
R 338.302 Opioid and other controlled substances awareness training for prescribers and  
dispensers of controlled substances.  
Rule 2. An individual who applies for a controlled substance license or who is licensed  
to prescribe or dispense controlled substances shall complete training in opioid and  
controlled substances awareness as prescribed in R 338.3135.  
R 338.303 Training standards for identifying victims of human trafficking; requirements.  
Rule 3. (1) Pursuant to section 16148 of the code, MCL 333.16148, an individual who is  
licensed or seeking licensure shall complete training in identifying victims of human  
trafficking that meets the following standards:  
(a) Training content that covers all of the following:  
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(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 by the board  
for initial licensure, or by a college or university.  
(iv) Reading an article related to the identification of victims of human trafficking  
that meets 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 may 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 shall  
include the individual’s name and either of the following:  
(i) For training completed pursuant to subrule (1)(b)(i) to (iii) of this rule, the date,  
training provider name, and name of training.  
(ii) For training completed pursuant to 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) Pursuant to section 16148 of the code, MCL 333.16148, the requirements specified  
in subrule (1) of this rule apply for license renewals beginning with the 2019 renewal  
cycle and for an initial license issued on or after December 21, 2021.  
R 338.304 Minimum English language standard.  
Rule 4. (1) Pursuant to section 16174(1)(d) of the code, MCL 333.16174(1)(d) an  
applicant who applies for initial licensure shall demonstrate a working knowledge of the  
English language if his or her educational or training program was taught outside the  
United States, unless exempted under subrule (3) of this rule.  
(2) To demonstrate a working knowledge of the English language, an applicant shall  
submit proof that he or she obtained a total score of not less than 84 on the test of English  
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as a foreign language internet-based test (TOEFL-IBT) administered by the Educational  
Testing Service and obtained the following scores:  
(a) A score of 21 for the speaking section of the test.  
(b) A score of 21 for the writing section of the test.  
(c) A score of 21 for the listening section of the test.  
(d) A score of 21 for the reading section of the test.  
(3) If an applicant’s educational or training program was taught in English within one  
or more of the following countries, he or she is exempted from the requirements of  
subrule (1) of this rule:  
(a) Canada, except Quebec.  
(b) England.  
(c) Ireland.  
(d) New Zealand.  
(e) Australia.  
R 338.305 Professional optometric degree program; approval standards.  
Rule 5. (1) The board approves and adopts by reference the standards of the  
Accreditation Council on Optometric Education set forth in the publication entitled  
"Accreditation Manual: Professional Optometric Degree Programs" dated August 2014,  
and revised July 1, 2017, which provide for the accreditation of professional optometric  
degree programs.  
(2) A professional optometric degree program accredited by the Accreditation Council  
on Optometric Education is considered approved by the board.  
(3) Copies of the Accreditation Manual of the Accreditation Council on Optometric  
Education are available free of charge from the American Optometric Association, 243  
N. Lindbergh Blvd., St. Louis, MO 63141 or from the association's website at  
http://www.aoa.org. Printed copies also are available for inspection and distribution at  
cost from the Bureau of Professional Licensing, Department of Licensing and Regulatory  
Affairs, Ottawa Building, 611 W. Ottawa, P.O. Box 30670, Lansing, MI 48909.  
R 338.306 Telehealth services; requirements.  
Rule 6. (1) An optometrist who provides telehealth services shall obtain informed  
consent for an established patient or informed consent for a new patient before providing  
a telehealth service pursuant to section 16284 of the code, MCL 333.16284.  
(2) An optometrist who provides a telehealth service shall maintain evidence of the  
informed consent in the patient record and shall retain evidence of the informed consent  
in compliance with section 16213 of the code, MCL 333.16213.  
(3) An optometrist who provides a telehealth service shall comply with section 16285  
of the code, MCL 333.16285.  
(4) An optometrist providing a telehealth service may prescribe a drug if the optometrist  
is a prescriber acting within the scope of his or her practice and in compliance with  
section 16285 the code, MCL 333.16285, if he or she does both of the following:  
(a) If medically necessary, refers the patient to a provider that is geographically  
accessible to the patient.  
