The take-it-anywhere CME fallacy: is it anywhere… or nowhere?

The pitch is hard to resist. Buy a CME course, pick any destination in the world, study by the pool, and come home with a certificate listing the city and dates. Some programs go further and suggest your tuition and your travel can be expensed.

It sounds like a perk designed for busy clinicians. Look closer, though, and the whole idea rests on a contradiction: a course you can take anywhere can't explain why you went somewhere. That gap matters, and the person who usually pays for it is the clinician who bought the course.

Why “anywhere” undercuts the trip

If the location doesn't matter, the trip is a personal choice. Education costs are generally deductible when they maintain or improve skills you already use in your work. Travel is another matter: the IRS asks whether the trip's main purpose was the education or something personal, largely by comparing the time spent on each. A course that works equally well at your kitchen table doesn't require a plane ticket. The tax code also specifically bars deducting travel as a form of education, so the destination itself can't be the lesson.

The trip's main purpose has to be business. A week in Italy with a few hours of self-paced videos looks like a vacation with homework attached, because that's what it is. When a trip is mainly personal, the airfare isn't deductible; at most, lodging and meals for the time you actually spend on qualifying education may be. The IRS says plainly that scheduling activities like “viewing videotapes or attending lectures dealing with general subjects” won't turn a vacation into a business trip.

Outside North America, the bar is higher. For a meeting held outside the North American area (the US and its possessions, Canada, Mexico, and certain Caribbean, Central American and Pacific jurisdictions), the IRS also asks whether the meeting is directly related to your work and whether it was as reasonable to hold it there as within North America. The burden is on you, the taxpayer, to show that the location was reasonable. A program whose whole pitch is “pick any destination” can't answer the question why there? And it's far from clear a self-paced course counts as a meeting at all.

A concrete example: orthopedics in Tanzania

Say you buy an orthopedics course. The lectures were recorded at a conference in San Diego, then repackaged as self-study material and sold as a pick-your-destination program. You choose Tanzania, take the course between safari days, and get a certificate that says “Tanzania” with your dates.

Now imagine an auditor asks the obvious question: why did you need to go to Tanzania to study material recorded in San Diego?

There's no good answer. Nothing in the course is about Tanzania. Nothing required you to be there. The only thing connecting the education to Tanzania is the word printed on the certificate, and you chose that word yourself.

The IRS has its own version of this example

IRS Publication 463 describes an alumni program of trips abroad. The sessions aren't aimed at any particular profession, and participants pick which ones to attend. A traveler spends about two hours at each session and the rest of the time sightseeing with family.

The IRS's conclusion: “Your travel expenses for the trip aren't deductible since the trip was primarily a vacation.” Only the registration fees and expenses directly tied to the sessions are deductible. Swap the alumni program for an “anywhere” destination CME course and the answer is the same.

A certificate records where you were, not why

Many of these programs print your chosen city and dates on the certificate. It looks official, but it records where you were, not why the education required you to be there. If the location came from your own vacation plans, the certificate is evidence of that choice and nothing more. Tax rules look at what actually happened, and travel expenses need a documented business purpose, not just a place and a date.

The “live” label is a second problem. Accredited CME distinguishes live activities, which happen at a scheduled time with real-time participation, from enduring materials, such as recorded courses you complete at your own pace. Describing a self-paced course as a live activity because you watched it in Lisbon misdescribes what you did. That matters when an employer, licensing board or auditor relies on the certificate.

Who carries the risk (hint: it's the clinician)

The company sells the course. The clinician claims the trip.

Most of these programs include a line telling you to consult your tax advisor. That line protects the seller, not you. If your return is examined, you're the one explaining why a self-paced course required a week abroad. Disallowed travel costs can come with interest and penalties.

Employer reimbursement has its own trap. If your employer pays for travel because a certificate says you attended a live conference in Italy, and the truth is that you watched recordings on vacation, you've given your employer an inaccurate picture of the trip. That's a conversation no clinician wants to have.

What's fair to say

The problem isn't the courses. Many are well made, accredited and genuinely useful. The tuition for accredited education that maintains your skills is often a legitimate business expense. And an employer can choose to cover whatever it likes, though a payment for travel that doesn't qualify is generally treated as taxable pay.

The weak link is the promise that the trip is justified. That promise rests on a location the education never needed. For the wider rules on CME, travel and W-2 versus 1099 income, see Are CME conferences tax deductible?

How Shift CME is different

Other programs put a destination on the certificate. We put the destination in the curriculum. Shift CME International programs, starting with CME Japan, are built so the place you're in is part of what you learn.

• Local modules tied to your topic. Each study day pairs the core Shift CME program with a module about the country, connected to that day's subject. A cardiology day in Japan might cover how Japan's medication rules affect cardiac patients who travel there.
• Sessions on local time. Presentations start at scheduled times in the country's time zone, like a conference you attend in person, not a library you browse whenever.
• Field activities that only make sense there. Short, self-guided activities included in every program, such as a drugstore medication survey or a heat and disaster preparedness walk: one in a 3-day program, two in a 7-day program, chosen from a short list.
• Presence you can show. A location check-in from your phone on each session day confirms you were in the country.
• Records that say exactly what you did. Your record lists each session and field activity you completed, with dates and places. Anything you skipped shows as not completed.
• Honest labels. We describe each program as what it is: a scheduled online program you complete in the country, with field activities. Not an in-person meeting, and never a promise about your taxes.

That honesty is the point. A program built this way gives you something real to show your employer or your advisor, and something worth learning while you're there.

Before you book any travel CME

Ask these questions of any program, including ours:

1. Is the content about the place, or could I take it anywhere?
2. Does it run at scheduled times, or is it self-paced?
3. Is the credit described accurately, as live or as enduring material?
4. Does anything require me to be there, and does the record show I was?
5. Does the marketing promise that my travel is deductible or reimbursable? If so, be wary.

Sources

1. IRS Publication 463 (2025), Travel, Gift, and Car Expenses: foreign conventions and the reasonableness test, travel primarily for personal reasons (including the alumni-trip example), recordkeeping and business purpose (chapter 5), and nonaccountable plans (chapter 6)
2. IRS Publication 970 (2025), Tax Benefits for Education: work-related education, travel as education, mainly personal travel, and the suspension of employee miscellaneous itemized deductions
3. IRS, Rev. Rul. 2016-16, North American area list (Internal Revenue Bulletin 2016-26)
4. IRS, Rev. Rul. 2011-26 (superseded by Rev. Rul. 2016-16)
5. IRS, Accuracy-related penalty
6. ACCME, Live course definition
7. ACCME, Enduring material definition