DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS
DIRECTOR'S OFFICE
OPTOMETRY - GENERAL RULES
Filed with the secretary of state on
These rules become effective immediately after filing with the secretary of state unless adopted under section 33, 44, or 45a(9) of the administrative procedures act of 1969, 1969 PA 306, MCL 24.233, 24.244, or 24.245a. Rules adopted under these sections become effective 7 days after filing with the secretary of state.
(By authority conferred on the director of the department of licensing and regulatory affairs by sections 16145, 16148, 16174, 16287, and 17431 of the public health code, 1978 PA 368, MCL 333.16145, 333.16148, 333.16174, 333.16287, and 333.17431 and Executive Reorganization Order Nos. 1991-9, 1996-2, 2003-1, and 2011-4, MCL 338.3501, 445.2001, 445.2011, and 445.2030)
R 338.301, R 338.321, R 338.322, R 338.325, R 338.328, R 338.331, R 338.332, and R 338.333 of the Michigan Administrative Code are amended, as follows:
PART 1. GENERAL PROVISIONS
R 338.301 Definitions.
Rule 1. (1) As used in these rules:
(a) “AAO” means the American Academy of Optometry.
(b) “ACOE” means the Accreditation Council on Optometric Education.
(c) “Adverse drug reaction" means an adverse physical or psychological reaction experienced by an individual resulting from a diagnostic therapeutic agent administered by an optometrist that occurs within 24 hours after the therapeutic agent was administered. An adverse drug reaction includes any of the following:
(i) Red eye.
(ii) Painful eye.
(iii) Decrease in vision.
(iv) Pale or red swelling of the periocular or periorbital tissues.
(v) Nausea.
(vi) Vomiting.
(vii) Fainting.
(viii) Mental confusion.
(ix) Cessation of respiration.
(d) “AOA” means the American Optometric Association.
(e) "Board" means the Michigan board of optometry.
(f) "Classroom
hour," for the purpose of determining whether a course of study meets the
requirements of section 17412(2)(a) or 17435(2)(b) of the code, MCL 333.17412
and 333.17435, means a 50 to 60 minute period of lecture, group discussion, or
laboratory directly associated with a course in pharmacology. Time spent
working in a clinic other than as part of a laboratory directly associated with
a course in pharmacology does not qualify as a “classroom hour.”
(g) “Code" means
the public health code, 1978 PA 368, MCL 333.1101 to 333.25211.
(h)(g) “COPE”
means the Council on Optometric Practitioner Education.
(i)(h)
"Course of study in general and clinical pharmacology" means a course
of study that is completed in a board-approved school or college, in general
and clinical pharmacology as it relates to optometry, with the characteristics
described in section 17412(2)(a) of the code, MCL 333.17412. Not less than 30
of the 60 classroom hours of the course of study must be allocated to ocular
pharmacology and must emphasize the systemic effects of, and reactions to,
topical ocular diagnostic pharmaceutical agents, including the emergency
management and referral of any adverse reactions that may occur. Time spent working in a clinic, other than as part of a
laboratory directly associated with a course in pharmacology, does not qualify
as a classroom hour.
(j)(i) "Course
of study relating to the didactic and clinical use of therapeutic
pharmaceutical agents" means a course of study that is comprised of a
minimum of 10 quarter hours or 7 semester hours of credit or 100 classroom
hours of study, is completed in a board-approved school or college, and is in
subjects relating to the didactic and clinical use of therapeutic
pharmaceutical agents related to optometry. Time spent working in a clinic,
other than as part of a laboratory directly associated with a course in pharmacology,
does not qualify as a classroom hour.
(k) “CPDO” means the
Continued Professional Development in Optometry.
(l)(j) “CPR”
means cardiopulmonary resuscitation.
(k) “CSE” means Clinical Skills Examination.
(m)(l)
"Department" means the department of licensing and regulatory
affairs.
(o)(n) “Informed
consent for an established patient” means consent by a patient or a patient’s
legal representative for treatment, medication, or services after there has
been full disclosure of the facts needed for the patient or the patient’s legal
representative to make a voluntary decision based on the elements of knowledge,
comprehension, and willingness to receive the treatment, medication, or
service.