(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.  
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(5) An optometrist may provide a telehealth service only when he or she complies with  
all of the following:  
(a) Part 174 of the code, MCL 333.17401 to 333.17437.  
(b) The eye care consumer protection law, part 55A of the code, MCL 333.5551 to  
333.5571, including the duty to perform an examination and evaluation, pursuant to  
sections 5551 to 5559 of the code, MCL 333.5551 to 333.5559.  
(6) An optometrist who provides a telehealth service shall exercise the same standard of  
care applicable to a traditional, face-to-face health care service, including any necessary  
face-to-face appointments with a patient to assess, reassess, and update the patient’s  
medical condition and the effectiveness of treatment modalities.  
PART 2. LICENSURE  
R 338.309 Licensure by endorsement.  
Rule 9. (1) An applicant for a Michigan optometry license by endorsement shall submit  
a completed application on forms provided by the department, together with the requisite  
fee. In addition to meeting the requirements of the code and the administrative rules  
promulgated under the code, an applicant shall have graduated from a professional  
optometric degree program approved by the board, pursuant to R 338.305, and satisfy the  
requirements of this rule.  
(2) An applicant shall be an optometrist who is engaged in the practice of optometry,  
holds a doctor of optometry degree, and is currently licensed at the highest level  
authorized in another state of the United States or province of Canada that has licensure  
requirements that are equivalent to those required in this state, as determined by the  
board. This subrule does not grant license authority that exceeds the level of privileges  
granted to individuals who are licensed under the code to engage in the practice of  
optometry.  
(3) An applicant shall have achieved a passing score on parts I, II, and III of the NBEO  
examinations, including a passing score on the TMOD examination, in a state of the  
United States or province of Canada for his or her initial licensure.  
(4) An applicant who was first licensed in another state of the United States or province  
of Canada is presumed to have met the requirements of section 16186(1)(a) and (b) of the  
code, MCL 333.16186(1)(a) and (b), if he or she meets all of the following requirements:  
(a) Provides verification of his or her license by the licensing agency of another state  
of the United States or province of Canada in which the applicant holds a current license  
or ever held a license as an optometrist, which includes, but is not limited to, showing  
proof of any disciplinary action taken or pending disciplinary action imposed upon the  
applicant.  
(b) Achieves a minimum scaled score of 75 on the examination of Michigan laws and  
rules related to the practice of optometry that is developed and administered by the  
department, or an entity approved by the department.  
(5) An applicant shall hold a license granting therapeutic prescriptive certification at the  
highest level authorized in the state of the United States or province of Canada where he  
or she currently practices.  
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R 338.313 Relicensure.  
Rule 13. An applicant whose Michigan license has lapsed, under the provisions of  
section 16201(3) or (4) of the code, MCL 333.16201(3) or (4), as applicable, may be  
relicensed by complying with the following requirements as noted by (√):  
Lapsed 3  
Lapsed more than Lapsed 6 years or  
years or less.  
3 years, but less  
than 6 years.  
more.  
(1) Application and fee:  
submit a completed  
√
√
√
√
√
√
√
√
√
√
application on a form  
provided by the  
department, together with  
the required fee.  
(2) Good moral character:  
establish that he or she is  
of good moral character  
as defined under 1974 PA  
381, MCL 338.41 to  
MCL 338.47.  
(3) Fingerprints: submit  
fingerprints as required  
under section 16174(3) of  
the code, MCL  
333.16174(3).  
(4) Continuing education:  
submit proof of having  
completed 40 hours of  
continuing education as  
required under R  
√
338.321, which was  
earned within the 2-year  
period immediately  
preceding the date of  
relicensure, subject to  
both of the following:  
(a) At least 2 of the 40  
hours of continuing  
education must be in pain  
and symptom  
management, as provided  
under R 338.321(3).  
(b) If certified to  
administer therapeutic  
pharmaceutical agents, at  
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least 20 of the 40 hours of  
continuing education  
must be in  
pharmacological  
management of ocular  
conditions, as provided in  
R 338.321(2).  
