TITLE examinimg-boards

Part 9. TEXAS STATE BOARD OF MEDICAL EXAMINERS

Chapter 161. GENERAL PROVISIONS

22 TAC §161.1

The Texas State Board of Medical Examiners proposes an amendment to §161.1, concerning Meetings. The amendment is necessary to outline new committee structure and responsibilities.

John S. Teer, General Counsel, Texas State Board of Medical Examiners, has determined that for the first five-year period the amendment is in effect there will be no fiscal implications to state or local government as a result of enforcing or administering the section as proposed.

Mr. Teer also has determined that for each year of the first five years the section as proposed is in effect the public benefit anticipated as a result of enforcing the section will be updated rules regarding committee structure and responsibility. There will be no effect on small businesses. There are no anticipated economic costs to persons who are required to comply with the rule as proposed.

Comments on the proposal may be submitted to Pat Wood, P.O. Box 2018, MC-901, Austin, Texas 78768-2018. A public hearing will be held at a later date.

The amendment is proposed under the Medical Practice Act, Texas Civil Statutes, Article 4495b, §2.09(a), which provides the Texas State Board of Medical Examiners with the authority to make rules, regulations and bylaws not inconsistent with this Act as may be necessary for the governing of its own proceedings, the performance of its duties, the regulation of the practice of medicine in this state, and the enforcement of this Act.

The Medical Practice Act, Texas Civil Statutes, Article 4495b, §2.09(b) is affected by the proposed rule.

§161.1.Meetings.

(a)

The board shall meet at least four times a year. It shall consider such matters as may be necessary.

(b)

Special meetings shall be called by the president of the board or by resolution of the board or upon written request signed by three members of the board.

(c)

It is a ground for removal from the board if a board member is absent from more than half of the regularly scheduled board meetings that the member is eligible to attend during a calendar year. If the executive director of the board has knowledge that a potential ground for removal exists due to a member's failure to attend an adequate number of regularly scheduled board meetings, the executive director shall notify the president of the board of the ground. The president shall then notify the governor that a potential ground for removal exists. A board member shall be considered to have been absent from a regularly scheduled board meeting if the member fails to attend at least a portion of either a full board session or a portion of a regularly scheduled committee meeting to which the member is assigned during such board meeting. Any dispute or controversy as to whether or not an absence has occurred shall be submitted to the full board for resolution by a majority vote after giving the purported absentee an opportunity to be heard and after allowing discussion by other members of the board.

(d)

Board and committee meetings shall be conducted pursuant to the provisions of Robert's Rules of Order Newly Revised unless the board by rule adopts a different procedure.

(e)

All elections and any other issues requiring a vote of the board shall be decided by a simple majority of the members present. A quorum for transaction of business by the board shall be one more than half the board's membership at the time of the meeting. If more than two candidates contest an election, and if no candidate receives a majority on the first ballot, a second ballot will be conducted between the two candidates receiving the highest number of votes.

(f)

At a meeting of the board, the board shall elect from its membership a vice-president and secretary treasurer.

(g)

The following are standing and permanent committees of the board, as established by the board in accordance with the Medical Practice Act. The responsibilities and authority of these committees include those duties and powers as set forth below and such other responsibilities and authority which the board may from time to time delegate to these committees. In order to handle the heavy workload of the Licensure Committee, the President of the Board or the Chairman of the Licensure Committee may divide the Licensure Committee into two subcommittees, each of whom will make recommendations to the Board.

(1)

Disciplinary Process Review Committee:

(A)

oversee the disciplinary process and give guidance to the board and board staff regarding means to improve the disciplinary process and more effectively enforce the Medical Practice Act;

(B)

monitor the effectiveness, appropriateness and timeliness of the disciplinary process and enforcement of the Medical Practice Act;

(C)

make recommendations regarding resolution and disposition of specific cases and approve, adopt, modify, or reject recommendations from board staff or board representatives regarding actions to be taken on pending cases. Approve dismissals of complaints and closure of investigations;

(D)

carry out the tasks and duties set forth in Chapter 187 of this title (relating to Procedure);

(E)

make recommendations to the board staff and the board regarding policies, priorities, budget, and any other matters related to the disciplinary process and enforcement of the Medical Practice Act.

(2)

Executive Committee:

(A)

review agendum for board meetings;

(B)

ensure records are maintained of all committee actions;

(C)

delegate tasks to other committees;

(D)

take action on matters of urgency that may arise between board meetings;

(E)

make recommendations concerning reactivation of licenses for physicians on retired status;

(F)

review contract negotiations;

(G)

review staff reports regarding finances and the budget;

(H)

make recommendations to the board regarding matters brought to the attention of the executive committee.

(3)

Finance Committee:

(A)

review staff reports regarding finances and the budget;

(B)

present budget needs to the Legislature and other state officials;

(C)

recommend proper fees for the agency to charge;

(D)

consider and make recommendations to the board regarding any aspect of board finances.

(4)

Legislative/Long Range Planning Committee:

(A)

study and make recommendations to the board regarding changes to the Medical Practice Act;

(B)

review and make recommendations to the board regarding proposed legislative changes for the regulation of medicine;

(C)

provide reports and recommendations to the board in regard to changes or proposed changes regarding the Medical Practice Act and the laws regulating the practice of medicine;

(D)

establish communication with members of the Legislature;

(E)

assist in the organization, preparation, and delivery of information and testimony to the Legislature and committees of the Legislature;

(F)

formulate and make recommendations to the board concerning future board goals and objectives and the establishment of priorities and methods for their accomplishment;

(G)

study and make recommendations to the board regarding the role and responsibility of the board offices and committees;

(H)

study and make recommendations to the board regarding the role and responsibility of individuals retained by the board;

(I)

study and make recommendations to the board regarding ways to improve the efficiency and effectiveness of the administration of the board;

(J)

study and make recommendations to the board regarding board rules or any area of a board function that, in the judgment of the committee, needs consideration;

(K)

make recommendations to the board regarding matters brought to the attention of the legislative/long range planning committee.

(5)

Licensure Committee.

(A)

review applications for licensure, make a determination of eligibility and report to the board its recommendations as provided by the Medical Practice Act;

(B)

review board rules regarding licensure and make recommendations to the board regarding changes or implementation of such rules;

(C)

determine that the board approves each examination administered;

(D)

report to the board any problems in the administration of examinations and recommend and implement ways of correcting identified problems

(E)

report results of examinations to the board for its approval;

(F)

be available for consultation with representatives of medical schools regarding issues related to performance on examinations;

(G)

make recommendations to the board regarding postgraduate training permits and issues concerning physicians in training.

(H)

maintain communication with medical schools;

(I)

be available for assistance with problems relating to medical school issues which may arise within the purview of the board;

(J)

plan and make visits to medical schools at specified intervals, with the goal of promoting opportunities to meet with the students so that they may become aware of the board and its functions;

(K)

develop information in regard to international medical schools in the areas of curriculum, faculty, facilities, academic resources, and performance of graduates;

(L)

study and make recommendations regarding documentation and verification of records from international medical schools;

(M)

coordinate cooperative efforts with the Educational Commission for Foreign Medical Graduates;

(N)

make recommendations to the board regarding matters brought to the attention of the licensure committee.

(6)

Non-Profit Health Organizations Committee:

(A)

review applications for approval and certification of non-profit health organizations pursuant to the Medical Practice Act, §5.01;

(B)

review applications and reports for continued approval and certification of non-profit health organizations pursuant to the Medical Practice Act, §5.01;

(C)

make initial determinations and recommendations to the board regarding approval, denial, revocation, decertification, or continued approval and certification of non-profit health organizations pursuant to the Medical Practice Act, §5.01;

(D)

review board rules regarding non-profit health organizations, and make recommendations to the board regarding changes or implementation of such rules;

(E)

make recommendations to the board regarding matters brought to the attention of the non-profit health organizations committee.

(7)

Public Information/Physician Profile Committee:

(A)

develop informational brochures for distribution to the public;

(B)

review and make recommendations to the board in regard to press releases, newsletters, and other publications;

(C)

exhibit display booths at conventions;

(D)

study and make recommendations to the board regarding all aspects of public information or public relations;

(E)

study and make recommendation to the board regarding all aspects of physician profiles;

(F)

make recommendations to the board regarding matters brought to the attention of the public information committee.

