PURPOSE: This rule clarifies the license renewal requirements and procedures.

1. (1) All Missouri podiatric physicians shall notify the board office of all offices, shared or individual; or changes in office addresses and designate at which address mail is to be received.
2. (2) Each applicant for license renewal shall certify to the board that s/he has attended twenty-four (24) hours of board-approved continuing medical education (CME) for the biennial renewal period immediately preceding the biennial license renewal date. Applicants who qualify under section 330.010.2, RSMo to perform surgery of the ankle must certify that s/he has attended an additional twenty-six (26) hours of board-approved CME for the biennial renewal period immediately preceding the biennial license renewal date. Prior to January 2005, a copy of Foot & Ankle Board Certification or certificate of a twenty-four (24)-month postgraduate clinical residency program in podiatric surgery shall be on file with the state board for acceptance of the additional CMEs, before the endorsement of “Ankle Surgery Certified” will be added to their biennial renewal license. After January 2005, a certificate of completion of a twenty-four (24)-month postgraduate clinical residency program in podiatric surgery is required for acceptance of the additional CMEs and the “Ankle Surgery Certified” endorsement.
3. (3) The reporting period for satisfying the CME requirements shall be the twenty-four (24)-month period immediately preceding the biennial license renewal date, which is February 28 of each even-numbered year. All CME hours shall be board approved. CME hours earned after the biennial renewal date (February 28 of even-numbered years) shall apply to the next reporting cycle. A renewal license will not be issued until all renewal requirements have been met.
4. (4) For the license renewal due on February 28, 2006, and each subsequent renewal thereafter, the licensee shall certify that s/he has obtained at least twenty-four (24) or fifty (50) hours, whichever is relevant, of continuing medical education during the two (2)-year period preceding the renewal on the renewal form provided by the board. The renewal form shall be submitted directly to the board, either by mail or online renewal, by February 28 of each even-numbered year. The licensee shall not submit the record of CME attendance to the board except in the case of a board audit.
5. (5) Every licensee shall maintain full and complete records of all approved CME hours earned for the two (2) previous reporting periods in addition to the current reporting period. The records shall document the titles of the courses taken, dates, locations, course sponsors, number of hours earned and certificate of attendance or completion. The board may conduct an audit of licensees to verify compliance with the continuing education requirements. Licensees shall assist the board in its audits by providing timely and complete responses to the board’s inquiries.
6. (6) Violation of any provision of this rule shall be grounds for discipline in accordance with section 330.160, RSMo.

7. (7) The following guidelines govern the CME requirements needed to apply for biennial licensure renewal:

   1. (A) Educational programs approved by the Council of Podiatric Medical Education of the American Podiatric Medical Association are currently approved by the board.

   2. (B) The board will review for consideration of CME credits, the following postgraduate study to meet the standards for biennial license renewal. The licensee shall submit a copy of the program schedule, the outline, and the appropriate Continuing Education Board Review Fee to the board office not less than sixty (60) days prior to the date of the program. The outline must indicate the program’s subject matter, the number of hours required for its presentation and the identity and qualifications of the speakers and instructors. After reviewing the schedule and outline, the board may grant approval. If the board approves the program, the credit will be accepted and the licensee may count the CME hours toward the total number of required hours. If the postgraduate study request is submitted after the sixty (60)-day deadline, payment of the Continuing Medical Education Reporting Period Late Fee will be required. The following programs may be reviewed by the board for CME credit:

      1. 1. Educational programs, appropriate to

the practice of podiatric medicine, presented by:

1. A. A hospital accredited by the Joint

Commission on Hospital Accreditation;

1. B. American Medical Association

(AMA); or

1. C. American Osteopathic Association

1. (AOA) or its equivalent.

   1. 2. Meetings. Registered attendance at

relevant podiatric medicine related professional meetings (international, national, regional, state or local). CME credits may be granted for no more than four (4) hours per day for professional meeting attendance.

1. 3. Presenting or speaking at a formal

professional meeting in the area of podiatric medicine or a related field. CME credits may be granted at the rate of four (4) hours for each presentation. No CME credit based on the same presentation will be allowed for use in the subsequent two (2)-year reporting period.

