2190.  In order to insure the continuing competence of licensed
physicians and surgeons the Division of Licensing shall adopt and
administer standards for the continuing education of such licensees.
The division shall require each licensed physician and surgeon to
demonstrate satisfaction of the continuing education requirements at
intervals of not less than four nor more than six years.



2190.1.  (a) The continuing medical education standards of Section
2190 may be met by educational activities that meet the standards of
the Division of Licensing and serve to maintain, develop, or increase
the knowledge, skills, and professional performance that a physician
and surgeon uses to provide care, or improve the quality of care
provided for patients, including, but not limited to, educational
activities that meet any of the following criteria:
   (1) Have a scientific or clinical content with a direct bearing on
the quality or cost-effective provision of patient care, community
or public health, or preventive medicine.
   (2) Concern quality assurance or improvement, risk management,
health facility standards, or the legal aspects of clinical medicine.

   (3) Concern bioethics or professional ethics.
   (4) Are designed to improve the physician-patient relationship.
   (b) Notwithstanding subdivision (a), educational activities that
are not directed toward the practice of medicine, or are directed
primarily toward the business aspects of medical practice, including,
but not limited to, medical office management, billing and coding,
and marketing shall not be deemed to meet the continuing medical
education standards for licensed physicians and surgeons.
   (c) Educational activities that meet the content standards set
forth in this section and are accredited by the California Medical
Association or the Accreditation Council for Continuing Medical
Education may be deemed by the Division of Licensing to meet its
continuing medical education standards.


2190.2.  The Division of Licensing shall establish criteria that
providers of continuing medical education shall follow to ensure
attendance by licensees throughout the entire course.



2190.3.  All general internists and family physicians who have a
patient population of which over 25 percent are 65 years of age or
older shall complete at least 20 percent of all mandatory continuing
education hours in a course in the field of geriatric medicine or the
care of older patients.



2190.5.  (a)  All physicians and surgeons shall complete a mandatory
continuing education course in the subjects of pain management and
the treatment of terminally ill and dying patients.  For the purposes
of this section, this course shall be a one-time requirement of 12
credit hours within the required minimum established by regulation,
to be completed by December 31, 2006.  All physicians licensed on and
after January 1, 2002, shall complete this requirement within four
years of  their initial license or by their second renewal date,
whichever occurs first.  The board may verify completion of this
requirement on the renewal application form.
   (b) By regulatory action the board may exempt physicians by
practice status category from the requirement in subdivision (a) if
the physician does not engage in direct patient care, does not
provide patient consultations, or does not reside in the State of
California.
   (c) This section shall not apply to physicians practicing in
pathology or radiology speciality areas.


2191.  (a) In determining its continuing education requirements, the
Division of Licensing shall consider including a course in human
sexuality as defined in Section 2090 and nutrition to be taken by
those licensees whose practices may require knowledge in those areas.

   (b) The division shall consider including a course in child abuse
detection and treatment to be taken by those licensees whose
practices are of a nature that there is a likelihood of contact with
abused or neglected children.
   (c) The division shall consider including a course in acupuncture
to be taken by those licensees whose practices may require knowledge
in the area of acupuncture and whose education has not included
instruction in acupuncture.
   (d) The division shall encourage every physician and surgeon to
take nutrition as part of his or her continuing education,
particularly a physician and surgeon involved in primary care.
   (e) The division shall consider including a course in elder abuse
detection and treatment to be taken by those licensees whose
practices are of a nature that there is a likelihood of contact with
abused or neglected persons 65 years of age and older.
   (f) In determining its continuing education requirements, the
division shall consider including a course in the early detection and
treatment of substance abusing pregnant women to be taken by those
licensees whose practices are of a nature that there is a likelihood
of contact with these women.
   (g) In determining its continuing education requirements, the
division shall consider including a course in the special care needs
of drug addicted infants to be taken by those licensees whose
practices are of a nature that there is a likelihood of contact with
these infants.
   (h) In determining its continuing education requirements, the
division shall consider including a course providing training and
guidelines on how to routinely screen for signs exhibited by abused
women, particularly for physicians and surgeons in emergency,
surgical, primary care, pediatric, prenatal, and mental health
settings.  In the event the division establishes a requirement for
continuing education coursework in spousal or partner abuse detection
or treatment, that requirement shall be met by each licensee within
no more than four years from the date the requirement is imposed.
   (i) In determining its continuing education requirements, the
division shall consider including a course in the special care needs
of individuals and their families facing end-of-life issues,
including, but not limited to, all of the following:
   (1) Pain and symptom management.
   (2) The psycho-social dynamics of death.
   (3) Dying and bereavement.
   (4) Hospice care.
   (j) In determining its continuation education requirements, the
division shall give its highest priority to considering a course on
pain management.



2191.1.  The Division of Licensing shall encourage every physician
and surgeon to take a course in pharmacology and pharmaceuticals as
part of his or her continuing education.



2191.2.  The division shall encourage every physician and surgeon to
take a course in geriatric medicine, including geriatric
pharmacology, as part of his or her continuing education.



2196.  The board shall periodically develop and disseminate
information and educational material regarding the detection and
treatment of child abuse and neglect to each licensed physician and
surgeon and to each general acute care hospital in the state.  The
board shall consult with the Office of Child Abuse Prevention in
developing the materials distributed pursuant to this section.



2196.1.  The board shall periodically develop and disseminate
information and educational material regarding the detection and
treatment of elder abuse and neglect to each licensed physician and
surgeon and to each general acute care hospital in this state.  The
board shall consult with the Adult Protective Services Division of
the State Department of Social Services in developing the materials
distributed pursuant to this section.



2196.2.  The board shall periodically develop and disseminate
information and educational material regarding pain management
techniques and procedures to each licensed physician and surgeon and
to each general acute care hospital in this state.  The board shall
consult with the State Department of Health Services in developing
the materials to be distributed pursuant to this section.



2196.5.  The board shall periodically disseminate information and
educational material regarding the detection and treatment of spousal
or partner abuse to each licensed physician and surgeon and to each
general acute care hospital in the state.