(8)

Standing Orders Committee:

(A)

oversee and make recommendations to the board regarding any aspect of standing orders;

(B)

review applications for acudetox specialist certification, make a determination of eligibility and report to the board its recommendations as provided by the Medical Practice Act;

(C)

review and make recommendations to the board regarding board rules pertaining to standing orders, acudetox specialist certification, and continuing auricular acupuncture education;

(D)

make recommendations to the board regarding issues concerning or referred by the Board of Acupuncture Examiners or other acupuncture issues;

(E)

make recommendations to the board regarding issues concerning or referred by the Board of Physician Assistant Examiners;

(F)

study and make recommendations to the board concerning ethical issues related to the practice of medicine;

(G)

draft, revise, and propose written statements, guidelines, and newsletter articles pertaining to medical ethics;

(H)

make recommendations to the board regarding matters brought to the attention of the standing orders committee.

(9)

Telemedicine Committee:

(A)

review, study and make recommendations to the board concerning the practice of telemedicine, including but not limited to licensure, regulation, and/or discipline of telemedicine license holders or applicants;

(B)

review, study and make recommendations to the board concerning interstate and intrastate telemedicine issues;

(C)

review, study and make recommendations to the board concerning board rules regarding or affecting the practice of telemedicine;

(D)

review, study and make recommendations to the board concerning any other issue brought to the attention of the committee.

[ (1)

Executive committee: ]

[ (A)

review agendum for board meetings; ]

[ (B)

ensure records are maintained of all committee actions;]

[ (C)

delegate tasks to other committees;]

[ (D)

take action on matters of urgency that may arise between board meetings;]

[ (E)

make recommendations concerning reactivation of licenses for physicians on retired status;]

[ (F)

review contract negotiations;]

[ (G)

review staff reports regarding finances and the budget;]

[ (H)

make recommendations to the board regarding matters brought to the attention of the executive committee.]

[ (2)

Medical school committee:]

[ (A)

maintain communication with medical schools;]

[ (B)

be available for assistance with problems relating to medical school issues which may arise within the purview of the board; ]

[ (C)

plan and make visits to medical schools at specified intervals, with the goal of promoting opportunities to meet with the students so that they may become aware of the board and its functions;]

[ (D)

develop information in regard to international medical schools in the areas of curriculum, faculty, facilities, academic resources, and performance of graduates;]

[ (E)

offer assistance to the examination and endorsement committees in determining eligibility of international medical graduates for licensure by endorsement or examination;]

[ (F)

study and make recommendations regarding documentation and verification of records from international medical schools;]

[ (G)

coordinate cooperative efforts with the Educational Commission for Foreign Medical Graduates;]

[ (H)

make recommendations to the board regarding matters brought to the attention of the medical school committee.]

[ (3)

Examination committee:]

[ (A)

determine that the board approves each examination administered;]

[ (B)

report to the board any problems in the administration of examinations and recommend and implement ways of correcting identified problems;]

[ (C)

review applications for licensure, make a determination of eligibility and report to the board its recommendations as provided by the Medical Practice Act;]

[ (D)

review board rules regarding licensure by examination and make recommendations to the board regarding changes or implementation of such rules;]

[ (E)

report results of examinations to the board for its approval;]

[ (F)

be available for consultation with representatives of medical schools regarding issues related to performance on examinations;]

[ (G)

make recommendations to the board regarding matters brought to the attention of the examination committee.]

[ (4)

Endorsement Committee:]

[ (A)

review applications for licensure, make a determination of eligibility and report to the board its recommendations as provided by the Medical Practice Act;]

[ (B)

present results of reviews of applicants for licensure by endorsement and make recommendations regarding licensure for board consideration;]

[ (C)

review board rules regarding licensure by endorsement, and make recommendations to the board regarding changes or implementation of such rules;]

[ (D)

make recommendations to the board regarding matters brought to the attention of the endorsement committee.]

[ (5)

Legislative committee:]

[ (A)

study and make recommendations to the board regarding changes to the Medical Practice Act;]

[ (B)

review and make recommendations to the board regarding proposed legislative changes for the regulation of medicine;]

[ (C)

provide reports and recommendations to the board in regard to changes or proposed changes regarding the Medical Practice Act and the laws regulating the practice of medicine;]

[ (D)

establish communication with members of the legislature;]

[ (E)

assist in the organization, preparation, and delivery of information and testimony to the legislature and committees of the legislature;]

[ (F)

make recommendations to the board regarding matters brought to the attention of the legislative committee.]

[ (6)

Standing orders committee:]

[ (A)

oversee and make recommendations to the board regarding any aspect of standing orders and physician assistants;]

[ (B)

act in conjunction with or in support of ad hoc committees of the board which are in existence or may be created from time to time by the board;]

[ (C)

review and make recommendations to the board regarding board rules pertaining to standing orders, physician assistants, and any other matters delegated to the standing orders committee or an ad hoc committee working with or through the standing orders committee;]

[ (D)

make recommendations to the board regarding matters brought to the attention of the standing orders committee;]

[ (E)

make recommendations to the board regarding issues concerning or referred by the Board of Acupuncture Examiners or other acupuncture issues.]

[ (7)

District review committee:]

[ (A)

carry out the tasks and duties set forth in Chapter 187 of this title (relating to Procedure);]

[ (B)

carry out the tasks and duties set forth in Chapter 191 of this title (relating to District Review Committees).]

[ (8)

Finance committee:]

[ (A)

review staff reports regarding finances and the budget;]

[ (B)

present budget needs to the legislature and other state officials;]

[ (C)

recommend proper fees for the agency to charge;]

[ (D)

consider and make recommendations to the board regarding any aspect of board finances.]

[ (9)

Disciplinary process review committee:]

[ (A)

oversee the disciplinary process and give guidance to the board and board staff regarding means to improve the disciplinary process and more effectively enforce the Medical Practice Act;]

[ (B)

monitor the effectiveness, appropriateness, and timeliness of the disciplinary process and enforcement of the Medical Practice Act;]

[ (C)

make recommendations regarding resolution and disposition of specific cases and approve, adopt, modify, or reject recommendations from board staff or board representatives regarding actions to be taken on pending cases. Approve dismissals of complaints and closure of investigations;]

[ (D)

carry out the tasks and duties set forth in Chapter 187 of this title (relating to Procedure);]

[ (E)

make recommendations to the board staff and the board regarding policies, priorities, budget, and any other matters related to the disciplinary process and enforcement of the Medical Practice Act.]

[ (10)

Physicians in Training Committee:]

[ (A)

make recommendations to the board regarding licensure and issues concerning physicians in training;]

[ (B)

make recommendations to the board regarding matters brought to the attention of the Physicians in Training Committee.]

[ (11)

Long range planning committee:]

[ (A)

formulate and make recommendations to the board concerning future board goals and objectives and the establishment of priorities and methods for their accomplishment;]

[ (B)

study and make recommendations to the board regarding the role and responsibility of the board offices and committees;]

[ (C)

study and make recommendations to the board regarding the role and responsibility of individuals retained by the board;]

[ (D)

study and make recommendations to the board regarding ways to improve the efficiency and effectiveness of the administration of the board;]

[ (E)

study and make recommendations to the board regarding board rules or any area of a board function that, in the judgment of the committee, needs consideration.]

[ (12)

Public information committee:]

[ (A)

develop informational brochures for distribution to the public;]

[ (B)

review and make recommendations to the board in regard to press releases, newsletters, and other publications;]

[ (C)

exhibit display booths at conventions;]

[ (D)

study and make recommendations to the board regarding all aspects of public information or public relations;]

[ (E)

make recommendations to the board regarding matters brought to the attention of the public information committee.]

[ (13)

Non-Profit Health Organizations Committee:]

[ (A)

review applications for approval and certification of non-profit health organizations pursuant to the Medical Practice Act, §5.01;]

[ (B)

review applications and reports for continued approval and certification of non-profit health organizations pursuant to the Medical Practice Act, §5.01;]

[ (C)

make initial determinations and recommendations to the board regarding approval, denial, revocation, decertification, or continued approval and certification of non-profit health organizations pursuant to the Medical Practice Act, §5.01;]

[ (D)

review board rules regarding non-profit health organizations, and make recommendations to the board regarding changes or implementation of such rules;]

[ (E)

make recommendations to the board regarding matters brought to the attention of the non-profit health organizations committee.]

[ (14)

Ethics Committee:]

[ (A)

study and make recommendations to the board concerning ethical issues related to the practice of medicine;]

[ (B)

draft, revise, and propose written statements, guidelines, and newsletter articles pertaining to medical ethics;]

[ (C)

make recommendations to the board regarding matters brought to the attention of the ethics committee.]

[ (15)

Telemedicine Committee:]

[ (A)

review, study and make recommendations to the board concerning the practice of telemedicine, including but not limited to licensure, regulation, and/or discipline of telemedicine license holders or applicants;]

[ (B)

review, study and make recommendations to the board concerning interstate and intrastate telemedicine issues;]

[ (C)

review, study and make recommendations to the board concerning board rules regarding or affecting the practice of telemedicine;]

[ (D)

review, study and make recommendations to the board concerning any other issue brought to the attention of the committee.]

