Naturopathic physicians attend four-year, graduate level programs at institutions recognized by the US Department of Education. There are currently six such schools in North America. Naturopathic medical schools provide the same foundational coursework as conventional medical schools. In fact, ND programs often provide more pharmacology and physiology than conventional medical schools. In addition, ND programs provide extensive education unique to their treatment approach, emphasizing disease prevention and wellness. ND students must sit for and pass two board exams known as the Naturopathic Physicians Licensing Exam (NPLEX.) The NPLEX exam is divided into 2 parts. NPLEX Part I is the equivalent to USMLE step 1 and NPLEX Part II is comparable to USMLE Steps 2 and 3 with a slanted focus towards naturopathic therapeutics. Further, in most licensed states NDs must complete yearly CME courses to maintain license in active status. The requirements for CME vary by state with requirements as high as 50 AANP approved or AMA category 1 per year.