(5) Examination: achieve a  
minimum scaled score of  
75 on the examination of  
Michigan laws and rules  
related to the practice of  
optometry that is  
√
√
√
developed and  
administered by the  
department, or an entity  
approved by the  
department.  
(6) Examination: achieve a  
passing score on parts I,  
II, and III of the NBEO  
examination, including a  
passing score on the  
Continued Professional  
Development in  
√
Optometry (CPDO)  
examination given by  
NBEO or its successor  
organization, unless he or  
she holds a current, valid,  
unrestricted license in  
another state or a  
province of Canada.  
(7) Proof of license  
verification from another  
state or province of  
√
√
√
Canada: An applicant’s  
license shall be verified  
by the licensing agency of  
each state of the United  
States or province of  
Canada in which the  
applicant holds or has  
ever held a license as an  
optometrist.  
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Verification must include  
the record of any  
disciplinary action taken  
or pending against the  
applicant.  
PART 3. CONTINUING EDUCATION  
R 338.319 Adoption of standards and criteria by reference; board approval by  
application.  
Rule 19. (1) The board approves and adopts by reference the standards and criteria of  
the Council on Optometric Practitioner Education (COPE) that are set forth in the  
publication entitled "Criteria for COPE Qualification of Continuing Education," revised  
July 2015. A copy of the publication may be obtained at no cost from the Association of  
Regulatory Boards of Optometry, 200 South College St., Suite 2030 Charlotte, NC  
28202, or from the council's website at http://www.arbo.org. Printed copies also are  
available for inspection and distribution at cost from the Bureau of Professional  
Licensing, Department of Licensing and Regulatory Affairs, Ottawa Building, 611 W.  
Ottawa, P.O. Box 30670, Lansing, MI 48909.  
(2) A continuing education program that has been accredited by COPE is considered  
approved by the board.  
(3) A continuing education program that is not accredited by COPE or approved as  
provided in R 338.320 may apply for board approval by submitting an application to the  
department. The application must be received not less than 90 days before the program  
presentation. The application must be reviewed by the board’s continuing education  
subcommittee. After review and recommendation of the program by the board’s  
continuing education subcommittee, approval of the continuing education program may  
be granted after a vote of the full board.  
(4) Applications for approval of a continuing education program must include all the  
following:  
(a) The sponsor’s name.  
(b) The sponsor’s address.  
(c) The program name.  
(d) The program date.  
(e) The program location.  
(f) The program outline, including all of the following:  
(i) An explanation of how the program is designed to further educate the licensee  
through acquisition and application of knowledge which results in improved patient  
outcomes.  
(ii) The topics and the name of the speaker of each topic.  
(iii) The times of the specific topics and breaks included in the program.  
(g) The résumé of each speaker or instructor for the program.  
(h) A description of the delivery method, or methods to be used, and the techniques  
that will be employed to assure active participation.  
(i) A brief description of the sponsoring organization.  
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(j) The name, title, and address of the program director and a description of his or her  
qualifications to direct the program.  
(k) A description of how participants will be notified that continuing education credit  
has been earned.  
(l) A description of the physical facilities or laboratory available to assure a proper  
learning environment.  
(m) A description of how attendance is monitored and the name of the person  
monitoring attendance.  
(n) The number of hours of course instruction including all of the following:  
(i) The number of hours related to clinical optometry, which may include any of the  
following COPE categories:  
(A) Contact lenses (CL).  
(B) Functional vision/pediatrics (FV).  
(C) General optometry (GO).  
(D) Low vision/vision impairment & rehabilitation (LV).  
(E) Public health (PB).  
(ii) The number of hours related to practice management, which may include the  
following COPE categories:  
(A) Practice management (PM).  
(B) Ethics/jurisprudence (EJ).  
(iii) The number of hours related to pharmaceutical management, which may include  
any of the following COPE categories:  
(A) Glaucoma (GL).  
(B) Injection skills (IS).  
(C) Laser procedures (LP).  
(D) Peri-operative management of ophthalmic surgery (PO).  
(E) Refractive surgery management (RS).  
(F) Surgery procedures (SP).  
(G) Treatment and management of ocular disease: anterior segment (AS).  
(H) Treatment and management of ocular disease: posterior segment (PS).  