(h)

The board shall contract with an executive director to act as the chief executive and administrative officer of the board. The executive director's duties shall be to assist in conducting meetings of the board and to carry out other responsibilities as provided by the Medical Practice Act. The executive director shall be compensated as provided in the Appropriations Act. Any responsibilities or authority of the secretary-treasurer of the board described in any rules of the board may be exercised by the executive director unless the board assigns specific duties or prerogatives exclusively to the secretary-treasurer.

(i)

To assist with meetings and functions of the board, the board may direct the executive director to employ a general counsel for the Texas State Board of Medical Examiners [ may be appointed by a majority vote of the board and shall hold office at the pleasure of the board ]. He or she shall be a member of the State Bar of Texas, but may not be a lobbyist registered with the Office of the Secretary of State of Texas. No person required to register personally as a lobbyist representing physicians, health care entities, or health care related professions may be employed by the board in any capacity. The executive director or secretary-treasurer may employ, compensate, and provide for special hearings and meetings, administrative hearing officers, and other professionals as may be found necessary in the executive director's or secretary-treasurer's opinion to provide for legal services.

(j)

The board shall authorize the executive director or secretary-treasurer to employ, compensate, and provide administrators, clerks, employees, consultants, professionals, and other persons as may be found necessary in the executive director's or secretary-treasurer's opinion, to carry out the duties related to meetings of the board and other provisions of the Medical Practice Act. The board shall authorize the executive director or secretary-treasurer to reimburse the previously mentioned persons for actual and necessary expenses, including investigation expenses, travel, and other incidental expenses incurred in the performance of official duties as determined by the executive director or secretary-treasurer.

(k)

Meetings of the board and of its committees are open to the public unless such meetings are conducted in executive session pursuant to state law and the Medical Practice Act, Article 4495b. In order that board meetings may be conducted safely, efficiently, and with decorum, members of the public shall refrain at all times from smoking or using tobacco products, eating, or reading newspapers and magazines. Members of the public may not engage in disruptive activity that interferes with board proceedings, including excessive movement within the meeting room, noise or loud talking, and resting of feet on tables and chairs. The public shall remain within those areas of the board's offices designated as open to the public. Members of the public shall not address or question board members during meetings unless recognized by the board's presiding officer pursuant to a published agenda item.

(l)

Journalists have the same right of access as other members of the public to board meetings conducted in open session, and are also subject to the rules of conduct described in subsection (k) of this section. Observers of any board meeting may make audio or visual recordings of such proceedings conducted in open session subject to the following limitations. The board's presiding officer may request periodically that camera operators extinguish their artificial lights to allow excessive heat to dissipate. Camera operators may not assemble or disassemble their equipment while the board is in session and conducting business. Persons seeking to position microphones for recording board proceedings may not disrupt the meeting or disturb participants. Journalists may conduct interviews in the reception area of the board's offices or, at the discretion of the board's presiding officer, in the meeting room after recess or adjournment. No interviews may be conducted in the hallways of the board's offices. The board's presiding officer may exclude from a meeting any person who, after being duly warned, persists in conduct described in this subsection and subsection (k) of this section.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State on September 3, 1999.

TRD-9905667

Bruce A. Levy, M.D., J.D.

Executive Director

Texas State Board of Medical Examiners

Earliest possible date of adoption: October 17, 1999

For further information, please call: (512) 305-7016


Chapter 163. LICENSURE

The Texas State Board of Medical Examiners proposes the repeal of §§163.1-163.17 and new §§163.1-163.12, concerning Licensure. The amendment is necessary to be in compliance with Senate Bill 1207.

Elsewhere in this issue of the Texas Register , the Texas State Board of Medical Examiners is withdrawing the amendment of §163.6, which was previously published in the July 2, 1999, issue of the Texas Register (24 TexReg 4955).

Elsewhere in this issue of the Texas Register , the Texas State Board of Medical Examiners contemporaneously proposes the review of Chapter 163. The review is in accordance with the Appropriations Act of 1997, HB 1, Article IX, Section 167.

John S. Teer, General Counsel, Texas State Board of Medical Examiners, has determined that for the first five-year period the repeal and new sections are in effect there will be no fiscal implications to state or local government as a result of enforcing or administering the sections as proposed.

Mr. Teer also has determined that for each year of the first five years the sections as proposed are in effect the public benefit anticipated as a result of enforcing the sections will be compliance with Senate Bill 1207. There will be no effect on small businesses. There are no anticipated economic costs to persons who are required to comply with the rules as proposed.

Comments on the proposal may be submitted to Pat Wood, P.O. Box 2018, MC-901, Austin, Texas 78768-2018. A public hearing will be held at a later date.

22 TAC §§163.1-163.17

(Editor's note: The text of the following sections proposed for repeal will not be published. The sections may be examined in the offices of the Texas State Board of Medical Examiners or in the Texas Register office, Room 245, James Earl Rudder Building, 1019 Brazos Street, Austin.)

The repeal is proposed under the Medical Practice Act, Texas Civil Statutes, Article 4495b, §2.09(a), which provides the Texas State Board of Medical Examiners with the authority to make rules, regulations and bylaws not inconsistent with this Act as may be necessary for the governing of its own proceedings, the performance of its duties, the regulation of the practice of medicine in this state, and the enforcement of this Act.

The Medical Practice Act, Texas Civil Statutes, Article 4495b, §§3.03, 3.04 and 3.05 are affected by the proposed repeals.

§163.1.Definitions.

§163.2.Licensure by Examination for United States/Canadian Medical School Graduates.

§163.3.Licensure by Examination for Graduates of Unapproved Medical Schools.

§163.4.Licensure by Endorsement for United States/Canadian Medical School Graduates.

§163.5.Licensure by Endorsement for Graduates of Unapproved Medical Schools.

§163.6.Procedural Rules for Licensure Applicants.

§163.7.Licensure Documentation.

§163.8.Administration of Examinations.

§163.9.Temporary Licensure--Regular.

§163.10.Distinguished Professors Temporary License.

§163.11.State Health Agency Temporary License.

§163.12.Relicensure.

§163.13.Medical Practice Act, §3.0305, Temporary License for Out-of-State Practitioners.

§163.14.Temporary Licensure of Primary Care Physicians for Practice in Rural Counties or Medically Underserved Areas in Texas.

§163.15.Active Practice of Medicine.

§163.16.Licensure by Endorsement for the Fifth Pathway.

§163.17.Licensure by Examination for the Fifth Pathway.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State on September 3, 1999.

TRD-9905669

Bruce A. Levy, M.D., J.D.

Executive Director

Texas State Board of Medical Examiners

Earliest possible date of adoption: October 17, 1999

For further information, please call: (512) 305-7016


22 TAC §§163.1-163.12

The new sections are proposed under the Medical Practice Act, Texas Civil Statutes, Article 4495b, §2.09(a), which provides the Texas State Board of Medical Examiners with the authority to make rules, regulations and bylaws not inconsistent with this Act as may be necessary for the governing of its own proceedings, the performance of its duties, the regulation of the practice of medicine in this state, and the enforcement of this Act.

The Medical Practice Act, Texas Civil Statutes, Article 4495b, §§3.03, 3.04 and 3.05 are affected by the proposed new sections.

§163.1.Definitions.

The following words and terms, when used in this chapter, shall have the following meanings, unless the contents clearly indicate otherwise.

(1)

Acceptable approved medical school - A medical school or college located in the United States or Canada that was approved by the Board at the time the degree was conferred.

(2)

Acceptable Unapproved medical school - A school or college located outside the United States or Canada that was not approved by the board at the time the degree was conferred but whose curriculum meets the requirements for an Unapproved medical school as determined by a committee of experts selected by the Texas Higher Education Coordinating Board.

(3)

Affiliated Hospital - Affiliation status of a hospital with a medical school as defined by the Liaison Committee on Medical Education and documented by the medical school in its application for accreditation.

(4)

Applicant - One who files an application as defined in this section.

(5)

Application - An application is all documents and information necessary to complete an applicant's request for licensure including the following:

(A)

forms furnished by the board, completed by the applicant:

(i)

all forms and addenda requiring a written response must be printed in ink;

(ii)

photographs must meet United States Government passport standards;

(B)

a fingerprint card, furnished by the board, completed by the applicant, that must be readable by the Texas Department of Public Safety;

(C)

all documents required under section 163.5 of this title (relating to Licensure Documentation); and

(D)

the required fee, payable by check through a United States bank.

(6)

Eligible for licensure in country of graduation - An applicant must be eligible for licensure in the country in which the medical school is located except for any citizenship requirements.

(7)

Examinations accepted by the board for licensure.

