01 In short
Implicit bias training is a state licensing requirement for most clinicians in Michigan (1 hour for each year of the license cycle), Illinois (1 hour every renewal) and Maryland (a one-time course, plus a one-time structural racism course at the first renewal after April 1, 2026). Massachusetts physicians take 2 credits once, newly licensed California RNs take 1 hour, and Washington requires 2 hours of health equity CE that must include implicit bias training.
- Michigan
- 1 hour per license year (R 338.7004)
- Illinois
- 1 hour each renewal period
- Maryland
- One-time, plus structural racism from April 1, 2026
- Massachusetts physicians
- 2.00 credits, one time
- Washington
- 2 hours health equity CE, at least every 4 years
02 States that require it
Which states require implicit bias training for health care providers?
Six states had an implicit bias rule for licensed clinicians when we checked the boards on October 31, 2026. Three of them cover almost every health license. The other three target one profession or fold the topic into a wider health equity course.
| State | Who must take it | Hours | How often | Source |
|---|---|---|---|---|
| Michigan | Nearly every license under the Public Health Code: physicians, PAs, nurses, pharmacists, dentists, hygienists, psychologists, counselors, social workers, MFTs. Veterinary licenses (part 188) are excluded. | 1 hour per year of the license cycle; 2 hours before a first license | Every renewal | R 338.7004 |
| Illinois | Health professionals under 24 practice acts who must do CE, incl. physicians, nurses, PAs, pharmacists, dentists, psychologists, social workers, counselors | 1 hour | Every renewal period, starting with the first renewal that requires CE | IDFPR |
| Maryland | Every license or certificate renewal from a Maryland health occupations board | No hour count in the law | One-time implicit bias course; one-time structural racism course at the first renewal after April 1, 2026 | Health Occ. § 1-225 |
| Massachusetts | Physicians: initial applicants and renewing licensees | 2.00 credits | One time | BORIM Policy 2021-04 |
| California | Registered nurses in the first 2 years after initial licensure | 1 hour | Once | Board of Registered Nursing |
| Washington | Licensees under Title 18 RCW who have a CE requirement | 2 hours of health equity CE that includes implicit bias training | At least once every 4 years (nurses: every renewal period) | WAC 246-12-820 |
03 Michigan (LARA)
Michigan implicit bias training: what LARA requires
Michigan's rule reaches more license types than any other in the table, and it draws the most searches. LARA's rule R 338.7004 asks for 1 hour of implicit bias training for each year of your license cycle, at every renewal. It is not a one-time course.
The cycle length decides your number. Nursing, pharmacy and psychology licenses renew every 2 years, so you need 2 hours. Medicine, osteopathic medicine, PAs, dentistry, dental hygiene, counseling, social work and marriage and family therapy renew every 3 years, so you need 3. First-time applicants need 2 hours completed within the 5 years before the license is issued.
A Michigan RN who renews in March needs 2 hours dated inside the current cycle. Hours from the last cycle don't carry forward, and repeating the same course twice in one cycle earns nothing the second time. The good news: unless your profession's rules say otherwise, those hours can also count toward your regular CE.
- Content must cover implicit bias and how it creates barriers to care, and it must include strategies to reduce disparities.
- The course must give a pre-test and a post-test implicit bias assessment.
- Acceptable sponsors include national or state health organizations, state or federal agencies, board-approved CE programs, accredited colleges and DEI organizations.
- Live webinars, live in-person sessions and asynchronous (recorded) webinars all qualify.
- Keep proof for 6 years: a certificate, or a self-attestation with the date, sponsor, course title and your name.
LARA does not publish a list of approved implicit bias courses. Before you pay for or sit through a "free implicit bias training Michigan" course, check that it includes the pre- and post-test. That is the rule's most specific requirement and the easiest one to miss.
Michigan physician CME · Michigan nursing CE · Michigan pharmacist CE
04 Maryland (incl. MBON)
Maryland implicit bias training and the 2026 structural racism rule
Maryland's rule is short. Under Health Occupations § 1-225, you attest on your renewal application that you completed an implicit bias and structural racism training program approved by the state's Cultural and Linguistic Health Care Professional Competency Program. The 2025 amendment applies to your first renewal after April 1, 2026.
Both trainings are one-time. If you already did implicit bias training for an earlier renewal, the Board of Nursing and the Board of Physicians both say you don't repeat it. Structural racism is the new piece, due before your next renewal.
This is what people mean when they search "MBON implicit bias training". The Maryland Board of Nursing applies the same law to every license and certificate it issues and points to the Office of Minority Health and Health Disparities (MHHD) website for the approved programs. The law sets no hour minimum.
The Board of Physicians adds three practical details. The course doesn't have to be specific to your profession. It must be ACCME-accredited or recognized by a health occupations board. You don't upload a certificate at renewal, but keep it for up to six years in case of an audit.
The structural racism course is a separate attestation. A Maryland nurse who took implicit bias training in 2023 still has to complete a structural racism program before the first renewal after April 1, 2026.
05 Illinois
Implicit bias training in Illinois
Illinois asks for one hour of implicit bias awareness training per renewal period from health care professionals who have a CE requirement. The hour starts with your first renewal that requires CE, applies at reinstatement and restoration too, and may count toward your CE minimum. If you hold several Illinois licenses, one course counts for each of them.
From July 1, 2026, a second rule applies to anyone who reports to IDFPR that they provide maternal health care. Their implicit bias hour must include maternal health risk factors for racial and ethnic groups with higher maternal mortality.
Illinois stacks other one-hour topics next to it: sexual harassment prevention every renewal, and cultural competency and Alzheimer's training once every six years for renewals on or after January 1, 2025. Plan them together, or you end up chasing four separate certificates in one cycle.
