1. (1) Physician supervision requires, at all times, a direct, continuing and close supervisory relationship between a bridge year graduate physician and the supervising physician.
2. (2) There shall be no independent, unsupervised practice by bridge year graduate physicians.
3. (3) The supervising physician shall, at a minimum, provide on-site supervision.
4. (4) Supervision does not necessarily require the constant physical presence of the supervising physician or a physician who is acting in a Board-approved supervisory role to the bridge year graduate physician; however, the physician must remain readily available in the facility to provide direct medical intervention.
5. (5) The supervising physician shall be available for consultation or referrals of patients from the bridge year graduate physician.
6. (6) In the event the supervising physician is not readily available, provisions must be made for professional medical oversight and direction by a covering physician who is readily available in the facility to provide direct medical intervention, who is preapproved by the Board of Medical Examiners, and who is familiar with these rules.
7. (7) In the event of an unanticipated, permanent absence of a supervising physician, a previously approved covering physician may be designated as a temporary supervising physician for a period of up to sixty (60) days.  During the sixty (60) day time period, a new supervising physician should be submitted for approval.
8. (8) The supervising physician and the bridge year graduate physician shall adhere to any written guidelines established by the Board to govern the prescription practices of bridge year graduate physicians.
9. (9) Irrespective of the location of the principal practice site and any other approved site(s) of the supervised practice, all services provided to patients and actions incident to services provided to patients of the supervised practice shall be deemed to have occurred in the state where the patient is located at the time of service or action incident to the service. The supervising physician, covering physician, and bridge year graduate physician shall comply with all applicable Alabama laws, rules, and regulations pertaining to services and actions incident to services provided to Alabama patients of the supervised practice. Actions incident to services include, but are not limited to, professional medical oversight and direction to the bridge year graduate physician regarding Alabama patients, consultation, or referral of Alabama patients from the bridge year graduate physician, quality assurance review of the medical records of Alabama patients, and maintenance of documentation pursuant to this chapter. The supervising physician shall maintain all documentation required pursuant to this chapter for the duration of the supervised practice and for three years following the termination of any supervisory relationship with a bridge year graduate physician.
10. (10) The supervising physician or a physician delegated by the supervising physician must be present in the operating room or be immediately available to that operating room whenever a bridge year graduate physician is involved in the care of a patient in the operating room.  Whenever a bridge year graduate physician performs or assists in performing invasive procedures with involvement deeper than the complete dermis, the supervising physician or the delegate must be present in the operating room, unless otherwise specifically approved by the Board. The supervising physician must ensure the delegated physician is aware of his or her responsibility prior to the bridge year graduate physician’s involvement in the care of a patient in the operating room.

Author: Alabama Board of Medical Examiners

Statutory Authority: Code of Ala. 1975, §34-24-75.2 and Act No. 23-233.

History: New Rule: Published May 31, 2024; effective July 15, 2024.