(A)

United States Medical Licensing Examination (USMLE), with a score of 75 or better on each step, all steps must be passed within seven years;

(B)

Federation Licensing Examination (FLEX), after July 1985, passage of both components within seven years with a score of 75 or better on each component;

(C)

Federation Licensing Examination (FLEX), prior to June 1985, with a FLEX weighted average of 75 or better in one sitting;

(D)

National Board of Medical Examiners Examination (NBME) or its successor all steps must be passed within seven years;

(E)

National Board of Osteopathic Medical Examiners Examination (NBOME) or its successor all steps must be passed within seven years;

(F)

Medical Council of Canada Examination (LMCC) or its successor, all steps must be passed within seven years;

(G)

State board examination, (with the exception of Florida, Virgin Islands, Guam, Tennessee Osteopathic Board or Puerto Rico after June 30, 1963); or

(H)

One of the following examination combinations with a score of 75 or better on each part, level, component, or step, all parts, levels, components, or steps must be passed within seven years:

(i)

FLEX I plus USMLE 3;

(ii)

USMLE 1 and USMLE 2, plus FLEX II;

(iii)

NBME I or USMLE 1, plus NBME II or USMLE 2, plus NBME III or USMLE 3;

(iv)

NBME I or USMLE 1, plus NBME II or USMLE 2, plus FLEX II;

(v)

NBOME I, plus NBOME II, plus FLEX II;

(vi)

the NBOME Part I or COMLEX Level I and NBOME Part II or COMLEX Level II and NBOME Part III or COMLEX Level III.

(I)

An applicant must pass each part of an examination within three attempts, except that an applicant who has passed all but one part of an examination within three attempts may take the remaining part of the examination one additional time.

(J)

Notwithstanding subparagraph (I) of this paragraph, an applicant is considered to have satisfied the requirements of this section if the applicant:

(i)

passed all but one part of an examination approved by the board within three attempts and passed the remaining part of the examination within five attempts;

(ii)

is specialty board certified by a specialty board that:

(I)

is a member of the American Board of Medical Specialties; or

(II)

is approved by the American Osteopathic Association; and

(iii)

completed in this state an additional two years of postgraduate medical training approved by the board.

(8)

Examinations administered by the board for licensure - To be eligible for licensure an Applicant must sit for the Texas medical jurisprudence examination administered by the board and pass. A passing score is 75 or better on the Texas medical jurisprudence examinations. The board shall administer the Texas medical jurisprudence examination in writing at times and places as designated by the board.

(9)

Full force - Applicants for licensure who possess a license in another jurisdiction must have it in full force and not restricted for cause, canceled for cause, suspended for cause or revoked. A physician with a license in full force may include a physician who does not have a current, active, valid annual permit in another jurisdiction because:

(A)

that jurisdiction requires the physician to practice in the jurisdiction before the annual permit is current; or

(B)

that jurisdiction requires the physician, prior to practicing in that jurisdiction, to hold a current professional liability insurance policy before the annual permit is current.

(10)

Good professional character - An Applicant for licensure must not be in violation of or committed any act described in the Medical Practice Act, §3.08.

(11)

One-year training program - Applicants who are graduates of acceptable approved medical schools must successfully complete one year of postgraduate training approved by the board that is:

(A)

accepted for certification by an American Specialty board that is a member of the American Board of Medical Specialties or the Bureau of Osteopathic Specialists; or

(B)

accredited by one of the following:

(i)

the Accreditation Council for Graduate Medical Education, or its predecessor;

(ii)

the American Osteopathic Association;

(iii)

the Committee on Accreditation of Preregistration Physician Training Programs, Federation of Provincial Medical Licensing Authorities of Canada;

(iv)

the Royal College of Physicians and Surgeons of Canada; or

(v)

the College of Family Physicians of Canada; or

(C)

a postresidency program, usually called fellowship, for additional training in a medical specialty or subspecialty in a program approved by the Texas State Board of Medical Examiners.

(12)

Requisite qualifications - An Applicant who is a graduate of an unapproved acceptable medical school who:

(A)

has for the preceding five years been a licensee of another state or a Canadian province;

(B)

is not the subject of a sanction imposed by or disciplinary matter pending in any state or Canadian province in which the Applicant is licensed to practice medicine; and

(C)

is either specialty board certified by a board that is a member of the American Board of Medical Specialties or the Bureau of Osteopathic Specialists or successfully passes the Special Purpose Examination (SPEX).

(13)

Substantially equivalent to a Texas medical school - A medical school or college located outside the United States or Canada must be an institution of higher learning designed to select and educate medical students; provide students with the opportunity to acquire a sound basic medical education through training in basic sciences and clinical sciences; to provide advancement of knowledge through research; to develop programs of graduate medical education to produce practitioners, teachers, and researchers; and to afford opportunity for postgraduate and continuing medical education. The school must provide resources, including faculty and facilities, sufficient to support a curriculum offered in an intellectual environment that enables the program to meet these standards. The faculty of the school shall actively contribute to the development and transmission of new knowledge. The medical school shall contribute to the advancement of knowledge and to the intellectual growth of its students and faculty through scholarly activity, including research. The medical school shall include, but not be limited to, the following characteristics:

(A)

The facilities for basic sciences and clinical training (i.e., laboratories, hospitals, library, etc.) shall be adequate to ensure opportunity for proper education.

(B)

The admissions standards shall be substantially equivalent to a Texas medical school.

(C)

The basic sciences curriculum shall include the contemporary content of those expanded disciplines that have been traditionally titled anatomy, biochemistry, physiology, microbiology and immunology, pathology, pharmacology and therapeutics, and preventive medicine, as defined by the Texas Higher Education Coordinating Board.

(D)

The fundamental clinical subjects, which shall be offered in the form of required patient-related clerkships, are internal medicine, obstetrics and gynecology, pediatrics, psychiatry, and surgery, as defined by the Texas Higher Education Coordinating Board.

(E)

The curriculum shall be of at least 130 weeks in duration.

(F)

All medical or osteopathic medical education received by the Applicant in the United States must be accredited by an accrediting body officially recognized by the United States Department of Education as the accrediting body for medical education leading to the doctor of medicine degree or the doctor of osteopathy degree in the United States. This subsection does not apply to postgraduate medical education or training.

(G)

An applicant who is unable to comply with the requirements of subparagraph (F) of this paragraph is eligible for an unrestricted license if the Applicant:

(i)

received such medical education in a hospital or teaching institution Sponsoring or participating in a program of graduate medical education accredited by the Accrediting Council for Graduate Medical Education, the American Osteopathic Association, or the Texas State Board of Medical Examiners in the same subject as the medical or osteopathic medical education if the hospital or teaching institution has an agreement with the applicant's school; or

(ii)

is specialty board certified by a board approved by the Bureau of Osteopathic Specialists or the American Board of Medical Specialties.

(14)

Three-year training program - Applicants who are graduates of unapproved medical schools must successfully complete three years of postgraduate training in the United States or Canada:

(A)

accredited by one of the following:

(i)

the Accreditation Council for Graduate Medical Education;

(ii)

the American Osteopathic Association;

(iii)

the Committee on Accreditation of Preregistration Physician Training Programs, Federation of Provincial Medical Licensing Authorities of Canada;

(iv)

the Royal College of Physicians and Surgeons of Canada;

(v)

the College of Family Physicians of Canada; and

(vi)

all programs approved by the board after August 25, 1984; or

(B)

a board-approved program for which a Faculty Temporary Permit was issued; or

(C)

a postresidency program, usually called fellowship, for additional training in a medical specialty or subspecialty in a program approved by the Texas State Board of Medical Examiners.

(15)

Unapproved medical school - A school or college located outside the United States or Canada that was not approved by the board at the time the degree was conferred.

§163.2.Licensure for United States/Canadian Medical School Graduates.

An applicant, to be eligible for licensure must:

(1)

be 21 years of age;

(2)

be of good professional character;

(3)

have completed 60 semester hours of college courses other than in medical school, which courses would be acceptable, at the time of completion, to The University of Texas at Austin for credit on a bachelor of arts degree or a bachelor of science degree;

(4)

be a graduate of an acceptable approved medical school;

(5)

have successfully completed a one-year training program of graduate medical training approved by the board;

(6)

submit evidence of passing, an examination, acceptable by the board for licensure; and,

(7)

pass the Texas Medical Jurisprudence Examination with a score of 75 or better.

§163.3.Licensure for Graduates of Unapproved Medical Schools.