(p)(o) “Informed
consent for a new patient” means a written agreement or documentation of a
verbal agreement by a patient or a patient’s legal representative for
treatment, medication, or services after there has been full disclosure of the
facts needed for the patient or the patient’s legal representative to make a
voluntary decision based on the elements of knowledge, comprehension, and
willingness to receive the treatment, medication, or service.
(q)(p) “MOA”
means the Michigan Optometric Association.
(r)(q) “NBEO”
means the National Board of Examiners in Optometry.
(s)(r) “New
patient” means a patient who has not received a professional service from a
provider in the optometrist’s practice group within the preceding 3 years and 1
day.
(s) “PEPS” means Patient Encounters and Performance Skills.
(t) “TMOD” means Treatment and Management of Ocular Disease.
(2) A term defined in the code has the same meaning when used in these rules.
PART 2. EDUCATIONAL PROGRAMS, EXAMINATIONS,
LICENSES AND CERTIFICATIONS
R 338.321 Professional optometric degree program; approval standards.
Rule 21. (1) The board approves
and adopts by reference the standards of ACOE set forth in the publication
entitled, "Accreditation Council on Optometric Education Policy and
Procedure Manual,” published June 2022 August 2023, which
provides for the accreditation of professional optometric degree programs. A
copy of the Accreditation Manual of ACOE is available free of charge from the
AOA’s website at https://www.aoa.org/AOA/Documents/Education/ACOE/ACOE_Policy_and_Procedure_Manual_07_2021.pdf
https://theacoe.org/Affiliates/ACOE/Documents/ACOE/Current%20ACOE%20Policy%20and%20Procedure%20Manual.pdf.
Printed copies also are available for inspection and distribution at a cost of 10
25 cents per page from the Bureau of Professional Licensing, Department
of Licensing and Regulatory Affairs, Ottawa Building, 611 West Ottawa, P.O. Box
30670, Lansing, Michigan 48909.
(2) A professional optometric degree program accredited by ACOE is considered approved by the board.
R 338.322 Examination approval and adoption; limitations; passing score.
Rule 22. (1) The board approves and adopts the NBEO examinations developed, administered, and scored by the NBEO or its successor.
(2) An applicant applying for licensure shall have achieved a passing score on all of the following parts of the NBEO examinations:
(a) Part I.
(b) Part II, including a passing score on the TMOD examination imbedded in Part II.
(c) Part III CSE or PEPS examination.
(3) An applicant for licensure is limited to attempting to achieve a passing score on the NBEO examination to no more than 6 attempts. A licensee shall not sponsor an applicant for licensure that is attempting to achieve a passing score on the NBEO examination if the applicant has previously attempted to pass the examination 6 or more times.
(4) The accepted passing score for each part of the NBEO examination for licensure is the passing scores established by the NBEO or its successor.
R 338. 325 Licensure by endorsement.
Rule 25. An applicant who
has never held an optometrist license in this state, for licensure by
endorsement shall who hold holds an active license in
good standing in another state or province of Canada, and who is not
applying for licensure by examination, may apply for licensure by endorsement
and submit a completed application on a form provided by the department,
together with the requisite fee. In addition to meeting the requirements of the
code and the administrative rules promulgated under the code, an applicant
shall comply with all of the following requirements as noted by (√):
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(a) For an applicant who is licensed in another state: |
Licensed for less than 3 years. |
Licensed 3 years or more. |
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(i) |
Establish that the applicant is of good moral character as defined in, and determined under, 1974 PA 381, MCL 338.41 to 338.47. |
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(ii) |
Submit fingerprints as required under section 16174(3) of the code, MCL 333.16174. |
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(iii) |
Graduate from a school of optometry approved by the board under R 338.321. |
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(iv) |
Achieve a passing score on parts I, II, and III of the NBEO examination, including a passing score on the TMOD examination given by NBEO or its successor organization. |
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(v) |
Achieve a minimum scaled score of 75 on the optometry jurisprudence examination developed and administered by the department or an entity approved by the department. |
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(vi) |
Hold a license in good standing granting therapeutic prescriptive certification at the highest level authorized in the state of the United States where the applicant is currently licensed. |
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(vii) |
Hold a valid CPR certificate issued by any of the following: (A) The Red Cross. (B) The American Heart Association. (C) An accredited hospital. (D) An organization or institution comparable to those identified in subparagraphs (A) to (C) of this paragraph. |
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(viii) |