1. 4. Writing a paper published in a pro-

fessional journal, writing an original chapter in a book or an edited book, or for editing or writing a book, in the area of podiatric medicine or a related field. Credits may be granted for the year of publication or presentation. CME credits may be granted at the rate of four (4) hours for each paper, eight (8) hours for each chapter in a book, ten (10) hours for editing a book, and fifteen (15) hours for the publication of a book. No CME credit based on the same materials will be allowed for use in the subsequent two (2)-year reporting period.

1. (C) Licensees who attend the open session of the Missouri State Board of Podiatric Medicine’s board meetings will receive one (1) hour of CME credit per meeting. To qualify, licensees must sign in at the beginning of the open meeting and sign out at the end of the open meeting.
2. (D) Licensees who give presentations in accordance with this rule will receive up to two (2) CME credit hours for each hour of the original presentation and an hour-forhour credit for subsequent presentation of the same material for a total of up to six (6) hours per each two (2)-year reporting period for licensees who are required to obtain twentyfour (24) hours of CME credit, or a total of up to twelve (12) hours per each two (2)-year reporting period for licensees who are required to obtain fifty (50) hours of CME credit.
3. (E) Licensees who are required to obtain twenty-four (24) hours of CME credit in a two (2)-year reporting period may use up to six (6) hours of self-study CME credit in each reporting period, in accordance with this rule. Licensees who are required to obtain fifty (50) hours of CME credit in a two (2)-year reporting period may use up to twelve (12) hours of self-study CME credit in each reporting period, in accordance with this rule.
4. (F) Licensees who are required to obtain twenty-four (24) hours of CME credit in a two (2)-year reporting period may carry over up to six (6) CME credit hours earned in excess of the required twenty-four (24) hours to the next two (2)-year reporting period. Licensees who are required to obtain fifty

1. (50) hours of CME credit in a two (2)-year reporting period may carry over up to twelve

2. (12) CME credit hours earned in excess of the required fifty (50) hours to the next two (2)-year reporting period.

   1. (G) An applicant who has not satisfied the CME requirements in accordance with this rule shall be required to meet the CME requirements retroactively as well as pay the required Continuing Medical Education Reporting Period Late Fee.

   2. (H) Exceptions to the provisions of this rule include the following:

      1. 1. Licensees who were in training at

least a minimum of six (6) months during the CME reporting period at a residency program approved by the Council of Podiatric Medical Education of the American Podiatric Medical Association are exempt from obtaining the required CME hours for the continuing medical education reporting period that the licensee was in the residency program. The residency program director must complete the form provided by the board, attesting that the applicant has attended an approved postgraduate clinical residency program for not less than six (6) months during the twentyfour (24)-month continuing medical education renewal reporting period. The certificate must indicate that the applicant was in good standing and indicate the dates of attendance during the postgraduate clinical residency program. The licensee shall maintain this certificate in his/her records of CME attendance.

1. 2. For the first renewal of a podiatrist’s

license, the board will consider the passing score of the national board (Part III) exam as satisfying twelve (12) hours of the required twenty-four (24) hours of CME as required by this rule if the national board (Part III) exam was taken within the CME reporting period.

1. 3. A licensee who has obtained Ameri-

can Podiatric Specialty Board certification or recertification during the reporting period shall be deemed to have obtained the required hours of CME. The licensee shall maintain documentation evidencing the certification or recertification.

1. 4. A licensee who participated in a fel-

lowship program in an approved teaching institution shall be deemed to have obtained the required hours of CME if at least sixty (60) days of the reporting period were spent in the fellowship and the fellowship is determined to be advanced training. The licensee shall maintain documentation from the fellowship program director verifying the number of days in the program and that the program is advanced training.

1. 5. Pursuant to section 41.946, RSMo

and notwithstanding any other provision of law, any person licensed or certified to prac- 20 CSR 2230-2

tice a trade or profession by the state of Missouri or any branch or agency thereof that requires an annual period of continuing education or training as a condition of continued or renewed licensing or certification, and who is or becomes a member of the National Guard or of any reserve component of the Armed Forces of the United States who is called to full-time active duty in the service of the United States under competent orders shall, during the period of full-time active duty, be exempt from any such requirement for continuing education or training without his/her status, license, certification or right to practice his/her trade or profession being affected and shall not be required, upon returning from full-time active duty, to make up or retake any training or education for which s/he was exempt under the provisions of this section.

