| (I) proof that all education completed in the United
States or Canada was while the applicant was enrolled as a visiting
student as evidenced by a letter of verification from the U.S. or
Canadian medical school.
(5) Medical Diploma. On request of board staff, an
applicant must submit a copy of his or her medical diploma, and translation
if necessary.
(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.
(A) An official translation from the medical school
(or appropriate agency) attached to the foreign language transcript
or other document is acceptable.
(B) If a foreign document is received without a translation,
the board will send the applicant a copy of the document to be translated
and returned to the board.
(C) Documents must be translated by a translation agency
that is a member of the American Translations Association or a United
States college or university official.
(D) The translation must be on the translator's letterhead,
and the translator must verify that it is a "true word for word translation"
to the best of his/her knowledge, and that he/she is fluent in the
language translated, and is qualified to translate the document.
(E) The translation must be signed in the presence
of a notary public and then notarized. The translator's name must
be printed below his/her signature. The notary public must use this
phrase: "Subscribed and Sworn to this ________ day of ________, 20___."
The notary must then sign and date the translation, and affix his/her
Notary Seal to the 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 do the following:
(A) have each medical liability carrier complete a
form furnished by the 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 the 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. The letter should include
supporting court records. If such letter is not available, the applicant
will be required to furnish a notarized affidavit explaining why this
letter cannot be provided; and
(C) provide a statement, composed by the applicant,
explaining the circumstances pertaining to patient care in defense
of the allegations.
(4) Inpatient Treatment for Alcohol/Substance Disorder
or Physical or Mental Illness. Each applicant who has been admitted
to an inpatient facility within the last five years for the treatment
of alcohol/substance disorder or mental illness (recurrent or severe
major depressive disorder, bipolar disorder, schizophrenia, schizoaffective
disorder, or any severe personality disorder), or a physical illness
that impairs or has impaired the applicant's ability to practice medicine,
shall submit documentation to include items listed in subparagraphs
(A) - (D) of this paragraph. An inpatient facility shall include a
hospital, ambulatory surgical center, nursing home, and rehabilitation
facility.
(A) an applicant's statement explaining the circumstances
of the hospitalization;
(B) all records, 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; and
(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 Disorder
or Mental Illness. Each applicant who has been treated on an outpatient
basis within the last five years for alcohol/substance disorder or
mental illness (recurrent or severe major depressive disorder, bipolar
disorder, schizophrenia, schizoaffective disorder, or any severe personality
disorder), or a physical illness that impairs or has impaired the
applicant's ability to practice medicine, shall submit documentation
to include, but not limited to:
(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) DD214. A copy of the DD214, indicating separation
from any branch of the United States military.
(7) Premedical School Transcript. Applicants, upon
request, may be required to 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 or education required
for country of graduation, the applicant may be requested to contact
the Office of Admissions at The University of Texas at Austin for
course work verification.
(8) Fingerprint Card. Upon request, applicants must
complete a fingerprint card and return to the board as part of the
application.
(9) Additional Documentation. Additional documentation
as is deemed necessary to facilitate the investigation of any application
for medical licensure.
(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.
|
| Source Note: The provisions of this §163.5 adopted to be effective November 10, 1999, 24 TexReg 9835; amended to be effective March 5, 2000, 25 TexReg 1623; amended to be effective July 2, 2000, 25 TexReg 6133; amended to be effective March 7, 2002, 27 TexReg 1487; amended to be effective September 19, 2002, 27 TexReg 8769; amended to be effective January 9, 2003, 28 TexReg 67; amended to be effective November 30, 2003, 28 TexReg 10480; amended to be effective May 2, 2004, 29 TexReg 3961; amended to be effective November 7, 2004, 29 TexReg 10104; amended to be effective January 25, 2006, 31 TexReg 382; amended to be effective January 4, 2007, 31 TexReg 10797; amended to be effective August 10, 2008, 33 TexReg6133; amended to be effective January 20, 2009, 34 TexReg 336; amended to be effective November 29, 2009, 34 TexReg 8530; amended to be effective July 4, 2012, 37 TexReg 4925; amended to be effective September 30, 2012, 37 TexReg 7485; amended to be effective January 20, 2014, 39 TexReg 273; amended to be effective August 3, 2014, 39 TexReg 5748; amended to be effective July 7, 2016, 41 TexReg 4823 |
