Radiologist? Here’s How Your CME/SA-CME Requirement Works

CME is required — but it doesn’t have to be painful


My passion is to simplify your life as a rising radiologist. This past year, I waded through the details of CME requirements and called various boards for clarification on behalf of us all. Here’s my distilled guide to your CME and SA-CME requirements.

I recently passed the ABR certifying exam. When should I start taking care of CME?
Right now is the perfect time to get your CME strategy lined up.

What is CME?
At some point we’re all going to be patients under the care of a doctor. Wouldn’t it be nice if they were up to date on what they need to know? CME is any training that keeps you current — information you can teach yourself or learn from others.

How do I know if an activity counts for CME?
Make sure you earn AMA PRA Category 1 Credit™ for the activity. These activities satisfy basic standards defined by the AMA. Hospitals, state medical boards, and the ABR all require this credit designation.

What is self-assessment CME (SA-CME) or SAM?
The ABR defines any AMA PRA Category 1 Credit™ that requires you to complete some sort of assessment as SA-CME. The term SAM is the same as SA-CME. Finish 9 SA-CME credits per year and you’ll be all set.

How much credit do I need to earn to stay in practice?
That depends on the details of your practice — hospital requirements, what state you’re in, whether you read mammography, etc.

All of us submit CME to these organizations:

ABR — you’ll need to earn 75 credits for every three-year period counting back from March 1 of each year. This comes down to 17 AMA PRA Category 1 Credits™ and 9 SA-CME per year in radiology. If you passed the certifying exam in October 2017, your first attestation to the ABR will be March 2021. But don’t fall asleep — your hospitals and state medical boards will ask you to submit CME certificates well before then.

State medical board — every state medical board has slightly different CME requirements. For example, California requires 50 credits for every two-year period counting back from the date your license expires. Check your state medical board website.

Hospital’s general requirement — every hospital has a general CME requirement, typically similar to the state medical board requirement.

Some of us have additional requirements:

Breast imaging — if you read mammography, then you need 15 breast topic-specific CME over the past three years, which is the Mammography Quality Standards Act requirement for CME. Your credits should relate to your scope of practice, with at least 6 credits in each mammographic modality, namely mammography and tomosynthesis. Note that breast ultrasound and MRI don't fall under this MQSA regulation.

Fluoroscopy license — some states have a fluoroscopy license. For example, the California Department of Public Health-Radiologic Health Branch issues fluoroscopy licenses to radiologists in California. If you don’t have a current fluoroscopy license, you’re not allowed to do fluoroscopy exams independently. You’ll need to be able to submit certificates for 15 fluoroscopy topic-specific CME when your fluoroscopy license renews every two years.

Controlled substance CME — many state medical boards have instituted requirements for CME related to controlled substances such as opioids for doctors with DEA licenses (which are many of us).

Practice group — some practice groups have internal standards for CME  — as many as 50 credits per year.

Cardiac CT and MR standards — if you’re credentialed to read cardiac CT or MR, each hospital typically has its own topic-specific CME requirement related to cardiac CT and/or cardiac MR. This is in the range of 40 topic-specific credits before you start reading these studies based on the ACR Practice Parameters, and possibly more on a recurring basis.

How do I earn all of these topic-specific credits?
There are many ways to earn all of these various credits. Although there are some free sites like Medscape to earn some general CME, you’re still going to need SA-CME/SAM and (depending on your scope of practice) subject-specific CME. Traditional options include conference travel or answering questions at the end of specialty-dedicated journal articles. But recommendations and research are accelerating at unprecedented rates, and realistically, we’re learning every day, each time we search the Internet for information related to a case. Soon, we’ll have technology that can recognize and award CME for the learning we’re already doing in the reading room every day.








Ram Srinivasan, MD, PhD, DABR, is a practicing radiologist in Palo Alto, Calif, course director at Core Physics Review, and founder of Orbit Radiology. He can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it..

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