(I) Neuro-optometry (NO).  
(J) Oral pharmaceuticals (OP).  
(K) Pharmacology (PH).  
(L) Principles of diagnosis (PD).  
(M) Systemic/ocular disease (SD).  
(iv) The number of hours related to pain management, which may include any of the  
following COPE categories:  
(A) Oral pharmaceuticals (OP).  
(B) Pharmacology (PH).  
(C) Treatment and management of ocular disease: anterior segment (AS).  
(D) Treatment and management of ocular disease: posterior segment (PS).  
(E) Functional vision/pediatrics (FV).  
R 338.320 Approved continuing education; limitations; documentation  
Rule 20. The board approves all of the following as continuing education if the subject  
matter falls within an approved COPE category as listed in R 338.319(4)(n):  
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Activity and Proof of Completion  
Successful completion of a course or  
courses offered for credit by an accredited earned for each academic quarter credit hour  
optometry school or college approved by  
the board under R 338.305.  
Number of Continuing Education Hours  
Granted or Permitted for Activity  
Ten hours of continuing education may be  
(1)  
(2)  
earned.  
Fifteen hours of continuing education may be  
earned for each academic semester credit  
If audited, a licensee shall submit an  
official transcript documenting successful hour earned. Hours may be earned without  
completion of the course.  
Successful completion of a continuing  
education program offered by an  
accredited optometry school or college  
approved by the board under R 338.319.  
limitation.  
One continuing education hour may be  
granted for each 50 to 60 minutes of program  
attendance, without limitation.  
If audited, a licensee shall submit 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 was held or activity  
completed.  
(3)  
Attendance at a continuing education  
program related to the practice of  
optometry offered by an educational  
program approved by the board under R  
338.319(3) or approved by another state  
board of optometry.  
One continuing education hour may be  
granted for each 50 to 60 minutes of program  
attendance, without limitation.  
If audited, a licensee shall submit 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 was held or activity  
completed.  
(4)  
Initial presentation of or at a continuing  
One continuing education in the appropriate  
education program approved by the board. COPE category may be granted for each 50  
to 60 minutes of program presentation,  
If audited, a licensee shall submit a letter  
from the program’s sponsor, verifying the  
licensee’s presentation of educational  
without limitation.  
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materials and lecture at the continuing  
education program.  
(5)  
Attendance at a continuing education  
program related to optometric topics  
approved for category 1 continuing  
education by the Michigan board of  
medicine or the Michigan board of  
osteopathic medicine and surgery.  
One continuing education hour in clinical  
optometry may be granted for each 50 to 60  
minutes of program attendance, limited to 8  
hours per renewal cycle.  
If audited, a licensee shall submit 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 was held or activity  
completed.  
(6)  
Attendance at a continuing education  
program related to optometric  
pharmacological topics approved for  
continuing education by the Michigan  
board of pharmacy.  
One continuing education hour in  
pharmacological management may be  
granted for each 50 to 60 minutes of program  
attendance, limited to 8 hours per renewal  
period. Applicants for renewal who hold  
certification to administer topical ocular  
diagnostic pharmaceutical agents or  
If audited, a licensee shall submit a copy  
of a letter or certificate of completion  
showing the licensee’s name, number of  
certification to administer and prescribe  
therapeutic pharmaceutical agents, or both,  
credits earned, sponsor name or the name may earn hours without limitation.  
of the organization that approved the  
program or activity for continuing  
education credit, and the date or dates on  
which the program was held or activity  
completed.  
(7)  
Initial presentation of a scientific exhibit,  
poster, or paper to a professional  
optometric organization.  
Two hours of continuing education in clinical  
optometry shall be granted for each  
presentation. No additional credit shall be  
granted for preparation of the presentation.  
If audited, the licensee shall submit a copy  
of the document presented with evidence  
of presentation or a letter from the  
program sponsor verifying the date of the  
presentation.  
(8)  
Initial publication of either of the  
following:  
Six hours of continuing education in clinical  
optometry shall be granted for serving as the  
primary author. Three hours of continuing  
education in clinical optometry shall be  
(a) A scientific article relating to the  
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practice of optometry in a peer-reviewed  
journal or periodical.  
granted for serving as a secondary author.  
