4611 PRE-LICENSURE PRACTICE BY STUDENTS AND POSTGRADUATE PHYSICIANS

4611.1 A student who is enrolled in a legally chartered medical school in the District which is accredited by the LCME may participate in patient care activities under the supervision of a licensed physician who is appointed to the faculty of the medical school.

4611.2 A student shall not administer, prescribe, or dispense controlled substances.

4611.3 A student's clinical supervisor shall evaluate the student's performance in writing after completion of each specialty or subspecialty rotation. An evaluation shall be kept on file at the student's medical school and is subject to inspection by the Board.

4611.4 A postgraduate physician may practice medicine in a clinical training program approved by the Accreditation Council for Graduate Medical Education (ACGME), American Osteopathic Association (AOA) or the Board, if the graduate qualifies for, and receives, a medical training license.

4611.5 A postgraduate physician shall do the following:

1. (a) Be enrolled with an institution sponsoring the clinical training program describing the terms and conditions of the postgraduate physician's employment, or participation in the program, which shall be kept on file at the sponsoring institution;
2. (b) Submit, prior to commencement of each training year, the documentation required for application review not later than June 30th of the training year;
3. (c) Inform or permit the training program to notify the Board in writing when the postgraduate physician leaves a clinical training program before the scheduled ending date of the program, specifying the reason for leaving as academic or nonacademic reasons; and
4. (d) Grant the Board access or permit the training program to disclose all postgraduate education records, to the extent the disclosure does not violate any District or Federal laws.

4611.6 A postgraduate physician applying for a medical training license shall submit for consideration the following, unless waived by the Board of Medicine:

1. (a) A completed application form, with a signed statement attesting to the truth and accuracy of its contents;

2. (b) A photograph not taken more than three (3) months prior to submission, whose dimensions are at least two inches (2 in.) by two inches (2 in.), which shall be affixed to the application;

3. (c) Certified transcripts from medical schools providing proof of satisfactory completion of the program;
4. (d) If a graduate of a medical program outside the US or Canada, the original of a currently valid Educational Commission for Foreign Medical Graduates (ECFMG) certification;
5. (e) An appointment letter from the program director of the Graduate Medical Education (GME) program verifying the applicant's acceptance in the program and the date the program commences;
6. (f) If applicable, documentation verifying name change;
7. (g) Proof that the applicant has taken and received a passing score on the United States Medical Licensing Examination Step 1 and both parts of Step 2 or the Comprehensive Osteopathic Medical Licensure Examination Levels 1 and 2;
8. (h) The GME's attestation of accuracy and veracity described in § 4611.8;
9. (i) Completed fingerprint record cards along with a signed consent form permitting an inquiry of local, state, national, and if applicable, international files for any criminal record;
10. (j) Payment of the license fee plus the cost of the criminal background check; and
11. (k) If requested, any additional information the Board considers necessary to properly evaluate the applicant's competence and character.

4611.7 Each GME program director shall submit to the Board by April 15th of each year a complete list of ACGME, AOA, and Board approved programs within their training institution including the names, specialty training, and participation year of all participants.

4611.8 Each GME program director shall review the application materials of each applicant, confirm that the applicant has been appointed to the program and is in good standing with the program, verify the immigration status of the applicant, and affix an attestation of the accuracy and veracity of the

application contents submitted by applicant, before returning the materials to each applicant for submission to the Board.

4611.9 Medical training licenses shall be classified as follows:- (a) Type I(A), who are qualifying applicants that are U.S. or Canadian trained medical postgraduate physicians;

- (b) Type I(B), who are qualifying applicants that are foreign trained postgraduate physicians enrolled in a residency program; or

- (c) Type II, who are qualifying applicants that are foreign trained medical physicians participating in an ACGME, AOA, or Board approved fellowship program.4611.10 Type I licensure provides a path to full licensure in the District of Columbia. Approval of a Type II licensee for full licensure in the District of Columbia shall be contingent upon the applicant satisfying the requirements specified in § 4603.4611.11 A postgraduate physician shall be supervised by a licensed physician who meets the following requirements:- (a) Is a member of the medical staff of the institution, agency, or organization that sponsors the clinical training program; and

- (b) Is appointed to the teaching staff of the clinical training program.4611.12 A postgraduate physician may practice pursuant to this section for a maximum of five (5) years in a postgraduate clinical training program if the postgraduate physician has a valid agreement with the institution, organization, or agency sponsoring the clinical training program:- (a) The five (5) year period for graduates of U.S. and Canadian medical schools shall begin with the graduation from medical school; and

- (b) The five (5) year period for graduates of foreign medical schools, other than Canadian medical schools, shall begin at the beginning of an approved U.S. postgraduate training program.4611.13 A postgraduate physician shall obtain a license to practice medicine in the District after five (5) years or the completion of a postgraduate clinical training program, which ever comes first.4611.14 A student or a postgraduate physician shall identify himself or herself as

such at all times when practicing medicine.

4611.15 A student or postgraduate physician shall comply with the standards of conduct for a licensed physician set forth in § 4612.

4611.16 A student or postgraduate physician may be disciplined for conduct that violates the Act or this chapter. The Board may deny an applicant a license, or take other disciplinary action against a student or postgraduate physician who is found to have violated the Act or this chapter, in accordance with Chapter 41 of this title.

4611.17 A Type I licensee may practice pursuant to this section for a maximum of five (5) years in a postgraduate clinical training program if the licensee has a valid agreement with the institution, organization, or agency sponsoring the clinical training program, provided that:

(a) The five (5) year period for graduates of U.S. and Canadian medical schools shall begin with the graduation date from medical school; and

(b) The five (5) year period for graduates of foreign medical schools, other than Canadian medical schools, shall begin at the beginning of an ACGME or AOA approved U.S. postgraduate training program.

4611.18 For purposes of this section, “postgraduate physician” means a person who holds a degree in medicine or osteopathy, who is enrolled in a postgraduate clinical training program prior to licensure in any jurisdiction in the United States,

4611.19 A postgraduate physician shall be exempt from the payment of the licensure fee and the cost of the criminal background check, provided such postgraduate physician is participating in a short term, required, ACGME or AOA approved training program rotation of ninety (90) days or less. Such participants must enroll as medical training registrants with the Board prior to commencing the rotation. Such participants, if licensed in another state, have the option of either enrolling as medical training registrants or applying for full licensure in the District of Columbia.

4611.20 Medical training licensees, during the final six (6) months before completion of their training program, may apply for and receive full licensure from another state without having to apply for full licensure in the District of Columbia.

4611.21 A medical training license is a limited license to practice in a medical education training program. Holders may only practice within the confines of that program including the primary and affiliate sites. The license will issue for a period not to exceed one (1) year.

SOURCE: Final Rulemaking published at 35 DCR 5999, 6009 (August 5, 1988); as amended by Final Rulemaking published at 51 DCR 6028 (June 11, 2004); as amended by Final Rulemaking published at 52 DCR 6834 (July 22, 2005); as amended by Final Rulemaking published at 59 DCR 9479, 9480 (August 10, 2012).