Texas Medical Board

Texas Physician Licensure Seminar

Donald W. Patrick, MD, JD Executive Director

10/9/2007

Presentation Topics
Governance Licensure Process Eligibility Requirements Demonstration of Eligibility through Documentation Tips for Applicants for a Smooth Licensure Process Current Status of Physician Licensing

Governance
Statute
Laws relating to licensure, registration, and discipline of physicians TMB Web site link www.tmb.state.tx.us Laws, Rules and Guidelines/Texas Statutes/Texas Occupations Code

Board Rules
Rules are adopted by the TMB Board cannot waive requirements in rule unless rules specifically allow it Rule change process TMB Web site link www.tmb.state.tx.us Laws, Rules and Guidelines/Board Rules

Physician Licensure Process

Applicant
FCVS (optional credentialing service) Online Application Submission of Additional Documentation

Recent/Upcoming Changes
Application Fee Increase - $885 Fingerprinting 10/1/2007 New Jurisprudence Examination Vendor 12/3/2007

Physician Licensure Process

TMB
Screening Licensure Processing Temporary and Permanent License Issuance

Physician Licensure Process continued

Applicants with issues concerning eligibility Statutory ineligibility Non-compliance with eligibility requirements under board rule File reviews and determinations of eligibility Appearance before the TMB Licensure Committee Appeal Process

Physician Licensure Process continued

Priority and Expedited Handling
Priority - Physician applicants who agree to treat Medicare/Medicaid Patients for 5 years following licensure Expedited - Physician applicants planning to practice in: A medically underserved area (MUA) A health professionals shortage area (HPSA) A rural area

Eligibility Requirements
Medical Education
Domestic International Medical Graduate (IMG) Fifth Pathway

Examinations
Licensing Examinations Refer to Handout - Exam Attempts and Eligibility Texas Medical Jurisprudence

Postgraduate Training
Domestic IMG

Eligibility Requirements continued

Professional Character - No violation of Medical Practice Act, Tex. Occ. Code Ann. 164.051-.053. Examples: Sec. 164.051. GROUNDS FOR DENIAL OR DISCIPLINARY ACTION. a felony; or a misdemeanor involving moral turpitude; violation of a rule is unable to practice medicine with reasonable skill and safety to patients because of illness; drunkenness; excessive use of drugs, narcotics, chemicals, or another substance; or a mental or physical condition; fails to practice medicine in an acceptable professional manner consistent with public health and welfare; disciplinary action taken by peers

Eligibility Requirements continued

repeated or recurring meritorious health care liability claims that in the board's opinion evidence professional incompetence likely to injure the public; or The board shall revoke a license issued under this subtitle if the license holder held a license to practice medicine in another state that has been revoked by the licensing authority in that state. Sec. 164.052. PROHIBITED PRACTICES BY PHYSICIAN OR LICENSE APPLICANT. submits to the board a false or misleading statement, document, or certificate presents to the board a license, certificate, or diploma that was illegally or fraudulently obtained; commits fraud or deception in taking or passing an examination;

Eligibility Requirements continued

uses alcohol or drugs in an intemperate manner that, in the board's opinion, could endanger a patient's life; uses an advertising statement that is false, misleading, or deceptive; advertises professional superiority or the performance of professional service in a superior manner if that advertising is not readily subject to verification; directly or indirectly employs a person whose license to practice medicine has been suspended, canceled, or revoked; Sec. 164.053. UNPROFESSIONAL OR DISHONORABLE CONDUCT. commits an act that violates any state or federal law if the act is connected with the physician's practice of medicine fails to keep complete and accurate records of purchases and disposals

Eligibility Requirements continued

writes prescriptions for or dispenses to a person who is known to be an abuser of narcotic drugs, controlled substances, or dangerous drugs; or the physician should have known was an abuser of narcotic drugs, controlled substances, or dangerous drugs; writes false or fictitious prescriptions prescribes or administers a drug or treatment that is nontherapeutic in nature or nontherapeutic in the manner the drug or treatment is administered or prescribed; prescribes, administers, or dispenses in a manner inconsistent with public health and welfare a dangerous drug or controlled substance fails to supervise adequately the activities of those acting under the supervision of the physician; or delegates professional medical responsibility or acts to a person if the delegating physician knows or has reason to know that the person is not qualified by training, experience, or licensure to perform the responsibility or acts.

