Washington State Board of Osteopathic Medicine and Surgery · OSTEOPATHIC

150 hours triennially reporting. 60-hour Category 1 floor. Annual birthday renewal.

A source-verified guide to Washington's CME requirements for osteopathic physicians — hours, mandatory topics, audit rules, and exemptions.

Updated April 2026Sourced from WSBOMS~1 min read
Licensed as an MD instead? Washington regulates MDs through a separate board. See Washington MD CME requirements →

Reviewed by Doug Doehrman, MD · Last reviewed April 21, 2026

Mandatory topics

For osteopathic physicians, 150 hours is the total CME requirement. Washington also requires a set of one-time topics that count toward the 150-hour total.

Suicide prevention[1]
6 hrs
One-time
One-time training. Must be completed by the end of the first full CE reporting period after January 1, 2016, or after initial licensure, whichever is later. Training must be on the DOH model list developed under RCW 43.70.442. Hours count toward the 150-hour triennial total.
View sourceVerbatim from source
“A licensed osteopathic physician, except for osteopathic physicians holding a post-graduate training limited license, must complete a board-approved one-time training that is at least six hours long in suicide assessment, treatment, and management.”
WAC 246-853-065See source [1] in Primary Sources
Opioid / controlled substances[2]
1 hr
One-time
One-time requirement. Must be completed by end of first full CE reporting period after January 1, 2019, or after initial licensure, whichever is later. Applies to DOs who prescribe opioids. Hours count toward the 150-hour triennial total.
View sourceVerbatim from source
“In order to prescribe an opioid in Washington state, an osteopathic physician licensed to prescribe opioids shall complete a one-time continuing education requirement regarding best practices in the prescribing of opioids and the current opioid prescribing rules in this chapter. The continuing education must be at least one hour in length.”
WAC 246-853-685(1)See source [2] in Primary Sources
Cultural competency[3]
2 hrs
Quadrennial
2 hours of health equity continuing education training every four years. These 2 hours count toward applicable CE requirements. Course content must include implicit bias training, individual and system-level interventions, cultural competency skills, and assessment of ability to apply health equity concepts.
View sourceVerbatim from source
“An osteopathic physician must complete two hours of health equity continuing education training every four years as described in WAC 246-12-800 through 246-12-830.”
WAC 246-853-075(1)See source [3] in Primary Sources
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Accepted credit

Credit must come from an organization accredited by the ACCME, AMA, Washington 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
AOA Category 1-A
DOs onlymin 60 hrs
A minimum of 60 credit hours of the total 150-hour requirement must be in Category 1. Category 1-A includes formal educational programs sponsored by nationally recognized osteopathic or medical institutions, organizations, and their affiliates. One clock hour equals one credit hour. The 60-hour Category 1 floor is a structural difference from Washington MDs, who have a 200-hour quadrennial requirement with different category rules.SourceWAC 246-853-070(1)[4]
AMA PRA Category 1
DOs only
A current AMA Physician's Recognition Award (PRA) may be used in lieu of individual 150-hour CME accumulation. However, alternative pathways do NOT waive Washington state-specific mandatory topics (suicide, opioid, health equity) per WAC 246-853-080(3).SourceWAC 246-853-080(2)(c)[5]
Board certification alternative pathways
DOs only
The 150-hour requirement may also be satisfied by ABOMS or ABMS certification/recertification within the last 6 years, or by holding a current AOA Certificate of Excellence in CME. These alternative pathways substitute for the 150-hour accumulation requirement but do NOT waive the Washington state-specific mandatory topic requirements.SourceWAC 246-853-080(2)[5]
Documentation & audit

Licenses are renewed every year on the physician's birthday.[6] Washington DOs have ANNUAL license renewal but TRIENNIAL (36-month) CME reporting — an unusual combination. The CME period is the 36 months preceding renewal.[4] The renewalCycleBasis 'birth_date' reflects the annual birthday renewal anchor.