An applicant, to be eligible for licensure must:

(1)

be 21 years of age;

(2)

be of good professional character;

(3)

have completed 60 semester hours of college courses other than in medical school, which courses would be acceptable, at the time of completion, to The University of Texas at Austin for credit on a bachelor of arts degree or a bachelor of science degree;

(4)

be a graduate of a school whose curriculum meets the requirements for an Acceptable Unapproved medical school as determined by a committee of experts selected by the Texas Higher Education Coordinating Board;

(5)

be a graduate of an acceptable unapproved medical school that is substantially equivalent to a Texas medical school;

(6)

have successfully completed a three-year training program of graduate medical training in the United States or Canada that was approved by the board on the date the training was completed;

(7)

submit evidence of passing, an examination, acceptable by the board for licensure;

(8)

pass the Texas Medical Jurisprudence Examination with a score of 75 or better;

(9)

be eligible for licensure in country of graduation;

(10)

possess a valid certificate issued by the Educational Commission for Foreign Medical Graduates (ECFMG);

(11)

have the ability to communicate in the English language; and

(12)

have supplied all additional information that the board may require concerning the Applicant's medical school.

§163.4.Procedural Rules for Licensure Applicants.

(a)

Applicants for licensure:

(1)

whose documentation indicates any name other than the name under which the Applicant has applied must furnish proof of the name change;

(2)

whose application for licensure which has been filed with the board office and which is in excess of one years old from the date of receipt, shall be considered inactive. Any fee previously submitted with that application shall be forfeited. Any further application procedure for licensure will require submission of a new application and inclusion of the current licensure fee.;

(3)

will be allowed to sit for the Texas medical jurisprudence examination only three times. After the third failure of the Texas medical jurisprudence examination, and after each subsequent failure, an applicant for licensure shall be required to appear before a committee of the board to address the applicant's inability to pass the Texas medical jurisprudence examination and to re-evaluate the applicant's eligibility for licensure;

(4)

who in any way falsify the application may be required to appear before the board. It will be at the discretion of the board whether or not the applicant will be issued a Texas license;

(5)

on whom adverse information is received by the board may be required to appear before the board. It will be at the discretion of the board whether or not the applicant will be issued a Texas license;

(6)

shall be required to comply with the board's rules and regulations which are in effect at the time the completed application form and fee are filed with the board;

(7)

may be required to sit for additional oral or written examinations that, in the opinion of the board, are necessary to determine competency of the applicant;

(8)

must have the application for licensure complete in every detail 20 days prior to the board meeting in which they are considered for licensure. Applicants may qualify for a Temporary License prior to being considered by the board for licensure, as required by §163.7 of this title (relating to Temporary Licensure - Regular);

(9)

must pass, within seven years all parts of all examinations required for licensure. The board may consider for licensure graduates of simultaneous MD-PhD or DO-PhD programs who have passed all parts of their required examinations no later than two years after their MD or DO degree was awarded.

(b)

Applicants for licensure who wish to request reasonable accommodations for the Texas jurisprudence examination, due to a disability, must submit the request upon filing the Application.

(c)

Applicants for licensure:

(1)

are required to complete an oath swearing that:

(A)

the license certificate under which the applicant has most recently practiced medicine in the state or Canadian province from which the applicant is transferring to this state or in the uniformed service in which the applicant served is in full force and not restricted, canceled, suspended or revoked;

(B)

the applicant is the identical person to whom the certificate or diploma was issued;

(C)

no proceedings have been instituted against the applicant for the restriction, cancellation, suspension, or revocation of the certificate, license, or authority to practice medicine in the state, Canadian province, or uniformed service of the United States in which it was issued; and

(D)

no prosecution is pending against the applicant in any state, federal, or Canadian court for any offense that under the laws of this state is a felony.

(2)

who have not been examined for licensure in a ten-year period prior to the filing date of the application must pass Day III or Component II of the FLEX prior to June 1988, or SPEX, with a grade of 75 or higher, unless the applicant has:

(A)

passed a specialty certification examination or formal evaluation, recertification examination or formal evaluation, or an examination of continued demonstration of qualifications by a board that is a member of the American Board of Medical Specialties or the Bureau of Osteopathic Specialists within the preceding ten years; or

(B)

obtained through extraordinary circumstances, unique training equal to the training required for specialty certification as determined by a committee of the board and approved by the board.

§163.5.Licensure Documentation.

(a)

An applicant must appear for a personal interview at the board offices and present original documents to a representative of the board for inspection. Original documents may include, but are not limited to, those listed in subsections (b)-(e) of this section.

(b)

Documentation required of all applicants for licensure.

(1)

Birth Certificate/Proof of Age. Each applicant for licensure must provide a copy of either a birth certificate and translation if necessary to prove that the applicant is a least 21 years of age. In instances where a birth certificate is not available the applicant must provide copies of a passport or other suitable alternate documentation.

(2)

Name Change. Any applicant who submits documentation showing a name other than the name under which the applicant has applied must present copies of marriage licenses, divorce decrees, or court orders stating the name change. In cases where the applicant's name has been changed by naturalization the applicant should send the original naturalization certificate by certified mail to the board office for inspection.

(3)

Examination Scores. Each applicant for licensure must have a certified transcript of grades submitted directly from the appropriate testing service to this board for all examinations used in Texas or another state for licensure.

(4)

Dean's Certification. Each applicant for licensure must have a certificate of graduation submitted directly from the medical school on a form provided by the board. The applicant shall attach a recent photograph, meeting United States Government passport standards, to the form before submitting to the medical school. The school shall have the Dean of the medical school or designated appointee sign the form attesting to the information on the form and placing the school seal over the photograph.

(5)

Medical Diploma. All applicants for licensure must submit a copy of their medical diploma.

(6)

Evaluations. All applicants must provide evaluations, on a form provided by the board, of their professional affiliations for the past ten years or since graduation from medical school, whichever is the shorter period.

(7)

Premedical School Transcript. Each applicant must submit a copy of the record of their undergraduate education. Transcripts must show courses taken and grades obtained. If determined that the documentation submitted by the applicant is not sufficient to show proof of the completion of 60 semester hours of college courses other than in medical school, which courses would be acceptable, at the time of completion, to The University of Texas at Austin for credit on a bachelor of arts degree or a bachelor of science degree, the applicant may be requested to contact the Office of Admissions at The University of Texas at Austin for course work verification.

(8)

Medical School Transcript. Each applicant must have his or her medical school submit a transcript of courses taken and grades obtained.

(9)

National Practitioner Data Bank (NPDB). Each applicant must contact the NPDB and have a report of action submitted directly to the board on the applicant's behalf.

(10)

Federation of State Medical Boards History Report. Each applicant must contact the Federation of State Medical Boards and have a history report submitted directly to the board on the applicant's behalf.

(11)

Physician's Profile. Each applicant must have a "Physician's Profile" report submitted directly to the board on the applicant's behalf from:

(A)

American Medical Association; or

(B)

American Osteopathic Association.

(12)

Fingerprint Card. Each applicant must complete a fingerprint card and return to the board as part of the application.

(13)

Graduate Training Verification. Each applicant must submit a certificate showing successful completion of required training. The certificate must show the beginning and ending dates of the program and state that the program was successfully completed. An applicant may have the Program Director of the program in which the applicant trained submit a letter, addressed to this board, submitted directly to this board stating the beginning and ending dates of the program and attesting to successful completion.

(14)

Temporary License Affidavit. Each applicant must submit a completed form, furnished by the board, titled "Temporary License Affidavit" prior to the issuance of a temporary license.

(15)

Additional Photograph. Applicants required to sit for the USMLE examination must submit two recent photographs that meet United States Government passport standards.

(16)

Specialty Board Certification. Each applicant that has obtained certification by a board that is a member of the American Board of Medical Specialties or the Bureau of Osteopathic Specialists must submit a copy of the certificate issued by the member showing board certification.

(17)

Continuing Medical Education (CME). Each applicant must provide copies of certificates showing completion of at least equal to the number of CME hours required by the endorsing state.

(18)

Medical License Verifications. Each applicant will have every state, in which he or she has ever been licensed, regardless of the current status of the license, submit on his or her behalf, directly to this board a letter verifying the status of the license and a description of any sanctions or pending disciplinary matters.

(c)

Applicants for licensure who are graduates of unapproved foreign medical schools must furnish all appropriate documentation listed in this subsection, as well as that listed in subsections (a) and (b) of this section.

(1)

Educational Commission for Foreign Medical Graduates (ECFMG) certificate. Applicants must submit a copy of a valid ECFMG certificate unless they have completed a Fifth Pathway program. All Fifth Pathway applicants must submit a copy of their ECFMG interim certificate.

(2)

Unique Documentation. The board may request documentation unique to an individual unapproved medical school and additional documentation as needed to verify completion of medical education.

(3)

Certificate of Registration. Each applicant must provide a copy of his or her certificate to practice in the country in which his or her medical school is located. If a certificate is unavailable, a letter, submitted directly to this board, from the body governing licensure of physicians in the country in which the school is located, will be accepted. The letter must state that the applicant has met all the requirements for licensure in the country in which the school is located. If an applicant is not licensed in the country of graduation due to a citizenship requirement, a letter attesting to this, submitted directly to this board, will be required.

