UCSD/ACCME Requirements & Guidelines for SYLLABUS OR HANDOUT Materials
Revised 04/17/11
**All print/electronic handout materials must be reviewed by the CME office prior to printing or
issuance. Please allow a minimum of 3 business days for review.**
Checklist 
DONE REQUIREMENT
Activity Title, Date and Location
(required)
Logo (required)
Sponsor Listed (required)
Course Description (required)
Target Audience (required)
Objectives (required)
COMMENTS
Please list prominently.
UC San Diego School of Medicine Logo is required on front cover. If
you need the logo, request from CME office.
The University of California, San Diego School of Medicine must be
listed as the accrediting sponsor. Please seek assistance from CME if
joint sponsor.
List a description which tells the potential participants what you would
like them to know about your program, e.g. highlight topic areas.
Identify the types of health professionals specifically targeted (i.e.,
primary care physicians, cardiologists, neurologists, etc.) for the
activity.
Learning objectives should be clearly stated , must be measureable and
written from the perspective of what you expect the learner to do in the
practice setting with the information you are teaching. It is helpful to
formulate the objectives by starting with:
At the conclusion of this activity, the participants should be able to:
Needs Assessment with practice
gap (required)
Accreditation Statement
(required)
A Needs Assessment defines the need for the activity and assesses the
practice gap in terms of knowledge, skills and behavior between “What
is” (actual patient care) and “What should be” (optimal patient care). Or
in other words, it is the difference between what is occurring in practice
and what is expected (the desired outcome), or, the difference between
what is and what should be.
The identified needs are the basis for content, format and evaluation. The
needs identification process sets the stage for the development of the
learning objectives (what the participants can expect to get out of the
activity) which is then followed by format selection (the best method to
deliver content and teach those objectives).
There are 2 types of ACCME accreditation statements, direct or joint.
Direct is used if UC San Diego directly sponsors the activity. The jointly
sponsored statement is used if UC San Diego and another organization
are jointly sponsoring the activity. Please refer to joint sponsorship
guidelines.
Direct:
The University of California, San Diego School of Medicine is
accredited by the Accreditation Council for Continuing Medical
Education to provide continuing medical education for physicians.
Joint:
This activity has been planned and implemented in accordance with the
Essential Areas and policies of the Accreditation Council for Continuing
Medical Education through the joint sponsorship of the University of
California, San Diego School of Medicine and (Joint Sponsor). The
University of California, San Diego School of Medicine is accredited by
the ACCME to provide continuing medical education for physicians.
AMA credit designation statement:
The University of California, San Diego School of Medicine designates
this [learning format] for a maximum of [number of credits] AMA PRA
Category 1 Credit(s)™. Physicians should claim only the credit
commensurate with the extent of their participation in the activity.
Credit Designation Statement
(required)
Cultural and Linguistic
Competency Statement
(required)
Program/Agenda/Schedule
(required)
Presenter List (required)
Disclosure Summary
(required)
Commercial Support
Acknowledgement
Exhibitor Acknowledgement
Notes: AMA PRA Category 1 Credit™ must be italicized. The 7 ACCME
approved learning formats include Live Activity, Enduring Material,
Journal-based CME Activity, Test-Item Writing Activity, Manuscript
Review Activity, PI CME Activity and Internet Point-of-Care Activity.
The number of credits will be included in your approval letter.
Other specialty credit designation statements may also be listed.
This is a California state requirement (regardless of location of activity)
and the subject of Cultural and Linguistic competency should be
incorporated in to your activity. The statement below is required:
California Assembly Bill 1195 requires continuing medical education
activities with patient care components to include curriculum in the
subjects of cultural and linguistic competency. It is the intent of the bill,
which went into effect on July 1, 2006, to encourage physicians and
surgeons, CME providers in the state of California, and the Accreditation
Council for Continuing Medical Education to meet the cultural and
linguistic concerns of a diverse patient population through appropriate
professional development. The planners, speakers and authors of this
CME activity have been encouraged to address issues relevant in their
topic area. In addition, a variety of resources are available that address
cultural and linguistic competency, some of which are included in your
syllabus or handout materials. Additional resources and information
about AB1195 can be found on the UC San Diego CME website at
http://cme.ucsd.edu.
Please be sure to list times with a.m. or p.m. designation and names of
talks along with presenter names.
Please list presenters with affiliations and break out the course
director(s).
