Texas Medical Board · MD

48 hours. Every two years. Tied to your license expiration.

A source-verified guide to Texas's CME requirements for physicians — hours, mandatory topics, audit rules, and exemptions.[3]

Updated April 2026Sourced from TMB~6 min read

Compiled by Atlas CME from official board sources · Last updated July 30, 2026

Mandatory topics

For physicians, 48 hours is the total CME requirement. Texas also requires a set of one-time topics that count toward the 48-hour total.

Legal & Risk Management[1]
2 hrs
Biennial
risk management, domestic abuse, or child abuse. Must be formal Category 1 or 1A. Counts within the 24 required formal hours. Cannot be carried forward to the next biennium.
View sourceVerbatim from source
“At least 2 of the 24 formal hours must involve the study of medical ethics and/or professional responsibility. Professional responsibility includes but is not limited to courses in: Risk management, Domestic Abuse; or Child Abuse.”
TMB Physician CE Requirements (board layer); 22 TAC §161.35(a)(2)(B) 'two credits in the topic of medical ethics and/or professional responsibility'See source [1] in Primary Sources
Opioid/Substance Use[2]
2 hrs
Custom
For physicians whose renewal application designates direct patient care, 2 hours of formal CME on safe pain management and opioid prescribing are required every 8 years after the first two renewal periods. The separate early-career row below applies during each of the first two Texas renewals. The same qualifying credit may satisfy both rows when their windows overlap.
View sourceVerbatim from source
“After the period described by Subsection (b), a physician must complete not less than two hours of continuing medical education described by Subsection (a) every eight years.”
Tex. Occ. Code § 156.055(c) (8-year steady-state cadence); TMB Physician CE page repeats 2 hours every 8 years after the first two renewals; 22 TAC § 161.35(a)(2)(C) incorporates § 156.055See source [2] in Primary Sources
Human Trafficking[1]
1 hr
Custom
Physicians who practice direct patient care complete at least 1 hour in their first renewal period and every third renewal period thereafter (every 6 years). The course must be HHSC-approved and may count toward the ethics requirement.
View sourceVerbatim from source
“every physician who practices direct patient care must complete at least 1 hour of CME in the identification and assistance of trafficked people in their first renewal period after license issuance, and at least 1 hour every third renewal period thereafter (every 6 years).”
TMB Continuing Education Requirements for Physicians (Board rule 161.35)See source [1] in Primary Sources
Atlas CME tracks each of these mandatory topics against your Texas cycle automatically. Start tracking free →
Conditional requirements

These rules apply only when the trigger described under each card is met (for example, holding a state-issued controlled substance registration or treating a specific patient population). Each cites the underlying statute or rule directly.

ConditionalOpioid/Substance Use[2]
2 hrs
Biennial

Physicians in either of their first two Texas registration renewal periods

View sourceVerbatim from source
“A physician must complete the hours required by Subsection (a) in each of the first two renewal periods following the issuance of the physician's initial registration permit under this chapter, with two of those hours to be completed not later than the first anniversary of the date of issuance.”
Tex. Occ. Code § 156.055(b); TMB Physician CE page states the same first-two-renewals cadenceSee source [2] in Primary Sources
ConditionalWomen's Health[1]
Hrs vary
One-time

Physicians practicing in OB/GYN, Maternal-Fetal Medicine, Family Medicine, Emergency Medicine, or other women's-health-adjacent specialties designated by TMB (15 specialties total per TMB FAQ #414)

View sourceVerbatim from source
“requires physician applicants and licensees who provide obstetric care to complete a one-time, mandatory continuing education (CE) course on pregnancy-related medical emergencies.”
TMB Physician CE Requirements (board layer); Tex. S.B. 31 (89R, 2025, enrolled) 'This is a one-time requirement.'See source [1] in Primary Sources
ConditionalPain Management[1]
10 hrs
Biennial

Medical directors of pain clinics

View sourceVerbatim from source
“the medical director of a pain management clinic must, on an biennial basis, ensure that all personnel (including the medical director) are properly licensed, and if applicable, trained to include 10 hours of continuing medical education (CME) related to pain management.”
TMB CE Requirements — Pain Management Clinics (board layer); 22 TAC §172.3(d)(2) 'at least ten hours of continuing education related to pain management in the preceding two years'See source [1] in Primary Sources
ConditionalEMS / Prehospital[1]
12 hrs
One-time

EMS medical directors

View sourceVerbatim from source
“12 hours of formal continuing medical education (CME) in the area of EMS medical direction;”
TMB CE Requirements — EMS Medical Director (board layer); 22 TAC §169.12 'a minimum of 12 hours of formal continuing medical education (CME), in the area of EMS medical direction within two years of initial notification'See source [1] in Primary Sources
ConditionalEMS / Prehospital[1]
1 hr
Biennial