(4)

Clinical Clerkship Affidavit. A form, supplied by the board, to be completed by the applicant, is required listing each clinical clerkship that was completed as part of an applicant's medical education. The form will require the name of the clerkship, where the clerkship was located (name of hospital and location of hospital) and dates of the clerkship.

(d)

Applicants may be required to submit other documentation, which may include the following.

(1)

Translations. Any document that is in a language other than the English language will need to have a certified translation prepared and a copy of the translation will have to be submitted along with the translated document.

(2)

Arrest Records. If an Applicant has ever been arrested a copy of the arrest and arrest disposition need to be requested from the arresting authority and said authority must submit copies directly to this board.

(3)

Malpractice. If an applicant has ever been named in a malpractice claim filed with any medical liability carrier or if an applicant has ever been named in a malpractice suit, the applicant must have the following submitted:

(A)

have each medical liability carrier complete a form furnished by this board regarding each claim filed against the applicant's insurance;

(B)

for each claim that becomes a malpractice suit have the attorney representing the applicant in each suit submit a letter directly to this board explaining the allegation, dates of the allegation, and current status of the suit. If the suit has been closed, the attorney must state the disposition of the suit, and if any money was paid, the amount of the settlement. If such letter is not available, the Applicant will be required to furnish a notarized affidavit explaining why this letter cannot be provided;

(C)

a statement, composed by the applicant, explaining the circumstances pertaining to patient care in defense of the allegations.

(4)

Inpatient Treatment for Alcohol/Substance Abuse or Mental Illness. Each applicant that has been admitted to an inpatient facility within the last ten years for the treatment of alcohol/substance abuse or mental illness must submit the following:

(A)

an applicant's statement explaining the circumstances of the hospitalization;

(B)

an admitting summary and discharge summary, submitted directly from the inpatient facility;

(C)

a statement from the applicant's treating physician/psychotherapist as to diagnosis, prognosis, medications prescribed, and follow-up treatment recommended;

(D)

a copy of any contracts signed with any licensing authority or medical society or impaired physician's committee.

(5)

Outpatient Treatment for Alcohol/Substance Abuse or Mental Illness. Each applicant that has been treated on an outpatient basis within the last ten years for alcohol/substance abuse or mental illness must submit the following:

(A)

an applicant's statement explaining the circumstances of the outpatient treatment;

(B)

a statement from the applicant's treating physician/psychotherapist as to diagnosis, prognosis, medications prescribed, and follow-up treatment recommended; and

(C)

a copy of any contracts signed with any licensing authority or medical society or impaired physician's committee.

(6)

Additional Documentation. Additional documentation as is deemed necessary to facilitate the investigation of any application for medical licensure.

(7)

DD214. A copy of the DD214 indicating separation from any branch of the United States military.

(e)

The board may, in unusual circumstances, allow substitute documents where proof of exhaustive efforts on the applicant's part to secure the required documents is presented. These exceptions are reviewed by the board's executive director on a case-by-case basis.

§163.6.Administration of Examinations.

(a)

The board shall administer the Texas medical jurisprudence examination in writing, at times and places as designated by the board.

(b)

An examinee shall not be permitted to bring medical books, compends, notes, medical journals, calculators or other help into the examination room, nor be allowed to communicate by word or sign with another examinee while the examination is in progress without permission of the presiding examiner, nor be allowed to leave the examination room except when so permitted by the presiding examiner.

(c)

Irregularities during an examination such as giving or obtaining unauthorized information or aid as evidenced by observation or subsequent statistical analysis of answer sheets, shall be sufficient cause to terminate an applicant's participation in an examination or to invalidate the applicant's examination results or to take other appropriate action.

(d)

An applicant shall not be eligible to sit for the Texas medical jurisprudence examination until the application is complete and until the applicant has made a personal appearance to have his or her required original documents inspected by a representative of the board.

§163.7.Temporary Licensure - Regular.

(a)

The executive director of the board may issue a temporary license to an applicant:

(1)

who has passed the Texas medical jurisprudence examination;

(2)

whose completed application has been filed, processed, and found to be in order; and

(3)

who has met all other requirements for licensure.

(b)

Each applicant shall receive only one temporary license prior to the issuance of a permanent license. The Board, in unusual circumstances, may allow the issuance of one additional temporary license if it finds it is in the best interest of the public and that the health and welfare of the public would not be endangered, but would be served. These exceptions are reviewed by the executive director on a case-by-case basis.

§163.8.Distinguished Professors Temporary License.

(a)

The executive director of the board may issue a distinguished professors temporary license to an applicant:

(1)

who has passed the Texas medical jurisprudence examination;

(2)

whose application has been filed, processed, and found to be in order. The application shall be complete in every detail except that the applicant will not be required to have taken and passed the SPEX examination as set forth in §163.4 of this title (relating to Procedural Rules for Licensure Applicants);

(3)

who holds an appointment as a salaried full professor on the faculty working full-time in one of the following institutions:

(A)

University of Texas Medical Branch at Galveston;

(B)

University of Texas Southwestern Medical Center at Dallas;

(C)

University of Texas Health Science Center at Houston;

(D)

University of Texas Health Science Center at San Antonio;

(E)

University of Texas Health Center at Tyler;

(F)

University of Texas M.D. Anderson Cancer Center;

(G)

Texas A&M University College of Medicine;

(H)

Texas Tech University School of Medicine;

(I)

Baylor College of Medicine; or

(J)

University of North Texas Health Science Center at Fort Worth.

(b)

The distinguished professors temporary license shall be requested by the president, dean or chief academic officer of the institution as defined in subsection (a)(3) of this section and shall be valid only in the institution or its affiliated hospitals.

(c)

The distinguished professors temporary license shall be valid for a continuous one-year period; however, the permit is revocable at any time the board deems necessary. The distinguished professors temporary license shall automatically expire one year after the date of issuance. The distinguished professors temporary license is renewable one time, at the discretion of the executive director.

(d)

At the conclusion of this one-year period, the distinguished professor shall present recommendations from the president, dean or chief academic officer of the institution, and shall petition the board for a permanent, unrestricted license to practice medicine in Texas. If this petition is denied, the institution may request a one-year extension of the distinguished professors temporary license. If an extension is granted, and following termination of such extension, the distinguished professor shall again present recommendations from the president, dean or chief academic officer of the institution and re-petition the board for a permanent, unrestricted license to practice medicine in Texas. If the petition is again denied, no further distinguished professors temporary license shall be issued.

(e)

If the board grants the petition for licensure, the distinguished professor may be issued a permanent, unrestricted license.

§163.9.State Health Agency Temporary License.

An applicant may elect to apply for a state health agency temporary license in lieu of licensure.

(1)

The executive director of the board may issue such a temporary license to an applicant:

(A)

who holds a valid license in another state or Canadian province on the basis of an examination, that is accepted by the board for licensure;

(B)

who has passed the Texas medical jurisprudence examination;

(C)

whose application has been filed, processed, and found to be in order. The application shall be complete in every detail with the exception of compliance with §163.4(c)(2) of this title (relating to Procedural Rules for all Licensure Applicants); and

(D)

who holds a salaried, administrative, or clinical position with an agency of the State of Texas.

(2)

The state health agency temporary license shall be requested by the chief administrative officer of the employing state agency and shall be issued exclusively to that agency. The chief administrative officer shall state whether the temporary license is for a:

(A)

clinical position. This temporary license will be valid for a one-year period from the date of issuance and will not be renewable. The temporary license is revocable at any time the board deems necessary. To practice beyond one year, the holder of the temporary license must fully comply with §163.4(c)(2) of this title (relating to Procedural Rules for all Licensure Applicants). During the period that the state health agency clinical temporary license is in effect, the physician will be supervised by a licensed staff physician who will regularly review the temporary license holder's skill and performance. This temporary license will be marked "clinical"; or

(B)

administrative non-clinical position. This temporary license will be valid for a one-year period from the date of issuance; however, it is revocable at any time the board deems necessary. The temporary license shall automatically expire one year after the date of issuance but may be re-issued annually at the request of the chief administrative officer of the employing state agency and at the discretion of the Texas State Board of Medical Examiners. The holder of a state health agency temporary license, not designated as clinical, shall not practice medicine as that term is defined in Texas Civil Statutes, Article 4495b, section 1.03(12)(A) and (B). This temporary license will be marked "administrative."

§163.10.Relicensure.

(a)

If a physician's license has been expired for one year, it is considered to have been canceled, and the physician may not renew the license. The physician may obtain a new license by submitting to reexamination and complying with the requirements and procedures for obtaining an original license.

