Continuing Education for Doctors: Staying Current on Generic Medications

Every year, over 90% of prescriptions in the U.S. are filled with generic drugs. Yet, many doctors still hesitate to prescribe them-not because they doubt their safety, but because they’re not sure they know enough about them. That’s a problem. Generics save patients billions annually. They work just as well as brand-name drugs. But if doctors aren’t trained to use them confidently, patients pay more, skip doses, or lose trust. Continuing medical education (CME) is meant to fix that. But right now, it’s uneven, outdated, and often irrelevant.

Why Generics Matter More Than Ever

Generic drugs aren’t cheap knockoffs. They’re exact copies, approved by the FDA after proving they deliver the same active ingredient, in the same dose, the same way, with the same effect. The FDA requires bioequivalence-meaning the drug hits the bloodstream at the same rate and level as the brand. In 2023 alone, over 1,000 new generics were approved. That’s more than ever before. And yet, a 2023 study from the National Board of Medical Examiners found that doctors who hadn’t taken recent pharmacology CME were 17% less likely to choose the right generic when it mattered.

It’s not just about cost. A 2022 RAND Corporation study showed that switching patients to generics improved adherence by 23.7%. That means fewer hospital visits, fewer complications, better outcomes. For a diabetic patient, a $30 generic metformin instead of a $200 brand-name version isn’t a luxury-it’s the difference between taking medicine daily or skipping it because of the price.

What CME Requirements Actually Look Like

CME rules vary wildly by state. In California, doctors need 50 hours of Category 1 CME every two years. But nowhere does it say “you must spend 2 hours on generics.” It’s buried under “pharmacology.” In Maryland, you need three hours on opioids-but only half an hour on drug monitoring systems. In Nevada, all 40 hours must be Category 1, but again, no specific mention of generics.

Only 42 states require doctors to understand the difference between generic and brand names. That’s it. No requirement to know the FDA’s Orange Book, no test on therapeutic equivalence, no training on biosimilars-which are now a growing part of the market. California updated its rules in January 2024 to include two hours on biosimilars. That’s progress. But most states haven’t changed a thing since 2018.

Then there’s the MATE Act. Starting in June 2025, every doctor with a DEA number must complete eight hours of training on substance use disorders-including education on generic alternatives to controlled substances. That’s the first time federal law has tied generics directly to CME. But it only applies to doctors who prescribe opioids, benzodiazepines, or other controlled drugs. What about the cardiologist prescribing a generic statin? The endocrinologist choosing a generic levothyroxine? They’re still flying blind.

The Gap Between Training and Practice

Doctors aren’t ignoring generics because they’re stubborn. They’re unsure because their training doesn’t match real-world complexity.

Take narrow therapeutic index (NTI) drugs-like warfarin, levothyroxine, or phenytoin. Small differences in absorption can cause big problems. A 2023 Health Affairs article warned that not all generics are interchangeable in these cases. But most CME courses don’t explain this. They just say “generics are fine.” That’s dangerous.

One family physician in California told a survey she used a RenewNowCE course to explain bioequivalence to patients. Her follow-up surveys showed patient concerns dropped by 40%. But that’s the exception. On physician forums like Sermo, 32% of respondents said their CME felt irrelevant. A radiologist complained about spending 12 hours on opioid prescribing when his biggest drug concern was contrast agents. A dermatologist said he never learned about generic topical steroids and ended up prescribing a brand-name cream because he didn’t know the generic was equivalent.

The American Medical Association’s 2022 survey found that 42% of doctors thought pharmacology CME was “somewhat to not at all useful.” That’s not because the content is bad-it’s because it’s generic. No one tailors it to your specialty. No one connects it to the drugs you actually prescribe.

How to Actually Learn What You Need

You don’t need another 50-hour course. You need targeted, practical learning.

Start with the FDA’s Orange Book. It’s free. It lists every approved generic, its therapeutic equivalence rating, and whether it’s interchangeable. If you’re prescribing a drug like levothyroxine, check the Orange Book before you write the script. If the generic is rated AB, it’s interchangeable. If it’s BX, don’t assume.

Use UpToDate. It integrates with Epic and other EHRs. Every time you look up a drug during a patient visit, you earn 0.5 CME credits. That’s how you learn-while you work. Over a year, that adds up to real knowledge without extra time.

Check out the American Society of Health-System Pharmacists (ASHP). Their free online modules cover generic substitution, bioequivalence, and NTI drugs. They’re short, focused, and updated quarterly. Forty-one percent of doctors already use them. Why not you?

And if your state requires opioid education? Use that as a starting point. The MATE Act training isn’t just about addiction-it’s about knowing which generics work for pain, which don’t, and why. That knowledge applies to every patient you see, not just those with substance use disorders.

What Needs to Change

CME shouldn’t be about checking a box. It should be about building competence.

States should stop requiring arbitrary hour totals and start requiring competency. Can you identify a generic’s therapeutic equivalence rating? Can you explain why two generics of the same drug might behave differently? Can you counsel a patient who’s afraid to switch? That’s what matters.

The National Academy of Medicine is already piloting competency-based assessments in 12 states. That’s the future. Instead of logging 10 hours of pharmacology, you take a quick, real-world quiz on drug equivalency. Pass? You’re done. Fail? You get targeted modules. No more sitting through 4 hours on antibiotics when you’re a psychiatrist.

And CME providers need to stop selling the same generic course to everyone. They need specialty-specific tracks. Radiologists need contrast agent equivalency. Oncologists need biosimilar training. Primary care needs NTI drugs. One size doesn’t fit all.

The Bottom Line

Generics are the backbone of affordable care. But doctors can’t use them effectively if they don’t understand them. Right now, CME is a patchwork of outdated rules and irrelevant content. It’s time to fix it-not by adding more hours, but by making the hours count.

Start today. Open the FDA’s Orange Book. Look up a drug you prescribe. Find the generic. Check its rating. Talk to a patient about it. That’s your first CME credit. No registration. No fee. Just better care.