Alliance meeting followup: AMA credit system update for 2006

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I ran into a couple of folks from the American Medical Association at the Alliance conference after I posted this item on their session, and they said it was fine after all to post about the policies they discussed at their session, as long as I don't quote anyone directly. My apologies for getting the wrong message the first time, though really, everything they talked about is pretty much covered in the 2006 booklet you can download from the AMA site (it's a PDF).


There are four areas of AMA PRA Category 1 Credit [TM] policy that are new for 2006 they said. The first of which is that you need to call it AMA PRA Category 1 Credit [TM] (including italics and trademark symbol, preferably superscripted), the first time you use the phrase in any publication, and you should scatter the full phrase in a few more times as well. This is to protect the AMA's intellectual property through trademarks (the italics make it clear exactly what is trademarked). You can't say "ACCME credit," or "Category 1 credit": it has to be AMA PRA Category 1 Credit [TM]. This, presenters said, provides a common terminology for both physicians and providers, and also gives the AMA more of a legal standing if it needs to make a legal challenge to someone's misuse of the term. Providers also have to use this revised designation statement in their materials:


    The [name of accredited provider] designates this educational activity for a maximum of [number of credits] AMA PRA Category 1Credit(s) TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.


This change in wording is designed to reflect the shift from a strictly time-based measure. The AMA will begin monitoring for compliance on July 1, 2006, which hopefully will give you enough time to make these changes to your CME materials. Presenters also stressed that AMA PRA Category 1 Credit can be given only to MDs and DOs; all others can receive a certification of attendance or participation, but not AMA PRA Category 1 Credit.


Another change, and one I would think providers would welcome, is that you no longer have to undergo a provider application process to make international physicians eligible for AMA PRA Category 1 Credit. The AMA has taken out the “U.S. licensed” requirement. To keep from having to know what all the non-U.S. degrees are, the credit claim form now just asks, "Are you a physician?" The AMA is, however, updating its database to allow non-U.S. designations.


Another new thing is that accredited providers now can award AMA PRA Category1Credit to their live activity faculty. Faculty can earn two AMA PRA Category 1 Credits for each sixty-minute teaching period, but they can't claim credit for both teaching at learning at the same activity. But they can claim credit for other activities held in conjunction with the one they're teaching. This could get interesting if you have to divvy up the credit between various faculty on a panel! In the Q&A, it also came up that a faculty member can only get credit for the first time they do a particular presentation, and not keep getting credit for doing the same presentation later on. For tumor boards, the easiest way to handle it is to allow each person to earn one credit as a learner. This policy goes into effect July 1, 2006. Please refer to the booklet for residency training, manuscript review, and test item writing credits, and for more details on this one.


The AMA also has been adopting performanance improvement activities into the list of formats approved for AMA PRA Category 1 Credit, and this year, it has added Internet point of care learning to that list. Here's the official verbiage:


    Physicians conducting structured online searches on clinical topics may claim a half (0.5) AMA PRA Category 1 Creditfor documented completion (either at the point of care or later) of the three step learning cycle defined above.


That means to get AMA PRA Category 1 Credit [TM] for Internet CME, they must "review the original clinical question(s); identify the relevant sources from among those consulted; and describe the application of their findings to practice." Committee work, learning plans, and other activities that include all the requirements for live activities also now can be eligible for AMA PRA Category 1 Credit. During the Q&A, panelists said that if an activity—say, a committee that is putting together guidelines for a specific disease state—meets all the ACCME rules for an accredited CME activity (needs assessment, etc.), you can designate it for AMA PRA Category 1 Credit.


Deleted from this year's booklet:

  • Recommendation that a physician not earn more than 50 credits per activity

  • The institutional oversight structure. ACCME now handles the oversight.

  • The specific description of activities not eligible for credit. AMA now just provides the guidance and principles to follow, not a specific set of activities that don't fit into the credit system.


    Also, the new booklet contains a more streamlined description of joint and co-sponsorship to be more in line with ACCME's description, a beefed up AMA PRA Category 2 Credit description, including examples, and excluding promotional activities from eligibility for this credit.

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