This is a summary of all disclosures that were collected. Please see
example. This summary should be placed after the presenter list.
If applicable, list all commercial supporter(s) for the activity that are on
file with UC San Diego CME.
Note: Fully executed Letters of Agreement are required in order to
acknowledge.
If applicable, list any exhibitor information.
University of California, San Diego
Continuing Medical Education (CME)
The Mission of the University of California, San Diego Continuing
Medical Education (UCSD CME) is to provide needs based education
for physicians and health care providers to improve knowledge,
competence and performance and enable the optimum provision of
health care.
UC San Diego Mission
Statement (optional)
We are committed to continual improvement of our educational mission
by researching current adult education and CME literature, participation
in national organizations committed to improving CME, and
implementation of innovative and creative programming that may further
our mission.
UCSD CME sponsors over 100 conferences per year, and produces many
home-study programs. For more information visit our website at
http://cme.ucsd.edu.
EXAMPLES:
Logo (required)
Course Description (required)
Example…
This conference, presented by UC San Diego School of Medicine and the University of Toronto, has been developed as an educational
opportunity to present and discuss the basic and more controversial areas of sleep apnea and anesthesia. The objective of the meeting
is to provide a forum for discussions of medical problems unique to the perioperative care of sleep apnea patients and to promote
excellence in medical care, research and education in anesthesia, sleep medicine and perioperative medicine.
Objectives (required)
Example…
At the conclusion of this activity, the participants should be able to:




Review the pathophysiology of OSA in the context of recent clinical research regarding perioperative care, sleep, and
anesthesia.
Determine the challenging link between comorbidities, including obesity, and their effects on airway management and
ventilation.
Formulate how to implement screening and treatment procedures for obstructive sleep apnea.
Discuss the preoperative, intraoperative, and postoperative risks to patients with OSA, and apply strategies to mitigate these
risks in support of positive patient outcomes.
Needs Assessment with Identified Practice Gap (required)
Example…
Upper airway patency is essential for normal respiratory function. The maintenance of a patent airway is dependent primarily on the
pharyngeal structures. However in some individuals, there is a loss of this airway patency and obstruction occurs during sleep. This
interruption of airflow is due to the collapse of pharyngeal soft tissue. Obstructive sleep apnea (OSA) is caused by repetitive partial or
complete obstruction of the upper airway, characterized by episodes of breathing cessation during sleep, which lasts 10 or more
seconds. This airway obstruction in turn causes increase in sympathetic output and tone, repetitive arousals from sleep to restore
airway patency, which may result in daytime hypersomnolence, memory loss, other psychological disturbances, and an increase in
inflammatory mediators. OSA has known associations with several comorbidities. These consist of cardiovascular disease including
acute myocardial infarction, heart failure, arrhythmias, hypertension, cerebrovascular disease, metabolic syndrome, obesity, and the
attendant risk of gastro-oesophageal reflux and pulmonary aspiration. Untreated OSA is associated with an increase in morbidity and
mortality.
OSA is the most prevalent breathing disturbance during sleep. From estimations in the general population, a high proportion (24%
men, 9% women) have an apnea hypopnea index of 5 or greater, and moderately severe OSA was present in 11.4% of men and 4.7%
of women. It has been estimated that 90% of the patients with OSA in the general population are undiagnosed. Similarly, a significant
proportion of these patients are undiagnosed prior to surgery. Severe OSA is a syndrome associated with hypoxaemia, hypercarbia,
polycythaemia, cor pulmonale, and hypertension. From the standpoint of the anesthesiologist, there are concerns with difficult
airways, and patient sensitivity to sedatives and analgesic medications. OSA has also been associated with an increase in postoperative
complications. Therefore, OSA is increasingly being recognized as a significant perioperative concern. It is important for
anesthesiologists, surgeons and physicians to have up-to-date knowledge about the perioperative management of the patients with
obstructive sleep apnea in order to improve their performance and care of this patient population.
This educational program will attempt to provide clinicians with “best practice” advice and practical solutions and is designed for
anesthesiologists, surgeons, and physicians interested in the perioperative care of patients with obstructive sleep apnea. Other
healthcare professionals who may benefit from this activity are nurses, certified nurse anesthetists and nurse practitioners, anesthesia
assistants, respiratory therapists, hospital administrators, and anesthesia fellows or residents.