(1)

The examinations required by this section are:

(A)

the Texas jurisprudence examination; and

(B)

SPEX, unless the Applicant:

(i)

has passed a licensure examination or has obtained specialty certification, recertification, or passed an examination of continued demonstration of qualifications by a board that is a member of the American Board of Medical Specialties or the Bureau of Osteopathic Specialists within the preceding ten years; or

(ii)

has been in a training program approved by the board within six months prior to application for relicensure.

(2)

The additional requirements for this new license shall be as required within the following sections:

(A)

Section 163.2 of this title (relating to Licensure for United States and Canadian Medical School Graduates);

(B)

Section 163.3 of this title (relating to Licensure for Graduates of Unapproved Medical Schools);

(C)

Section 163.4 of this title (relating to Procedural Rules for all Licensure Applicants); and

(D)

Section 163.5 of this title (relating to Licensure Documentation).

(b)

A person may qualify for renewal of his or her original license without reexamination if that person:

(1)

held a license previously in this state;

(2)

moved to another state

(3)

practiced in that other state for not more than two years since the expiration of his or her Texas license; and

(4)

files an application for relicensure under subsection (a)(2) of this section.

§163.11.Active Practice of Medicine.

(a)

All applicants for licensure shall provide sufficient documentation to the board that the applicant has, on a full-time basis, actively diagnosed or treated persons or has been on the active teaching faculty of an acceptable approved medical school, within each of the last two years preceding receipt of an Application for licensure.

(b)

The term "full-time basis," for purposes of this section, shall mean at least 20 hours per week for 40 weeks duration during a given year.

(c)

Applicants who do not meet the requirements of subsections (a) and (b) of this section may, in the discretion of the executive director or board, be eligible for an unrestricted license or a restricted license subject to one or more of the following conditions or restrictions:

(1)

current certification or recertification by the American Board of Medical Specialties or Bureau of Osteopathic Specialists;

(2)

passage of the SPEX examination;

(3)

completion of specified continuing medical education hours approved for Category I credits by the American Medical Association or the American Osteopathic Association;

(4)

limitation of the practice of the applicant to specified activities of medicine and/or exclusion of specified activities of medicine;

(5)

remedial education, including but not limited to a mini-residency, fellowship or other structured program;

(6)

such other remedial or restrictive conditions or requirements which, in the discretion of the board are necessary to ensure protection of the public and minimal competency of the applicant to safely practice medicine.

§163.12.Licensure for the Fifth Pathway.

An applicant who has completed a Fifth Pathway Program to be eligible for licensure must:

(1)

be at least 21 years of age;

(2)

be of good professional character;

(3)

have completed 60 semester hours of college courses other than in medical school, which courses would be acceptable, at the time of completion, to The University of Texas at Austin for credit on a bachelor of arts or a bachelor of science degree;

(4)

have completed all of the didactic work of the foreign medical school, whose curriculum meets the requirements for an acceptable unapproved medical school as determined by a committee of experts selected by the Texas Higher Education Coordinating Board, but has not graduated from an unapproved acceptable medical school;

(5)

have completed all of the didactic work of the foreign medical school, that is substantially equivalent to a Texas medical school, but has not graduated from an acceptable unapproved medical school;

(6)

have successfully completed a three-year training program of graduate medical education in the United States or Canada that was approved by the board on the date the training was completed;

(7)

submit evidence of passing an examination, , that is acceptable to the board of licensure;

(8)

pass the Texas Medical Jurisprudence Examination with a score of 75 or better;

(9)

submit a sworn affidavit that no proceedings, past or current, have been instituted against the applicant before any state medical board, provincial medical board, in any military jurisdiction or federal facility;

(10)

have attained a passing score on the ECFMG examination;

(11)

have the ability to communicate in the English language;

(12)

have attained a satisfactory score on a qualifying examination and have completed one academic year of supervised clinical training for foreign medical students as defined by the American Medical Association Council on Medical Education (Fifth Pathway Program) in a United States medical school; and

(13)

have supplied all additional information, that the board may require, concerning the applicant's medical school, before approving the applicant.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State on September 3, 1999.

TRD-9905670

Bruce A. Levy, M.D., J.D.

Executive Director

Texas State Board of Medical Examiners

Earliest possible date of adoption: October 17, 1999

For further information, please call: (512) 305-7016


Chapter 173. APPLICATIONS

22 TAC §173.1

(Editor's note: The text of the following section proposed for repeal will not be published. The section may be examined in the offices of the Texas State Board of Medical Examiners or in the Texas Register office, Room 245, James Earl Rudder Building, 1019 Brazos Street, Austin.)

The Texas State Board of Medical Examiners proposes the repeal of §173.1, concerning Applications. The repeal is necessary because chapters 173 and 175 are being combined to reorganize and update applications and fees. The Texas State Board of Medical Examiners is contemporaneously adopting an amendment to §175.1 on an emergency basis in the emergency section of this issue of the Texas Register . New Chapter 175 is proposed simultaneously in this issue of the Texas Register .

Elsewhere in this issue of the Texas Register , the Texas State Board of Medical Examiners is withdrawing the previously published repeal of §173.1.

The proposed review of Chapters 173 and 175 (concerning Applications and Schedule of Fees and Penalties) was previously published in the September 18, 1998, issue of the issue of the Texas Register (23 TexReg 9583). The review of these Chapters was reproposed in the March 5, 1999, issue of the Texas Register (24 TexReg 1643). Elsewhere in this issue of the Texas Register , the Texas State Board of Medical Examiners contemporaneously reproposes the review of Chapters 173 and 175. The review is in accordance with the Appropriations Act of 1997, HB 1, Article IX, Section 167.

John S. Teer, General Counsel, Texas State Board of Medical Examiners, has determined that for the first five-year period the repeal is in effect there will be no fiscal implications to state or local government as a result of enforcing or administering the section as proposed.

Mr. Teer also has determined that for each year of the first five years the section as proposed is in effect the public benefit anticipated as a result of enforcing the section will be updated rules. There will be no effect on small businesses. There is no anticipated economic cost to persons who are required to comply with the section as proposed.

Comments on the proposal may be submitted to Pat Wood, P.O. Box 2018, MC-901, Austin, Texas 78768-2018. A public hearing will be held at a later date.

The repeal is proposed under the Medical Practice Act, Texas Civil Statutes, Article 4495b, §2.09(a), which provides the Texas State Board of Medical Examiners with the authority to make rules, regulations and bylaws not inconsistent with this Act as may be necessary for the governing of its own proceedings, the performance of its duties, the regulation of the practice of medicine in this state, and the enforcement of this Act.

The Medical Practice Act, Texas Civil Statutes, Article 4495b, §2.09(a) is affected by the proposed repeal .

§173.1.Applications.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State on September 3, 1999.

TRD-9905672

Bruce A. Levy, M.D., J.D.

Executive Director

Texas State Board of Medical Examiners

Earliest possible date of adoption: October 17, 1999

For further information, please call: (512) 305-7016


Chapter 175. SCHEDULE OF FEES AND PENALTIES

22 TAC §§175.1-175.4

(Editor's note: The text of the following sections proposed for repeal will not be published. The sections may be examined in the offices of the Texas State Board of Medical Examiners or in the Texas Register office, Room 245, James Earl Rudder Building, 1019 Brazos Street, Austin.)

The Texas State Board of Medical Examiners proposes the repeal of §175.1-175.4, concerning Schedule of Fees and Penalties and new §§175.1-175.5, concerning Fees, Penalties, and Applications. Chapters 173 and 175 are being combined to reorganize and update applications and fees. The repeal of Chapter 173 is proposed simultaneously in the issue of the Texas Register . The Texas State Board of Medical Examiners is contemporaneously adopting an amendment to §175.1 on an emergency basis in the emergency section of this issue of the Texas Register . The repeal of §173.1 is proposed simultaneously in this issue of the Texas Register .

Elsewhere in this issue of the Texas Register , the Texas State Board of Medical Examiners is withdrawing the previously published repeal of §§175.1-175.4 and new §§175.1-175.5.

The proposed review of Chapters 173 and 175 (concerning Applications and Schedule of Fees and Penalties) was previously published in the September 18, 1998, issue of the issue of the Texas Register (23 TexReg 9583). The review of these Chapters was reproposed in the March 5, 1999, issue of the Texas Register (24 TexReg 1643). Elsewhere in this issue of the Texas Register , the Texas State Board of Medical Examiners contemporaneously reproposes the review of Chapters 173 and 175. The review is in accordance with the Appropriations Act of 1997, HB 1, Article IX, Section 167.