Comply with both of the following: (A) Disclose each license, registration, or certification in a health profession or specialty issued by another state, the United States military, the federal government, or another country on the application form. (B) Satisfy the requirements of section 16174(2) of the code, MCL 333.16174, including verification from the issuing entity showing that disciplinary proceedings are not pending against the applicant and sanctions are not in force at the time of application. |
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(b) For an applicant who is licensed in a province of Canada: |
Licensed less than 10 years. |
Licensed 10 years or more. |
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(i) |
Establish that the applicant is of good moral character as defined in, and determined under, 1974 PA 381, MCL 338.41 to 338.47. |
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(ii) |
Submit fingerprints as required under section 16174(3) of the code, MCL 333.16174. |
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(iii) |
Graduate from a school of optometry approved by the board under R 338.321. |
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(iv) |
Achieve a passing score on parts I, II, and III of the NBEO examination, including a passing score on the TMOD examination given by NBEO or its successor organization. |
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(v) |
Achieve a minimum scaled score
of 75 on the optometry jurisprudence examination |
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(vi) |
Hold a license in good standing granting therapeutic prescriptive certification at the highest level authorized in the province of Canada where the applicant is currently licensed. |
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(vii) |
Hold a valid CPR certificate issued by any of the following: (A) The Red Cross. (B) The American Heart Association. (C) An accredited hospital. (D) An organization or institution comparable to those identified in subparagraphs (A) to (C) of this paragraph. |
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(viii) |
Comply with both of the following: (A) Disclose each license, registration, or certification in a health profession or specialty issued by another state, the United States military, the federal government, or another country on the application form. (B) Satisfy the requirements of section 16174(2) of the code, MCL 333.16174, including verification from the issuing entity showing that disciplinary proceedings are not pending against the applicant and sanctions are not in force at the time of application. |
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R 338.328 Relicensure.
Rule 28. (1) An applicant whose license has lapsed may be relicensed under section 16201(3) or (4) of the code, MCL 333.16201, as applicable, if the applicant meets the requirements of the code and the administrative rules promulgated under the code and satisfies the following requirements as noted by (√):
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(a) For an applicant who has let his or her Michigan license lapse and is not currently licensed in another state or in Canada: |
Lapsed 3 years or less. |
Lapsed more than 3 years, but less than 6 years. |
Lapsed 6 years or more. |
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(i) |
Submit a completed application on a form provided by the department, together with the required fee. |
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(ii) |
Establish that the applicant is of good moral character as defined in, and determined under, 1974 PA 381, MCL 338.41 to 338.47. |
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(iii) |
Submit fingerprints as required under section 16174(3) of the code, MCL 333.16174. |
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(iv) |
Submit proof of having completed 40 hours of continuing education as required under R 338.331, that was earned within the 2-year period immediately preceding the date of relicensure, subject to both of the following: (A) At least 2 of the 40 hours of continuing education must be in pain and symptom management, as provided under R 338.331(3). (B) If certified to administer therapeutic pharmaceutical agents, at least 20 of the 40 hours of continuing education must be in pharmacological management of ocular conditions, as provided under R 338.331(2), and the applicant shall hold a current CPR certificate. |
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(v) |
Achieve a minimum scaled score of 75 on the optometry jurisprudence examination developed and administered by the department, or an entity approved by the department. |
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(vi) |
Achieve a passing score on parts I, II, and III of the
NBEO examination |
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(vii) |
An applicant who is or has ever been licensed, registered, or certified in a health profession or specialty by another state, the United States military, the federal government, or another country, shall do both of the following: (A) Disclose each license, registration, or certification on the application form. (B) Satisfy the requirements of section 16174(2) of the code, MCL 333.16174, including verification from the issuing entity showing that disciplinary proceedings are not pending against the applicant and sanctions are not in force at the time of application. |
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(b) For an applicant who has let his or her Michigan license lapse and is currently licensed in another state or in Canada: |
Lapsed 3 years or less. |
