Continuing medical education (CME) has changed dramatically over the past century, evolving from voluntary professional learning into a complex system of state requirements, accreditation, post-graduate learning in the United States was largely voluntary and fragmented. CME emerged in the late 1920s in response to concerns about the uneven quality of physicians' initial medical training, and early efforts were led primarily by medical schools. The first mandatory specialty-based continuing education program was introduced in urology in 1934, and by the late 1960s, many states had adopted continuing education requirements for physician relicensure, although standards varied considerably from one jurisdiction to another. This series examines how CME developed, compares requirements across the country, explores why Michigan is an outlier, and offers common-sense reforms that support lifelong learning while reducing unnecessary regulatory burdens.
History of Continuing Medical Education
Before continuing medical education (CME) became a formalized system, the American Medical Association (AMA) published its first guidelines for good medical practice and later established a voluntary recognition program for physicians completing substantial postgraduate education, reflecting a growing interest in defining professional expectations beyond initial licensure (Josseran & Chaperon, 2001).
By the 1980s, CME had evolved from a small-scale, voluntary activity into a nationwide system of accredited educational programs increasingly linked to relicensure and professional certification. Rather than relying primarily on disparate state requirements, physicians' continuing education came to be shaped by specialty boards, accredited CME providers, professional societies, hospitals, and medical schools. At the same time, leaders in medical education anticipated that recertification would increasingly emphasize continuous learning supported by emerging computer and telecommunications technologies rather than periodic examinations alone. This evolution positioned national professional organizations to play a leading role in determining not only what physicians should know throughout their careers but also the most effective methods for delivering and assessing continuing education (Manning & Petit, 1987).
This article is the first in an ongoing series exploring how and why the Michigan State Medical Society is advocating for meaningful CME reform in Michigan and supporting House Bill 5313. Members are encouraged to visit the MSMS Grassroots Action Center to stay informed and easily contact legislators about the issues shaping the future of medicine in Michigan.
Josseran L, Chaperon J. History of continuing medical education in the United States. Presse Med. 2001 Mar 17;30(10):493-7. French. PMID: 11307493.
Manning PR, Petit DW. The past, present, and future of continuing medical education. Achievements and opportunities, computers and recertification. JAMA. 1987 Dec 25;258(24):3542-6. PMID: 3316729.