06 CA, MA and WA
California, Massachusetts and Washington
California splits by profession. Registered nurses still within two years of their first license must complete one hour of direct participation in an implicit bias course from a board-approved CE provider (BPC 2811.5, in effect since January 1, 2023). Physicians have no separate course to take: the law puts the burden on CME providers, whose courses must include implicit bias curriculum under BPC 2190.1.
Massachusetts applies the rule to physicians. Board policy 2021-04, in effect since June 1, 2022, requires a one-time 2.00 credits on implicit bias in health care, at initial licensure or renewal. Those 2 credits can count toward the 10 risk management credits a physician already needs every two years, so the total doesn't grow.
Washington calls it health equity CE. Every health professional credentialed under Title 18 RCW with a CE requirement needs at least 2 hours every four years, and the course must include implicit bias training aimed at reducing bias in assessment and diagnosis. Nurses get a tighter schedule: 2 hours every renewal period, counted inside their 8 required hours, with current RNs and LPNs due by their 2026 renewal.
California physician CME · Washington physician CME · Washington nursing CE
07 Free official courses
Where to find free implicit bias training with a certificate
Only two boards in our table name specific free courses. Maryland's health department says some courses on its approved list are free and some charge a fee, without marking which. Michigan and Illinois publish no list at all.
| Course | Sponsor | Length | Named by | What it satisfies |
|---|---|---|---|---|
| What's Important: A Patient-Centered Approach to Contraceptive Counseling | PICCK Program, Boston Medical Center and Boston University School of Medicine | 4.5 credits (online, interactive) | Massachusetts BORIM | The full course completes the MA requirement: 2.0 credits to implicit bias, 2.5 to general CME |
| Unconscious Bias in Medicine | Stanford University School of Medicine | 1 hour | Massachusetts BORIM | Half of the MA 2.00 credits |
| Racial Differences in Prostate Cancer Outcomes: Promoting Equality by Improving Access to Care | Massachusetts Medical Society | 0.75 hours | Massachusetts BORIM | Part of the MA 2.00 credits |
| Washington Implicit Bias in Healthcare | Listed by WA DOH | 2 hours CE, online self-study | Washington DOH | WA 2-hour health equity requirement |
| Racism, Bias, and Other Determinants of Health: Issues and Actions | Region IV Public Health Training Center | Two modules, 90 minutes | Washington DOH | Needs a second course to reach 2 hours |
08 Step by step
How to finish implicit bias training before your renewal
- List every license you hold and the state that issued it. Each state counts separately, and Michigan's hours depend on that license's cycle length.
- Mark your next renewal date for each. Maryland's structural racism attestation falls on the first renewal after April 1, 2026; Washington nurses owe 2 hours by their 2026 renewal.
- Pick a course that meets the strictest rule you face. For Michigan, confirm the pre- and post-test. For Maryland, use the MHHD list. For Massachusetts, check the board's list or its learning objectives.
- Download the certificate the day you finish. Michigan accepts a certificate or a self-attestation with date, sponsor, title and your name, kept for 6 years.
- If your board uses a CE tracker, upload it there too. Our CE Broker guide shows which boards do.
- Add the hour to your totals. Michigan and Illinois let it count toward regular CE, and Washington nurses count it inside their 8 hours.
Holding licenses in Michigan and Maryland? One well-chosen course can cover both if it includes Michigan's pre- and post-test and appears on Maryland's approved list. Check both before you enroll, then use the multi-state CE planner to line up the deadlines.
09 Questions
Implicit bias training questions
What is implicit bias training?
Michigan's rule defines implicit bias as an attitude or internalized stereotype that affects perception, action or decisions unconsciously and often leads to unequal treatment. Implicit bias training for health care providers teaches how that bias creates barriers to care and what clinicians can do to reduce it.
How many hours of implicit bias training does Michigan LARA require?
One hour for each year of your license cycle, at every renewal: 2 hours for 2-year licenses such as nursing and pharmacy, 3 hours for 3-year licenses such as medicine, dentistry and social work. New applicants need 2 hours within the 5 years before licensure.
Does Michigan implicit bias training count toward CE?
Yes, unless your profession's code or rules prohibit it. R 338.7004 lets the hours satisfy other CE requirements for license renewal.
Do Maryland nurses need implicit bias training (MBON)?
Yes. The Maryland Board of Nursing requires a one-time implicit bias course and, at the first renewal after April 1, 2026, a one-time structural racism course. Approved programs are listed on the MHHD website.
Is there free implicit bias training for healthcare providers?
Yes. The Massachusetts Board of Registration in Medicine lists three free courses, and Washington's Department of Health lists free health equity courses, including a 2-hour Washington Implicit Bias in Healthcare self-study. Check that a free course meets your own state's rule before you rely on it.
Where can I get free implicit bias training with a certificate?
Use the lists your board points to: Massachusetts BORIM, Washington DOH and Maryland MHHD. Washington warns that some video resources on its page give no certificate and may not count, so confirm a certificate is issued.
Is there free implicit bias training for nurses?
Washington nurses can use the free courses on the DOH health equity list. In Maryland, the health department says some approved courses are free. California RNs need a course from a board-approved CE provider.
Does Illinois require implicit bias training every renewal?
Yes. Health care professionals with a CE requirement complete a one-hour implicit bias awareness course each renewal period, and it may count toward their CE minimum.
Does California require implicit bias training?
For RNs within two years of initial licensure, yes: one hour from a board-approved provider. For physicians, CME courses must contain implicit bias content, so there is no separate course to log.
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