CME for new Texas physicians and residents: what's due, and when it starts

Key facts: CME for new Texas physicians

PIT permit holder

No CME and no CE Broker account needed; CME applies once a full license is issued (TMB FAQ 443)

First registration

Newly licensed physicians are exempt from the CME requirement the first time they register (TMB CE page)

Short first period

If the initial registration period is under 24 months, no CE is required before the first renewal (TMB CE page FAQ)

Opioid (direct patient care)

2 formal hours in each of the first two renewal periods, 2 of them by the first anniversary of issuance, then every 8 years (Occ. Code §156.055)

Human trafficking (direct patient care)

1 hour in the first renewal period after issuance, then every third renewal period (Occ. Code §156.060)

In residency or fellowship

Alternate compliance: the training program satisfies the hours (22 TAC §161.35(b)(2))

Finished training recently

TMB page: within 6 months before your renewal application. Rule text: within six months before obtaining licensure (TMB CE page; 22 TAC §161.35(b)(3))

Registration fee

Due within 90 days of the license issue date; no fee exemption for physicians in training (TMB renewal page)

Last verified October 17, 2026. Not affiliated with TMB or CE Broker.

The general rule (48 credits every two years, at least 24 formal) is on the Texas CME requirements page. This guide covers what's different in your first years.

Do residents need CME in Texas?

Not while you're on a Physician-in-Training permit. TMB says PIT holders aren't required to complete CME or open a CE Broker account. If you hold a full Texas license during residency or fellowship, TMB's rules presume your training program satisfies the hour requirement, though topic courses can still apply.

Do I need CME for my first Texas license renewal?

Usually not for the hour total. TMB exempts newly licensed physicians the first time they register, and if your initial registration period was shorter than 24 months, no CE is required before your first renewal. Check the topic deadlines anyway, because opioid and human trafficking timing starts at licensure.

Which CME is still due in my first years?

TMB defines direct patient care as "any in-person or real-time audio or visual communication with a patient or a patient's legal medical decision-maker for the purpose of evaluation, treatment, diagnosis, directly testing or ordering of tests, or reviewing or interpreting of test results."

Example timeline for a physician licensed on July 1 (illustration only):

1. Within 90 days: pay the first registration fee ($281.48 for a 12-month permit or $467.48 for 24 months, per TMB as of 9/1/2025).
2. By the next July 1: 2 formal opioid hours, if you provide direct patient care. See Texas opioid CME.
3. Before the first renewal: 1 HHSC-approved human trafficking hour if you provide direct patient care (free courses); the Life of the Mother Act course if your specialty is on TMB's list; and forensic evidence CME if you work in an ER or urgent care and your license expires on or after February 28, 2027.
4. Later renewals: the full 48 credits (24 formal) and 2 ethics hours apply, and 2 opioid hours are due again in the second renewal period.

Does finishing residency count as CME?

It can, but two official sources word it differently. TMB's page says physicians who finished training within six months before their renewal application satisfy CME through the program. The rule text, 22 TAC §161.35(b)(3), says within six months before obtaining licensure. If you're relying on this, confirm with TMB Registrations which wording applies to you.

We show both wordings and don't pick one. Alternate compliance covers ethics but not human trafficking, and whether it covers opioid depends on your board, per TMB's CME Hours Requirement Chart.

Do I need a CE Broker account as a new physician?

Yes, once you hold a full license. All TMB licensees renewing on or after September 1, 2026 need an active CE Broker account, and the free Basic plan is enough. PIT permit holders don't need one. Set it up early so courses you take in your first year are recorded with certificates.

See CE Broker Basic is free and how to report CME in CE Broker.

Are residents exempt from the Texas registration fee?

No. TMB states there are no registration fee exemptions for physicians who are in training. A new license must be registered within 90 days of the issue date. After that a $75 penalty applies, then $150 after 120 days, and the license is considered canceled if it isn't registered within 12 months.

Fee table and deadlines: first registration of a new license.