1. (I) A licensee who cannot complete the required hours of CME because of personal illness or other circumstances beyond the licensee’s control, which the board deems to be sufficient to impose an insurmountable hardship may apply for an extension of time to complete the CME requirements. Any extension of time to complete the CME requirements will be granted solely at the discretion of the board. The licensee shall make a written application for extension of time prior to the February 28 deadline for completion of the CME requirement. The application for extension shall be accompanied by the Continuing Medical Education Reporting Period Late Fee. The licensee shall provide full and complete written documentation of the grounds supporting the reasons for which an extension is sought.

   1. 1. Illness extensions may be granted

only to a licensee who has suffered a personal illness or personal disability of a nature as to prevent him/her from engaging in the active practice of podiatry for at least a majority of the reporting period. At a minimum, the licensee shall provide the board with written documentation from the licensee’s treating physician stating the nature of the illness or disability, the period of the illness or disability, any limitations on the licensee’s activities that resulted from the illness or disability, documentation of the number of CME hours earned in the two (2)-year reporting period and a plan for completing the balance of the CME requirement.

1. 2. The board, solely at its discretion,

may grant an extension based on unforeseeable circumstances beyond the licensee’s control that impose an insurmountable hardship precluding the licensee from obtaining the required CME. At a minimum, the licensee shall provide written documentation FINANCIAL INSTITUTIONS AND PROFESSIONAL REGISTRATION

explaining specifically and in detail the nature of the circumstances, why the circumstances were unforeseeable and beyond the licensee’s control, the period during which the circumstances were in existence, documentation of the number of CME credits earned in the two (2)-year reporting period and the licensee’s plan for completing the balance of the CME requirement.

1. 3. An extension of time shall not be

granted to any licensee who obtained an extension in the immediately preceding CME reporting period in which the licensee held an active license.

1. (8) Any application for biennial license renewal received by the board more than six
2. (6) months after the renewal date shall be void and the applicant shall be required to make new application and pay the applicable fees in accordance with section 330.030, RSMo, which shall include successful completion of the Missouri Law Examination administered by the board.
3. (9) A Missouri licensed podiatrist has the ongoing obligation to keep the board informed if the licensee has been finally adjudicated or found guilty, or entered a plea of guilty or nolo contendere, in a criminal prosecution under the laws of any state or of the United States, for any offense reasonably related to the qualifications, functions or duties of any profession licensed or regulated under Chapter 330, RSMo, for any offense an essential element of which is fraud, dishonesty, or an act of violence, or for any offense involving moral turpitude, whether or not sentence was imposed. The licensee shall provide this information to the board within thirty (30) days of being finally adjudicated or found guilty.

AUTHORITY: sections 330.010, 330.070 and 330.140, RSMo 2000.* This rule originally filed as 4 CSR 230-2.030. Original rule filed Dec. 23, 1975, effective Jan. 2, 1976. Rescinded and readopted: Filed Dec. 9, 1981, effective March 11, 1982. Amended: Filed Nov. 12, 1982, effective Feb. 11, 1983. Amended: Filed Dec. 6, 1982, effective March 11, 1983. Amended: Filed Sept. 24, 1984, effective Feb. 13, 1985. Amended: Filed Oct. 15, 1985, effective Jan. 12, 1986. Amended: Filed July 17, 1989, effective Oct. 12, 1989. Amended: Filed Aug. 2, 1991, effective Dec. 9, 1991. Amended: Filed Feb. 4, 1992, effective June 25, 1992. Amended: Filed Oct. 30, 1997, effective May 30, 1998. Amended: Filed Aug. 20, 1998, effective Jan. 30, 1999. Amended: Filed April 29, 1999, effective Oct. 30, 1999. Amended: Filed Sept. 1, 2004, effective March 30, 2005. Moved to 20 CSR 2230-2.030, effective Aug. 28, 2006.

*Original authority: 330.010, RSMo 1939, amended 1945, 1961, 1969, 1976, 1995, 1998; 330.070 RSMo 1945, amended 1947, 1971, 1981, 1999; and 330.140, RSMo 1945, amended 1981, 1993, 1995, 1998. Op. Atty. Gen. No. 410, Fulkerson (12-5- 68). It would be valid exercise of inherent police power of state to adopt legislation requiring reasonable “continuing education” program in the field of podiatry as condition to annual registration.