CME requirements for NJ Physician License

Question F. :  Continuing Medical Education Courses: Pursuant to N.J.S.A. 45:9-7.1, all licensed physicians are required as a condition for biennial renewal to complete 100 credits of continuing medical education courses.

All credits must be in Category I or Category II as recognized by the American Medical Association, the American Osteopathic Association, the American Podiatric Medical Association, the Accreditation Council for Continuing Medical Education or other comparable organizations recognized by the Board.

Forty of the 100 credits must be in Category I and 2 of those 40 Category I credits must be in programs or on topics relating to end-of-life.

Newly licensed individuals who have completed an accredited graduate medical education program within the 24 months prior to 7/1/13 are exempt from the CME requirement for this renewal.

All licensees must complete a NJ Board Orientation course within 24 months of becoming licensed. If you are a new licensee and have completed or are scheduled to attend a NJ State Board Orientation course, answer “yes” to question f.

If you have been granted a waiver from a continuing education requirement including the end-of-life credits, or if you sought a waiver on or before April 30, 2015, and have not yet been advised as to the Board’s decision concerning your request, you may answer “yes” to question f.

The Board will conduct a random audit of licensees at a later date.

ASA Classification


CLASS I No organic, physiological, biochemical or psychiatric disturbance.  The pathologic process for which operation is to be performed is localized and is not a systemic disturbance.

CLASS II Mild to moderate systemic disturbance caused either by the condition to be treated or by other pathophysiological processes.

CLASS III Severe systemic disturbance or disease from whatever cause, even though it may not be possible to define the degree of disability with finality.

CLASS IV Severe systemic disorder already life‐threatening, not always correctable by the procedure.

CLASS V Moribund patient who has little chance of survival, but is submitted to the procedure in desperation. CLASS VI Organ donor.

NSLIJ Definition of Sedation


1. Minimal sedation (anxiolysis) A drug‐induced state during which patients respond normally to verbal commands.   Although cognitive function and coordination may be impaired, ventilatory and cardiovascular functions are unaffected.

2. Moderate (conscious) sedation/analgesia   A drug‐induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation.  No interventions are required to maintain a patent airway, and spontaneous ventilation is adequate.  Cardiovascular function is usually maintained.  The difference between analgesia and moderate sedation is the intent.  With moderate sedation there is the intent to produce an altered mental state, for the performance of a procedure, as opposed to analgesia (for relief of pain without intentional production of altered mental state such as sedation).

3. Deep sedation/analgesia A drug‐induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation.  The ability to independently maintain ventilatory function maybe impaired.  Patients may require assistance in maintaining a patent airway and spontaneous ventilation may be inadequate.   Cardiovascular function is usually maintained.

4. Anesthesia Consists of general anesthesia and spinal or major regional anesthesia.  It does not include local anesthesia.  General anesthesia is a drug‐induced loss of consciousness during which patients are not arousable, even by painful stimulation.  The ability to independently maintain ventilatory function is often impaired.  Patients often require assistance in maintaining a patent airway, and positive pressure ventilation may be required because of depressed spontaneous ventilation or drug‐induced depression of neuromuscular function.   Cardiovascular function may be impaired.

Ultrasonography of the Diagphragm to Detect Diaphragmatic Dysfunction

Perform US of diphragm during all spontaneous breathing trials and afer extubation every 72 hours until ICU discharge.

Patient supine with 30 degrees HOB elevation.

Use 4-2 probe on area between rib 8 and rib 9, midaxillary line, directed cranially (oblique transverse section)

Identify diaphragm in 2D mode based on phrenicopleural fascia (a bright curved line).

Visualize right hemidiaphragm on transhepatic section trough kidney and L hemidiaphragm on transsplenic section.

Measure diaphragmatic movement directly in 2D mode.

Measure diaphragmatic excusrsion in M-mode using beam directed perpendicular to diaphragmatic line during inspiration.  (Excursion is measured as distance in mm between point A at beginning of inspiration and point B at end of inspiration.  

Obtain 3-4 measurements each evaluation and record best value.

performed into a coronal plan. The ultrasound scan used in the present study was Philips Envisor Series.

Definition of DD

Diaphragmatic dysfunction was defined, during quiet breathing, as a diaphragmatic excursion of 11 mm or less in 2D mode17 and of 10 mm or less on the right and 11 mm or less on the left in M-mode.15 Ultrasound results from the most trained examiner (LFM) were considered as the reference for DD diagnosis.