Lapsed more than 3 years, but less than 6 years. |
Lapsed 6 years or more. |
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(i) |
Submit a completed application on a form provided by the department, together with the required fee. |
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(ii) |
Establish that the applicant is of good moral character as defined in, and determined under, 1974 PA 381, MCL 338.41 to 338.47. |
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(iii) |
Submit fingerprints as required under section 16174(3) of the code, MCL 333.16174. |
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(iv) |
Submit proof of having completed 40 hours of continuing education as required under R 338.331, that was earned within the 2-year period immediately preceding the date of relicensure, subject to both of the following: (A) At least 2 of the 40 hours of continuing education must be in pain and symptom management, as provided under R 338.331(3). (B) If certified to administer therapeutic pharmaceutical agents, at least 20 of the 40 hours of continuing education must be in pharmacological management of ocular conditions, as provided under R 338.331(2), and the applicant shall hold a current CPR certificate. |
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(v) |
Achieve a minimum scaled score of 75 on the optometry jurisprudence examination developed and administered by the department, or an entity approved by the department. |
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(vi) |
An applicant who is or has ever been licensed, registered, or certified in a health profession or specialty by another state, the United States military, the federal government, or another country, shall do both of the following: (A) Disclose each license, registration, or certification on the application form. (B) Satisfy the requirements of section 16174(2) of the code, MCL 333.16174, including verification from the issuing entity showing that disciplinary proceedings are not pending against the applicant and sanctions are not in force at the time of application. |
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(2) If relicensure is granted and it is determined that a sanction has been imposed by another state, the United States military, the federal government, or another country, the disciplinary subcommittee may impose appropriate sanctions under section 16174(5) of the code, MCL 333.16174.
PART 3. CONTINUING EDUCATION AND LICENSE RENEWAL
R 338.331 License renewal; continuing education, requirements, limitations.
Rule 31. (1) An applicant for
license renewal shall satisfy the requirements of the R 338.7001 to R
338.7005 and accumulate not less than 40 continuing education hours
approved by the board under R 338.332 or R 338.333 during the 2 years
immediately preceding the date of application for renewal.
(2) An applicant for license renewal who holds certification to administer topical ocular diagnostic pharmaceutical agents or certification to administer and prescribe therapeutic pharmaceutical agents, or both, shall do both of the following:
(a) Accumulate not less than 20 hours of board-approved continuing education in pharmacological management of ocular conditions. The 20 required hours are part of, and not in addition to, the 40 hours required in subrule (1) of this rule. A continuing education program that falls within COPE categories listed in R 338.332(7)(n)(iii)(A) to (I) meets the requirements of this subdivision.
(b) Hold a valid CPR certificate issued by any of the following:
(i) The Red Cross.
(ii) The American Heart Association.
(iii) An accredited hospital.
(iv) An organization or
institution comparable to those identified in paragraphs (i) to (iii) of this paragraph
subdivision.
(3) An applicant for license renewal shall accumulate not less than 2 hours of board approved continuing education in pain and symptom management related to the practice of optometry. A continuing education program that falls within COPE categories listed in R 338.332(6)(n)(iv)(A) to (C) meets the requirements of this subrule. Continuing education hours in pain and symptom management, as they relate to the practice of optometry, may include, but are not limited to, the following:
(a) Ethics and health policy related to pain.
(b) Pain definitions.
(c) Basic sciences related to pain, including pharmacology, psychology, sociology, and anthropology.
(d) Clinical sciences related to pain, including specific pain conditions and pain in special contexts and settings.
(e) Clinician-patient communications related to pain.
(f) Management of pain, including evaluation and treatment and non-pharmacological and pharmacological management.
(g) Ensuring quality pain care.
(h) Michigan programs and resources relevant to pain.
(4) A minimum of 20 of the
required continuing education hours must be completed in a live, synchronous
learning format. At least 20 hours of the required 40 hours of
continuing education must be completed in-person or in a live, synchronous format
that provides for the opportunity of direct interaction between the presenter
and the participants, including, but not limited to, lectures, symposia, live
teleconferences, and workshops. The remaining 20 hours may be
completed in any other format.
(5) An applicant for license renewal may earn a maximum of 9 continuing education hours per licensure cycle in practice management. A continuing education program that falls within COPE categories listed in R 338.332(6)(n)(ii)(A) and (B) meets the requirements of this subrule.