John S. Teer, General Counsel, Texas State Board of Medical Examiners, has determined that for the first five-year period the repeal and new sections are in effect there will be no fiscal implications to state or local government as a result of enforcing or administering the sections as proposed.

Mr. Teer also has determined that for each year of the first five years the sections as proposed are in effect the public benefit anticipated as a result of enforcing the sections will be reorganization of the chapters and updated information. There wil be an estimated increase to state revenue of $90,920 for the following: $58,700 for new permits; $24,720 for renewals; and $7,500 for approval of fellowship programs. In addition, there will be increased revenue of $2,095,680 for physician annual renewal fees over the next biennium.

Comments on the proposal may be submitted to Pat Wood, P.O. Box 2018, MC-901, Austin, Texas 78768-2018. A public hearing will be held at a later date.

The repeals are proposed under the Medical Practice Act, Texas Civil Statutes, Article 4495b, §2.09(a), which provides the Texas State Board of Medical Examiners with the authority to make rules, regulations and bylaws not inconsistent with this Act as may be necessary for the governing of its own proceedings, the performance of its duties, the regulation of the practice of medicine in this state, and the enforcement of this Act.

The Medical Practice Act, Texas Civil Statutes, Article 4495b, §2.09(k) is affected by the proposed repeals.

§175.1.Fees.

§175.2.Penalties.

§175.3.Payment of Fees or Penalties.

§175.4.Partial Refund.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State, on September 3, 1999.

TRD-9905675

Bruce A. Levy, M.D., J.D.

Executive Director

Texas State Board of Medical Examiners

Earliest possible date of adoption: October 17, 1999

For further information, please call: (512) 305-7016


Chapter 175. FEES, PENALTIES AND APPLICATIONS

22 TAC §§175.1-175.5

The new sections are proposed under the Medical Practice Act, Texas Civil Statutes, Article 4495b, §2.09(a), which provides the Texas State Board of Medical Examiners with the authority to make rules, regulations and bylaws not inconsistent with this Act as may be necessary for the governing of its own proceedings, the performance of its duties, the regulation of the practice of medicine in this state, and the enforcement of this Act.

The Medical Practice Act, Texas Civil Statutes, Article 4495b, §2.09(k) is affected by the proposed new sections.

§175.1.Fees.

The board shall charge the following fees.

(1)

Physicians:

(A)

processing an application for complete or partial licensure examination (includes one USMLE Step 3 or COMLEX Level 3 and jurisprudence examination fee) -$800;

(B)

processing an application for licensure by endorsement (includes one jurisprudence examination fee) - $800;

(C)

examination fees (required and payable each time applicant is scheduled for examination):

(i)

USMLE Step 3 - $500;

(ii)

COMLEX Level 3 - $500;

(iii)

Jurisprudence - $30;

(D)

processing an application for a special purpose license for practice of medicine across state lines (includes one jurisprudence examination fee) - $800;

(E)

temporary license:

(i)

regular - $50;

(ii)

distinguished professor - $50;

(iii)

state health agency - $50;

(iv)

section 3.0305 - $50;

(v)

rural/underserved areas - $50;

(vi)

continuing medical education - $50;

(F)

annual renewal - $330.

(2)

Physicians in Training:

(A)

institutional permit (began training program prior to 6-1-2000) - $50;

(B)

renewal of institutional permit (began training program prior to 6-1-2000) - $35;

(C)

basic postgraduate resident permit - $75;

(D)

advanced postgraduate resident permit - $75;

(E)

temporary postgraduate resident permit - $50;

(F)

renewal of basic postgraduate resident permit - $50;

(G)

renewal of advanced postgraduate resident permit - $50;

(H)

faculty temporary permit - $110;

(I)

visiting professor permit - $110;

(J)

evaluation or re-evaluation of postgraduate training program -$150.

(3)

Physician Assistants:

(A)

processing application for licensure as a physician assistant - $200;

(B)

temporary license - $50;

(C)

annual renewal - $150.

(4)

Acupuncturists/Acudetox Specialists:

(A)

processing an application for license as an acupuncturist - $300;

(B)

temporary license for an acupuncturist - $50;

(C)

annual renewal for an acupuncturist - $250;

(D)

acupuncturist distinguished professor - $50;

(E)

processing an application for acudetox specialist - $50;

(F)

annual renewal for acudetox specialist - $25;

(G)

review of continuing acupuncture education courses - $50;

(H)

review of continuing acudetox acupuncture education courses - $50.

(5)

Non-Certified Radiologic Technicians:

(A)

processing an application - $50;

(B)

annual renewal - $50.

(6)

Certification as a Non-Profit Health Organization:

(A)

processing an application for initial certification - $2,500;

(B)

processing an application for biennial recertification - $500.

(7)

Miscellaneous Fees:

(A)

duplicate license - $45.

(B)

endorsement - $40.

(C)

reinstatement after cancellation for cause - $350.

§175.2.Penalties. The board shall charge the following penalties:

(1)

Physicians:

(A)

renewal of physician's license expired for 31-90 days - $50;

(B)

renewal of physician's license expired for longer than 90 days but less than one year - $100.

(2)

Physician Assistants:

(A)

renewal of physician assistant's license expired for 90 days or less - $50;

(B)

renewal of physician assistant's license expired for longer than 90 days but less than one year - $100.

(3)

Acupuncturists/Acudetox Specialists:

(A)

renewal of acupuncturist's license expired for 90 days or less - $125;

(B)

renewal of acupuncturist's license expired for longer than 90 days but less than one year - $250;

(C)

renewal of acudetox specialist certification expired for less than one year - $25.

(4)

Non-Certified Radiologic Technicians. Renewal of non-certified radiologic technician's registration expired for 1-90 days - $25.

§175.3.Payment of Fees or Penalties.

All licensure fees or penalties must be submitted in the form of a money order or cashier's check payable on or through a United States bank. Fees and penalties cannot be refunded. If a single payment is made for more than one individual permit, it must be made for the same class of permit and a detailed listing, on a form prescribed by the board, must be included with each payment.

§175.4.Partial Refund.

Fees for processing an application for complete or partial licensure examination may be subject to a partial refund equal to the cost of the examination. The applicant must request a refund before April 1, because the applicant has been accepted in an out-of-state training program starting in June or July as a result of the National Matching Program and elects to not take the licensure examination in Texas.

§175.5.Applications.

(a)

All information required on applications used by this board will conform to the Medical Practice Act and rules promulgated by this board. The board hereby adopts by reference the following forms:

(1)

Physicians:

(A)

application for licensure by examination;

(B)

application for licensure by endorsement;

(C)

application for a special purpose license for practice of medicine across state lines;

(D)

application for temporary license;

(E)

application for annual renewal of physician's permit.

(2)

Physicians in Training:

(A)

application for institutional permit (physician began program prior to 5-31-2000);

(B)

application for renewal of institutional permit (physician began program prior to 5-31-2000);

(C)

application for basic postgraduate resident permit;

(D)

application for advanced postgraduate resident permit;

(E)

application for temporary postgraduate resident permit;

(F)

application for renewal of basic postgraduate resident permit;

(G)

application for renewal of advanced postgraduate resident permit;

(H)

application for faculty temporary permit;

(I)

application for visiting professor permit;

(J)

application for National Health Service Corps Permit.

(3)

Physician Assistants:

(A)

licensure application;

(B)

application for temporary license;

(C)

notice of intent to supervise a physician assistant;

(D)

notice of intent to practice as a physician assistant;

(E)

application for annual renewal of license.

(4)

Acupuncturists/Acudetox Specialists:

(A)

licensure application for acupuncturist;

(B)

application for acupuncturist temporary license;

(C)

application for acupuncture distinguished professor temporary license;

(D)

application for annual renewal of acupuncturist license;

(E)

application for acudetox specialist certification;

(F)

application for annual renewal of acudetox specialist certification;

(G)

application for approval of continuing acupuncture education courses;

(H)

application for approval of continuing acudetox acupuncture education courses.

(5)

Non-Certified Radiologic Technicians:

(A)

application for non-certified radiologic technician permit;

(B)

application for annual renewal of non-certified radiologic technician.

(6)

Certification as a Non-Profit Health Organization:

(A)

application for initial certification;

(B)

application for biennial recertification.

(7)

Miscellaneous Applications:

(A)

application for a duplicate license;

(B)

application for reinstatement of medical license for cause;

(C)

physician designation of prescriptive delegation.

(b)

These forms may be examined and copies may be obtained at the offices of the Texas State Board of Medical Examiners, 333 Guadalupe, Tower 3, Suite 610, Austin, Texas.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State, on September 3, 1999.

TRD-9905676

Bruce A. Levy, M.D., J.D.

Executive Director

Texas State Board of Medical Examiners

Earliest possible date of adoption: October 17, 1999

For further information, please call: (512) 305-7016