Target Audience (required)
Example…
This educational program is designed for anesthesiologists, surgeons, and physicians interested in the perioperative care of patients
with obstructive sleep apnea. Other healthcare professionals who may benefit from this activity are nurses, certified nurse anesthetists
and nurse practitioners, anesthesia assistants, respiratory therapists, hospital administrators, and anesthesia fellows or residents.
Accreditation Statement and AMA Credit Designation Statement(required)
The appropriate accreditation statement will be included in your approval letter.
**NEW: Type of learning format must now be added. Note: The 7 ACCME approved learning formats include Live Activity,
Enduring Material, Journal-based CME Activity, Test-Item Writing Activity, Manuscript Review Activity, PI CME Activity and
Internet Point-of-Care Activity.
Example 1…for Directly Sponsored activities, use statement below:
The University of California, San Diego School of Medicine is accredited by the Accreditation Council for Continuing Medical
Education to provide continuing medical education for physicians.
The University of California, San Diego School of Medicine designates this [learning format] for a maximum of [number of credits]
AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the
activity.
Example 2… for Jointly Sponsored (with organizations outside of UC San Diego) activities, use statement below:
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for
Continuing Medical Education through the joint sponsorship of the University of California, San Diego School of Medicine and (Joint
Sponsor). The University of California, San Diego School of Medicine is accredited by the ACCME to provide continuing medical
education for physicians.
The University of California, San Diego School of Medicine designates this [learning format] for a maximum of [number of credits]
AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the
activity.
Cultural and Linguistic Competency (required)
California Assembly Bill 1195 requires continuing medical education activities with patient care components to include curriculum in
the subjects of cultural and linguistic competency. It is the intent of the bill, which went into effect on July 1, 2006, to encourage
physicians and surgeons, CME providers in the state of California, and the Accreditation Council for Continuing Medical Education to
meet the cultural and linguistic concerns of a diverse patient population through appropriate professional development. The planners,
speakers and authors of this CME activity have been encouraged to address issues relevant in their topic area. In addition, a variety of
resources are available that address cultural and linguistic competency, some of which are included in your syllabus or handout
materials. Additional resources and information about AB1195 can be found on the UC San Diego CME website at
http://cme.ucsd.edu.
Progam/Schedule/Agenda (required)
Challenges in the Perioperative Management of OSA Patients
October 15, 2010
PROGRAM
7:00 am Registration and Continental Breakfast
8:00
Welcome Address
Frances Chung, MD
Session One
Moderator: Terence M. Davidson, MD
8:05
OSA and Anesthesia: More Questions Than Answers
Frances Chung, MD
8:30
Overview of OSA Pathophysiology:
Implications in Perioperative Airway Managements
Shiroh Isono, MD
8:55
Upper Airway Patency during Sleep and Anesthesia
Matthias Eikermann, MD
9:20
Morbid Obesity and OSA: The Challenging Link
Thomas Ebert, MD
9:45
Question & Answer
10:10
Coffee Break
Session Two
Moderator: Yandong Jiang, MD, PhD
10:40
OSA and Anesthesia
Terence M. Davidson, MD
11:05
Obstructive Sleep Apnea in the Hospital?