(6) A licensee may not earn continuing education credit for completing a continuing education program or activity that is identical or substantially identical to a program or activity the licensee has already earned credit for during that renewal period.
(7) If a licensee completes a continuing education program approved by the board under R 338.332 that satisfies the implicit bias training required under R 338.7004, that program may be used to satisfy the requirements of R 338.7004 and continuing education credit for license renewal.
(6)(8) Submission
of an application for renewal constitutes the applicant's certificate of
compliance with the requirements of this rule.
(7)(9) An
optometrist shall retain documentation of meeting the requirements of this rule
for a period of 4 years after the date of applying for license renewal. The
licensee’s documentation must show the licensee’s name, number of credits
earned per program or activity, the sponsor’s name or the name of the
organization that approved the program or activity, and the date that the
program was held or activity was completed. The board may require an applicant
or licensee to submit evidence to demonstrate compliance with this rule.
Failure to comply with this rule is a violation of section 16221(h) of the
code, MCL 333.16221.
(8)(10) A request
for a waiver under section 16205 of the code, MCL 333.16205, must be received
by the department at least 30 days before the last regularly scheduled board
meeting before the expiration date of the license.
R 338.332 Adoption of standards and criteria by reference; board approval of continuing
education programs.
Rule 32. (1) The board approves
and adopts by reference the standards and criteria of COPE for accreditation of
an activity or qualification of a course that are set forth in the publications
entitled “Activity Accreditation Manual,” revised July December 2022,
and “Course Qualification Manual,” revised July December 2022. A
copy of the publications may be obtained at no cost from the Association of
Regulatory Boards of Optometry’s website at http://www.arbo.org https://www.arbo.org/cope/qualifications.
Printed copies also are available for inspection and distribution at a cost of 10 25 cents per page from the
Bureau of Professional Licensing, Department of Licensing and Regulatory Affairs,
Ottawa Building, 611 West Ottawa, P.O. Box 30670, Lansing, Michigan 48909.
(2) A continuing education program related to the practice of optometry that has been accredited by COPE is considered approved by the board.
(3) A course or continuing education program related to the practice of optometry offered by a college or university program approved by the board under R 338.321 is considered approved by the board.
(4) A continuing education program related to the practice of optometry that has been approved or sponsored by the AAO, the AOA, or the MOA is considered approved by the board.
(5) A continuing education program related to the practice of optometry that has been approved by another state board of optometry is considered approved by the board.
(6) A continuing education
program that is not approved by the board under subrules (1) to (5) of this
rule, or as provided in R 338.333, may apply for board approval by submitting
an application to the department. The application must be received not less
than 90 calendar days before the program presentation. The department shall
deny An an application received less than 90 days before the
program presentation will be denied as untimely.
(7) An application for approval of a continuing education program must include all the following:
(a) The sponsor’s name.
(b) The sponsor’s address.
(c) The program name.
(d) The date of the next scheduled program.
(e) The program location.
(f) The program outline, including all of the following:
(i) An explanation of how the
program is designed to further educate the licensee through acquisition and
application of knowledge, that results in improved patient outcomes.
(ii) The topics and the name of the speaker of each topic.
(iii) The times of the specific topics and breaks included in the program.
(g) The résumé of each speaker or instructor for the program.
(h) A description of the
delivery method, or methods to be used, and the techniques that will be employed
to ensure active participation.
(i) A brief description of the sponsoring organization.
(j) The name, title, and
address of the program director and a description of his or her the
program director’s qualifications to direct the program.
(k) A description of how participants will be notified that continuing education credit has been earned.
(l) A description of the physical facilities or laboratory available to ensure a proper learning environment.
(m) A description of how attendance is monitored and the name of the individual monitoring attendance.
(n) The number of hours of course instruction including all of the following:
(i) The number of hours related to clinical optometry, which may include any of the following COPE categories:
(A) Contact lenses (CL).
(B) Functional vision/pediatrics (FV).
(C) General optometry (GO).
(D) Low vision/vision impairment & rehabilitation (LV).
(E) Public health (PB).
(ii) The number of hours related to practice management, which may include the following COPE categories:
(A) Practice management (PM).
(B) Ethics/jurisprudence (EJ).