EMS medical directors (ongoing maintenance after initial 12 hours)

View sourceVerbatim from source
“Complete one hour of formal CME in the area of EMS medical direction in each subsequent biennial renewal of the registration.”
TMB CE Requirements — EMS Medical Director (board layer); 22 TAC §169.12(c) 'must complete one hour of formal CME in the area of EMS medical direction in each subsequent biennial renewal of the registration'See source [1] in Primary Sources
ConditionalSexual Assault Response[2]
2 hrs
Biennial

Physicians whose practice includes treating patients in an emergency room setting

View sourceVerbatim from source
“shall complete at least two hours of continuing medical education relating to:”
Tex. Occ. Code § 156.057(a)See source [2] in Primary Sources
Accepted credit

Credit must come from an organization accredited by the ACCME, AMA, Texas Medical Association, or AAFP. ACGME residency or fellowship time accrues toward the requirement. Teaching or presenting accredited CME can satisfy a portion of required hours.

Credit systemNotes
AMA PRA Category 1
min 24 hrs
At least 24 of your 48 hours must be formal Category 1 or 1A from an ACCME-accredited provider.SourceTMB Physician CE Requirements[3]
AOA Category 1-A
DOs only
AOA Category 1-A designated courses count toward the formal hour requirement for DOs.SourceTMB Physician CE Requirements[3]
AAFP Prescribed
AAFP-approved courses count toward the formal hour requirement.SourceTMB Physician CE Requirements[3]
Board-approved credit
max 24 hrs
TMA-approved courses meeting AMA standards count as formal credit. Up to 24 of your 48 hours may be informal — self-study, hospital lectures, grand rounds, and case conferences not formally approved for CME credit all qualify.SourceTMB Physician CE Requirements[3]
Documentation & audit

Physicians are responsible for retaining CME documentation and producing it on request. Requirements include course title, dates, hours, sponsoring organization, and accrediting body.

Waivers & exemptions

Board certification or recertification meeting ABMS standards exempts physicians from all CME requirements for one registration period. Maintenance of Certification programs satisfy formal/informal requirements but do not exempt ethics, pain management, or human trafficking training.[3]

Residency/fellowship training or completion within 6 months prior to renewal satisfies CME except for pain management and human trafficking requirements. Residents, fellows, and recent graduates are exempt from most CME but must still complete pain management and human trafficking training.[3]

FAQ
How many CME hours do Texas physicians need?
Texas physicians must complete 48 hours of continuing medical education every 24 months, with at least 24 of those hours in formal Category 1/1A courses.[3] The remaining 24 may come from informal activities like self-study, hospital lectures, grand rounds, or case conferences. Both MDs and DOs are regulated by the same board and follow the same 48-hour rule.
Are there mandatory CME topics in Texas?
Yes. Within the 24 formal hours, Texas physicians complete at least 2 hours of medical ethics or professional responsibility each biennium. Direct-patient-care physicians also complete 2 hours of pain-management and opioid-prescribing CME in each of their first two renewal periods and every 8 years thereafter, plus at least 1 hour of HHSC-approved human-trafficking CME in the first renewal period and every third renewal period thereafter (every 6 years).[3]
Where can I check my Texas medical license renewal date?
The Texas Medical Board provides a public license verification tool at profile.tmb.state.tx.us/Search.aspx.[4] You can search by name or license number to see your current expiration date, registration status, and any disciplinary actions of record. Renewal notices are sent by the TMB approximately 60 days before expiration, but the licensee bears the responsibility for tracking the date.
Does Texas accept board certification in place of CME?
Yes. Board certification or recertification meeting ABMS standards exempts physicians from all CME requirements for one registration period.[3] MOC participation satisfies the formal/informal requirements but does not exempt the mandatory ethics, pain management, or human trafficking topics. Those mandates always apply to MOC participants.
What conditional or specialty-specific CME requirements apply in Texas?
Covered OB/GYN and other women's-health-adjacent physicians must complete a one-time TMB-approved CE course on pregnancy-related medical emergencies under Senate Bill 31; neither the statute nor the Board page specifies an hour count.[3] Pain clinic medical directors must ensure 10 biennial hours in pain management.[3] EMS medical directors need 12 initial hours in EMS medical direction, then 1 hour per biennium.[3] Physicians whose practice includes treating patients in an emergency room setting must complete 2 hours of CME on forensic evidence collection and sexual assault survivor care at each renewal, for renewal applications filed on or after September 1, 2026.[5] These apply only to physicians in the specified specialty or role.
Do Texas MDs and DOs have different CME requirements?
No. Texas does not maintain a separate osteopathic licensing board — DOs and MDs are both licensed by the Texas Medical Board and subject to the same CME requirements (48 hours per renewal cycle).[3]

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Other roles in Texas

Physicians CME requirements in other states

Sources & Citations

Every mandatory topic and conditional requirement above cites the underlying statute or rule. Numbered references below correspond to the bracketed citations next to each requirement.