Daniel Davis, MD
11:30
Code Blue and Respiratory Monitoring on the General Care Floor:
Connecting the Dots/ Future Directions
Frank Overdyk, MD
11:55
Question & Answer
12:15 pm
Lunch – MARRIOTT HALL 2
Session Three
Moderator: Suzanne Karan, MD
1:15
The Prototypical OSA Malpractice Law Case
Jonathan Benumof, MD
1:55
Sleep-Disordered Breathing in Hospital Patients: Protocols for Identifying and Treating Patients at Risk for
Sleep-Disordered Breathing
Peter C. Gay, MD
2:35
Question & Answer
3:00 pm Adjournment
Presenter List (required)
Example…
Co-Directors
Frances Chung, MD
Professor, Department of Anesthesia
Medical Director, Combined Surgical Unit
and Ambulatory Surgical Unit
University Health Network
University of Toronto
Toronto, Ontario, Canada
Terence M. Davidson, MD
Professor of Surgery, Head and Neck Surgery
Associate Dean, Continuing Medical Education
University of California, San Diego School of Medicine
VA San Diego Healthcare System
La Jolla, California, USA
Visiting
Thomas Ebert, MD
Professor and Program Director
Department of Anesthesiology
Medical College of Wisconsin
Staff Anesthesiologist
VA Medical Center
Milwaukee, Wisconsin, USA
Matthias Eikermann, MD
Staff Intensivist and Anesthesiologist
Department of Anesthesia, Critical Care
and Pain Medicine
Massachusetts General Hospital
Assistant Professor of Anesthesia
Harvard Medical School
Boston, Massachusetts, USA
Peter C. Gay, MD
Professor of Sleep Medicine
Mayo Clinic, USA
Shiroh Isono, MD
Associate Professor, Department of Anesthesiology
Graduate School of Medicine
Chiba University
Chiba, Japan
Yandong Jiang, MD, PhD
Assistant Professor
Harvard Medical School
Boston, Massachusetts, USA
Suzanne Karan, MD
Assistant Professor of Anesthesiology
Vice Chair for Education
Residency Program Director
Department of Anesthesiology
University of Rochester, School of Medicine and Dentistry
Rochester, New York, USA
Frank Overdyk, MD
Professor of Anesthesiology
Medical University of South Carolina
Charleston, South Carolina, USA
UC San Diego
Jonathan L. Benumof, MD
Professor
Department of Anesthesiology
Daniel Davis, MD
Professor of Clinical Medicine
Director, UCSD Center for Resuscitation Science
UC San Diego Emergency Medicine
Syllabus Disclosure Summary- EXAMPLE (required)
Challenges in the Perioperative Management of OSA Patients
October 15, 2010
It is the policy of the University of California, San Diego School of Medicine to ensure balance, independence, objectivity and
scientific rigor. All persons involved in the selection, development and presentation of content are required to disclose any real or
apparent conflicts of interest. All conflicts of interest will be resolved prior to an educational activity being delivered to learners
through one of the following mechanisms 1) altering the financial relationship with the commercial interest, 2) altering the
individual’s control over CME content about the products or services of the commercial interest, and/or 3) validating the activity
content through independent peer review. All persons are also required to disclose any discussions of off label/unapproved uses of
drugs or devices. Persons who refuse or fail to disclose are disqualified from participating in the CME activity. Participants will be
asked to evaluate whether the speaker’s outside interests reflect a possible bias in the planning or presentation of the activity. This
information is used to plan future activities.
Speaker Name
Frances Chung, MD
Name of Commercial Interest
Nature of Relevant Relationship
Employee, Grants/Research Support recipient,
Board Member, Advisor or Review Panel member,
Consultant, Independent Contractor, Stock
Shareholder (excluding mutual funds), Speakers’
Bureau, Honorarium recipient, Royalty recipient,
Holder of Intellectual Property Rights, or Other
Research Grants
Terence M. Davidson, MD
ResMed Foundation, Respironic
Foundation
ResMed
Suzanne Karan, MD
Hospira
Member of ResMed Foundation Board. Current work
supported by an unrestricted grant.
Provides dexmedetomidine for use in study
Frank Overdyk, MD
Covidien
Carefusion
Honorarium, Consultant
Honorarium
NOTE: Please list all faculty, even if they have “Nothing to Disclose”.
The following have no relevant financial relationships to disclose:
Jonathan L. Benumof, MD
Daniel Davis, MD
Peter C. Gay, MD
Shiroh Isono, MD
Thomas Ebert, MD
Matthias Eikermann, MD
Yandong Jiang, MD, PhD
The CME staff, meeting planners, planning committee and CME committee reviewers other than listed above do not have any relevant
financial relationships to disclose.
This educational activity may contain discussion of unlabeled and/or investigational uses of agents that are not approved by the FDA.
Please consult the prescribing information for each product.
The views and opinions expressed in this activity are those of the faculty and do not necessarily reflect the views of the University of
California, San Diego School of Medicine.
Commercial Support Acknowledgement Sample
 ACKNOWLEDGEMENTS 
We would like to thank the following companies for their educational
grant support. Their financial support has made this conference possible.
Novare Surgical Systems, Inc.
Olympus America, Inc.
Takeda Pharmaceuticals North America, Inc.
USGI Medical
Exhibitor Acknowledgement Sample
 ACKNOWLEDGEMENTS 
We would like to acknowledge the following companies and
organizations for exhibiting at this conference.
Apollo Endosurgery, Inc.
Novare Surgical Systems, Inc.
Power Medical Interventions