(iii) The number of hours related to pharmaceutical management, which may include any of the following COPE categories:
(A) Glaucoma (GL).
(B) Injection skills (IS).
(C) Laser procedures (LP).
(D) Peri-operative management of ophthalmic surgery (PO).
(E) Surgery procedures (Optometric) (SP).
(F) Treatment and management of ocular disease (TD).
(G) Neuro-optometry (NO).
(H) Pharmacology (PH).
(I) Systemic diseases (SD).
(iv) The number of hours related to pain management, which may include any of the following COPE categories:
(A) Pharmacology (PH).
(B) Treatment and management of ocular disease (TD).
(C) Functional vision/pediatrics (FV).
R 338.333 Approved continuing education activities; limitations; documentation.
Rule 33. The board approves all of the following as continuing education if the
subject matter falls within an approved COPE category as listed in R
338.331338.332(7)(n):
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Activity and Proof of Completion |
Number of
Continuing Education Hours Granted or |
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(a) |
Attendance at a continuing education program related to optometric topics approved for category 1 continuing education by the Michigan board of medicine or the Michigan board of osteopathic medicine and surgery.
If audited, a licensee shall submit a copy of a letter or certificate of completion showing the licensee’s name, number of credits earned, sponsor name or the name of the organization that approved the program or activity for continuing education credit, and the date or dates that the program was held or activity completed. |
One continuing education hour in clinical optometry is earned for each 50 to 60 minutes of program attendance. A maximum of 8 continuing education hours may be earned for this activity in each renewal period. |
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(b) |
Attendance at a continuing education program related to optometric pharmacological topics approved for continuing education by the Michigan board of pharmacy.
If audited, a licensee shall submit a copy of a letter or certificate of completion showing the licensee’s name, number of credits earned, sponsor name or the name of the organization that approved the program or activity for continuing education credit, and the date or dates that the program was held or activity completed. |
One continuing education hour in pharmacological management is earned for each 50 to 60 minutes of program attendance. A maximum of 8 continuing education hours may be earned for this activity in each renewal period. Applicants for renewal who hold certification to administer topical ocular diagnostic pharmaceutical agents or certification to administer and prescribe therapeutic pharmaceutical agents, or both, may earn continuing education hours without limitation. |
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(c) |
Initial presentation of or at a continuing education program approved by the board.
If audited, a licensee shall submit a letter from the program’s sponsor, verifying the licensee’s presentation of educational materials and lecture at the continuing education program. |
One continuing education hour in the appropriate COPE category is earned for each 50 to 60 minutes of program presentation, without limitation.
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(d) |
Initial presentation of a scientific exhibit, poster, or paper to a professional optometric organization.
If audited, the licensee shall submit a copy of the document presented with evidence of presentation or a letter from the program sponsor verifying the date of the presentation. |
Two hours of continuing education in clinical optometry are earned for each presentation. No additional credit is granted for preparation of the presentation. |
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(e) |
Initial publication of either of the following: (i) A scientific article relating to the practice of optometry in a peer-reviewed journal or periodical. (ii) A chapter or a portion of a chapter related to the practice of optometry in either a professional healthcare textbook or peer-reviewed textbook.
If audited, the licensee shall submit a copy of the publication that identifies the licensee as the author or a publication acceptance letter and documentation of the peer-review process. |
Six hours of continuing education in clinical optometry are earned for serving as the primary author. Three hours of continuing education in clinical optometry are earned for serving as a secondary author. |
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(f) |
Participating on either of the following: (i) A peer review committee dealing with quality of patient care as it relates to the practice of optometry. (ii) A national or state committee, board, council, or association related to the practice of optometry.
Participation on a committee, board, council, or association is considered acceptable by the board if it enhances the participant’s knowledge and understanding of the field of optometry.
If audited, the licensee shall submit a letter from an organization official verifying the licensee’s participation in at least 50% of the regularly scheduled meetings of the committee, board, council, or association. |
Six hours of continuing education in clinical optometry are earned for participating on a committee. A maximum of 6 continuing education hours may be earned for this activity in each renewal period. |
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(g) |
Taking and passing any nationally recognized advanced competency examination in optometry. |
Every 2 years, 12 hours of continuing education in pharmacology management or clinical optometry are earned. |