(b) A chapter or a portion of a chapter  
related to the practice of optometry in  
either a professional health care textbook  
or peer-reviewed textbook.  
If audited, the licensee shall submit a copy  
of the publication that identifies the  
licensee as the author or a publication  
acceptance letter and documentation of  
the peer-review process.  
(9)  
Participating on either of the following:  
Six hours of continuing education in clinical  
optometry shall be granted for participating  
on a committee. A maximum of 6 hours of  
(a) A peer review committee dealing  
with quality of patient care as it relates to continuing education may be earned for this  
the practice of optometry.  
activity in each renewal period.  
(b) A national or state committee, board,  
council, or association related to the  
practice of optometry.  
Participation on a committee, board,  
council or association is considered  
acceptable by the board if it enhances the  
participant’s knowledge and  
understanding of the field of optometry.  
If audited, the licensee shall submit a  
letter from an organization official  
verifying the licensee’s participation in at  
least 50% of the regularly scheduled  
meetings of the committee, board, council  
or association.  
(10) Taking and passing any nationally  
recognized advanced competency  
examination in optometry.  
Every 2 years, 12 hours of continuing  
education in pharmacology management or  
clinical optometry shall be granted.  
R 338.321 License renewal; continuing education, requirements, limitations.  
Rule 21. (1) An applicant for license renewal shall accumulate not less than 40  
continuing education hours approved by the board pursuant to R 338.319 or R 338.320  
during the 2 years immediately preceding the expiration date of the license.  
(2) An applicant for license renewal who holds certification to administer topical ocular  
diagnostic pharmaceutical agents or certification to administer and prescribe therapeutic  
pharmaceutical agents, or both, shall accumulate not less than 20 hours of board-  
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approved continuing education in pharmacological management of ocular conditions.  
The 20 required hours are part of, and not in addition to, the 40 hours required in subrule  
(1) of this rule. A continuing education program that falls within the COPE categories  
listed in R 338.319(4)(n)(iii)(A) to (M) meets the requirements of this subrule.  
(3) An applicant for license renewal shall accumulate not less than 2 hours of board  
approved continuing education in pain and symptom management related to the practice  
of optometry. A continuing education program that falls within the COPE categories  
listed in R 338.319(4)(n)(iv)(A) to (E) meets the requirements of this subrule. Continuing  
education hours in pain and symptom management, as they relate to the practice of  
optometry, may include, but are not limited to, the following:  
(a) Ethics and health policy related to pain.  
(b) Pain definitions.  
(c) Basic sciences related to pain, including pharmacology, psychology, sociology, and  
anthropology.  
(d) Clinical sciences related to pain, including specific pain conditions and pain in  
special contexts and settings.  
(e) Clinician-patient communications related to pain.  
(f) Management of pain, including evaluation and treatment; non-pharmacological and  
pharmacological management.  
(g) Ensuring quality pain care.  
(h) Michigan programs and resources relevant to pain.  
(4) A minimum of 20 of the required continuing education hours must be completed in a  
face-to-face real-time learning format. The remaining hours may be completed in any  
other format including but not limited to self-evaluation journal tests, multimedia  
education, real time webinars, video conferencing, webcasts, and podcasts.  
(5) An applicant for license renewal may earn a maximum of 9 continuing education  
hours per licensure cycle in practice management. A continuing education program that  
falls within the COPE categories listed in R 338.319(4)(n)(ii)(A) and (B) meets the  
requirements of this subrule.  
(6) Submission of an application for renewal constitutes the applicant's certificate of  
compliance with the requirements of this rule. An optometrist shall retain documentation  
of meeting the requirements of this rule for a period of 4 years from the date of applying  
for license renewal. The board may require an applicant or licensee to submit evidence to  
demonstrate compliance with this rule. Failure to comply with this rule is a violation of  
section 16221(h) of the code, MCL 333.16221(h).  
(7) A request for a waiver under section 16205 of the code, MCL 333.16205, must be  
received by the department before the expiration date of the license.  
R 338.323 Rescinded.  
;