Licensure Application and Documentation

Application form Supplemental documentation and additional licensure forms
Refer to Handout - Supplemental Documentation and Important Information Described in instructions for completing additional licensure forms Requested by licensure analyst as needed

Demonstration of Eligibility Through Documentation

Medical Education
Domestic International Medical Graduate (IMG) Fifth Pathway

Postgraduate Training
Domestic IMG

Examinations Professional Character Other

Documentation: Medical Education

Licensure Form D - Dean's Certification Medical School Transcript Fifth Pathway Certificate and Letter Licensure Form J - Clinical Clerkship Affidavit Licensure Form M Educational Commission for Foreign Medical Graduates (ECFMG) Status

Documentation: Medical Education

Licensure Form N - AACRAO Credentials Evaluation (American Association of Collegiate Registrars and Admissions Officers) Review Eligibility to Practice in Country of Graduation

Documentation: Medical Education

Licensure Forms Z1 Z7 Substantial Equivalence of Medical Education American University of the Caribbean, St. Georges University, and Universidad Autonoma de Guadalajara are now on the list of schools whose graduates do not need to demonstrate substantial equivalence

Documentation: Postgraduate Training

Form L Training Certificates

Documentation: Examinations
Examination Transcripts Licensing Examinations Score Reports JP Exam Note: USMLE Steps 1 and 2 (including Clinical Skills Assessment) are part of ECFMG certification for IMGs

Documentation: Professional Character

Application Form Yes answers
Honesty Consequences of falsification

National Practitioner Data Bank and Health Integrity Data Bank Reports Licensure Form AA - Additional Licenses Licensure Form I - Medical Professional Liability Claims Report

Documentation: Professional Character Medical Liability Reporting

Old Requirements Claims Suits Pending Final-No payment on behalf of applicant Final-Payment on behalf of applicant New Requirements Claims Suits Pending Final-No payment on behalf of applicant Final-Payment on behalf of applicant No No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Documentation: Professional Character - Medical Liability Reporting

New requirements are in effect However, application question has not yet been changed online and is not changed in the copy you have in your handout

Documentation: Professional Character

Licensure Form L - Evaluations and Verification of Postgraduate Training Licensure Form Q - Work Experience, Closed Programs Licensure Form R - Arrest/Criminal History Licensure Form S - Disciplinary Action History Licensure Form U - Actions/Investigations Licensure Form V - Professionalism

Documentation: Professional Character

Form W - Mental and Physical Health Criminal Background Check conducted by TMB staff AMA profiles and FSMB Disciplinary Action Reports conducted by TMB staff; applicants may be asked to supply additional documentation.

Documentation: Other
Alternate Name Documentation Birth Certificate or Passport Licensure Form B - Photo Affidavit Personal Appearances and Inspection of Original Documents

Documentation: Other
Reissuance Applicants
License has been revoked by the board Must meet current statutory requirements and board rules Must demonstrate that reissuance of a license is in applicants best interest and the best interest of the public

Documentation: Other
Relicensure Applicants
License has been canceled for non-payment or by request Must meet current statutory requirements and board rules

Specialty Board Certification Documentation

Copy of the most recent certificate awarded by American Board of Medical Specialties or the Bureau of Osteopathic Specialists

Current Status
Applications to Screen 732 (oldest 7/8/2007) In Screen 970 Applications to Assign, Once Screening Successfully Completed or Sent Directly to Licensure 40 (oldest 8/27/2007) Applications Not Yet Initially Processed 224 (oldest 6/16/2007) In Process 786

Tips for Applicants for a Smooth Licensure Process

Review your eligibility use the TMB web site Read and follow all instructions Review your application for completeness If in doubt, answer yes Send supplemental documentation in one package Track your mail use a service that delivers to
TMBs physical address, not the PO Box

Contact Information
Jaime Garanflo Tonie Knight Director, Licensure & Customer Affairs Manager, Licensure Jaime.garanflo@tmb.state.tx.us Tonie.knight@tmb.state.tx.us Denise Meyer Team Leader, Licensure Denise.meyer@tmb.state.tx.us Monique Johnston Licensure Specialist Monique.johnston@tmb.state.tx.us Customer Information Center Verifcic@tmb.state.tx.us 512-305-7030 Nori Peterson Team Leader, Licensure Nori.peterson@tmb.state.tx.us