  1. https://www.tmb.texas.gov/apply-renew/physician/continuing-education-requirements-for-physicians
    Source
    Show verbatim text
    “At least 2 of the 24 formal hours must involve the study of medical ethics and/or professional responsibility. Professional responsibility includes but is not limited to courses in: Risk management, Domestic Abuse; or Child Abuse.”TMB Physician CE Requirements (board layer); 22 TAC §161.35(a)(2)(B) 'two credits in the topic of medical ethics and/or professional responsibility'
    “every physician who practices direct patient care must complete at least 1 hour of CME in the identification and assistance of trafficked people in their first renewal period after license issuance, and at least 1 hour every third renewal period thereafter (every 6 years).”TMB Continuing Education Requirements for Physicians (Board rule 161.35)
    “requires physician applicants and licensees who provide obstetric care to complete a one-time, mandatory continuing education (CE) course on pregnancy-related medical emergencies.”TMB Physician CE Requirements (board layer); Tex. S.B. 31 (89R, 2025, enrolled) 'This is a one-time requirement.' · Effective 2026-01-01
    “the medical director of a pain management clinic must, on an biennial basis, ensure that all personnel (including the medical director) are properly licensed, and if applicable, trained to include 10 hours of continuing medical education (CME) related to pain management.”TMB CE Requirements — Pain Management Clinics (board layer); 22 TAC §172.3(d)(2) 'at least ten hours of continuing education related to pain management in the preceding two years'
    “12 hours of formal continuing medical education (CME) in the area of EMS medical direction;”TMB CE Requirements — EMS Medical Director (board layer); 22 TAC §169.12 'a minimum of 12 hours of formal continuing medical education (CME), in the area of EMS medical direction within two years of initial notification'
    “Complete one hour of formal CME in the area of EMS medical direction in each subsequent biennial renewal of the registration.”TMB CE Requirements — EMS Medical Director (board layer); 22 TAC §169.12(c) 'must complete one hour of formal CME in the area of EMS medical direction in each subsequent biennial renewal of the registration'
  2. Tex. Occ. Code ch. 156 — Registration of Physicians; subch. B Continuing Medical Education Requirements (current through 89th 2nd C.S., 2025)
    Primary sourceAccessed 2026-07-02
    Show verbatim text
    “After the period described by Subsection (b), a physician must complete not less than two hours of continuing medical education described by Subsection (a) every eight years.”Tex. Occ. Code §§156.051-156.061
    “A physician must complete the hours required by Subsection (a) in each of the first two renewal periods following the issuance of the physician's initial registration permit under this chapter, with two of those hours to be completed not later than the first anniversary of the date of issuance.”Tex. Occ. Code § 156.055(b); TMB Physician CE page states the same first-two-renewals cadence
    “shall complete at least two hours of continuing medical education relating to:”Tex. Occ. Code § 156.057(a) · Effective 2026-09-01
  3. Continuing Education Requirements for Physicians — Texas Medical Board
    Primary sourceAccessed 2026-04-21
    Show verbatim text
    “Physicians need to complete at least 48 credits of continuing medical education every 24 months (24 month timeline is in relation to the biennial registration period, not the calendar year). At least half of these hours must be in formal, category I or 1A courses.”TMB Physician CE Requirements
  4. Texas Medical Board — License Verification
    Primary sourceAccessed 2026-04-21
  5. Tex. HB 47 (89R, Enrolled) — Forensic Evidence Collection CE
    Primary sourceAccessed 2026-04-20
    Show verbatim text
    “emergency room setting shall \[may\] complete at least two hours of”Tex. HB 47 (89R, 2025) § 17 · Effective 2025-09-01
  6. Tex. SB 912 (89R, Enrolled) — CE Tracking System
    Primary sourceAccessed 2026-04-20

This page is provided for general educational purposes and reflects the best available information as of the last reviewed date above. CME requirements change. Atlas CME is not affiliated with the Texas Medical Board, or any other state medical board, licensing authority, or professional organization. Physicians are solely responsible for verifying their own current CME requirements directly with their state medical board before relying on any information presented here.

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