Waivers & exemptions

Post-graduate training limited license holders are exempt from the one-time suicide assessment, treatment, and management training requirement.[1]

FAQ
How many CME hours do Washington DOs need?
Washington DOs must complete 150 hours of CME per three-year reporting period,[5] with at least 60 hours in Category 1 (formal institutional programs).[4] Licenses renew annually on the physician's birthday,[6] but the CME window is the 36 months preceding that renewal. A one-time 6-hour suicide assessment, treatment, and management training applies.[1] A one-time 1-hour opioid-prescribing training applies to opioid-prescribing DOs.[2] Every four years, DOs must also complete 2 hours of health equity training.[3]
How is the Washington DO rule different from the MD rule?
Washington DOs are licensed by the Washington State Board of Osteopathic Medicine and Surgery under RCW 18.57 and WAC 246-853, a separate agency from the Washington Medical Commission (MDs under RCW 18.71 / WAC 246-919).[7] The numeric frameworks differ — DOs owe 150 hours per three years, MDs 200 hours per four years — and renewal cadence differs as well (DO annual birthday renewal vs. MD biennial). The mandatory-topic requirements (suicide 6 hours one-time, opioid 1 hour one-time, health equity 2 hours every four years) are substantively identical in hours, timing, and how they count toward the overall total.
How does Washington's annual-renewal triennial-reporting structure work?
Annual renewal is set on the physician's birthday,[6] but the CME reporting window is pegged to the 36 months preceding each renewal.[4] Washington DOs therefore renew every year but remain accountable for the full 150-hour triennial total at each renewal — the reporting window rolls forward with birthday. Alternative pathways (ABOMS or ABMS certification, AOA Certificate of Excellence, current AMA PRA) substitute for the 150-hour accumulation but do not waive the Washington state-specific mandatory topics.[5]

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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. WAC 246-853-065 — Mandatory One-Time Training in Suicide Assessment, Treatment, and Management (DO)
    Primary sourceAccessed 2026-04-18
    Show verbatim text
    “A licensed osteopathic physician, except for osteopathic physicians holding a post-graduate training limited license, must complete a board-approved one-time training that is at least six hours long in suicide assessment, treatment, and management.”WAC 246-853-065
  2. WAC 246-853-685 — Continuing Education Requirements for Opioid Prescribing (DO)
    Primary sourceAccessed 2026-04-18
    Show verbatim text
    “In order to prescribe an opioid in Washington state, an osteopathic physician licensed to prescribe opioids shall complete a one-time continuing education requirement regarding best practices in the prescribing of opioids and the current opioid prescribing rules in this chapter. The continuing education must be at least one hour in length.”WAC 246-853-685(1)
  3. WAC 246-853-075 — Health Equity Continuing Education Training Requirements (DO)
    Primary sourceAccessed 2026-04-18
    Show verbatim text
    “An osteopathic physician must complete two hours of health equity continuing education training every four years as described in WAC 246-12-800 through 246-12-830.”WAC 246-853-075(1)
  4. WAC 246-853-070 — Categories of Creditable CE Activities (DO)
    Primary sourceAccessed 2026-04-18
    Show verbatim text
    “The credits must be earned in the thirty-six month period preceding application for renewal of licensure. One clock hour shall equal one credit hour. (1) Category 1 – A minimum of sixty credit hours of the total one hundred fifty hour requirements are mandatory under this general category.”WAC 246-853-070(1)
  5. WAC 246-853-080 — Continuing Education (DO)
    Primary sourceAccessed 2026-04-21
    Show verbatim text
    “Licensed osteopathic physicians and surgeons must complete 150 hours of creditable continuing medical education (CME) every three years in accordance with chapter 246-12 WAC.”WAC 246-853-080(1)
  6. WAC 246-853-990 — Osteopathic Fees and Renewal Cycle
    Primary sourceAccessed 2026-04-18
    Show verbatim text
    “Licenses must be renewed every year on the physician's birthday as provided in chapter 246-12 WAC, except postgraduate training limited licenses.”WAC 246-853-990(1)
  7. RCW 18.57.050 — Osteopathic License Renewal and Continuing Education Authority
    Primary sourceAccessed 2026-04-21
    Show verbatim text
    “The board may establish rules and regulations governing mandatory continuing education requirements which shall be met by physicians applying for renewal of licenses.”RCW 18.57.050(1)

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 Washington State Board of Osteopathic Medicine and Surgery, 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's medical board before relying on any information presented here.

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