Continuing medical education implements the credit system. The subjects of continuing medical education participate in continuing medical education activities every year and get no less than 25 credits, including 5- 10 credits for Class I and 5-20 credits for Class II. Medical and health institutions in provinces, autonomous regions and municipalities directly under the Central Government shall participate in national continuing medical education programs within five years and obtain no less than 10 credits. The subjects of continuing medical education get no more than 10 credits each year. The first and second types of credits cannot be substituted for each other.