PURPOSE: This rule sets forth the requirements for licensure in this state for those individuals who graduate from a school of medicine which is located outside the United States.

1. (1) Notwithstanding any other provision of law, an individual who has graduated from a school of medicine which is located outside the United States may be eligible for licensure to practice the healing arts in this state by reciprocity if s/he has satisfied the following requirements:

   1. (A) An applicant must have completed all of the prescribed curriculum at his/her school of medicine and the curriculum in this state and the applicant must be a graduate of a medical school whose curriculum has been approved by the proper government agency of the country in which the school is located;
   2. (B) An applicant must meet the academic and postgraduate training requirements for licensure to practice medicine in the country in which the applicant’s school of graduation is located;

   3. (C) An applicant must be certified by the Educational Commission for Foreign Medical Graduates (ECFMG) and be either American Specialty Board-eligible or have completed three (3) years of American Medical Association (AMA)-approved postgraduate training in one (1) recognized specialty area of medicine.

      1. 1. ECFMG certification may be waived

for a foreign graduate who is currently American Specialty Board-certified.

1. 2. ECFMG certification may be waived

for a foreign medical graduate who holds a current state/provincial medical license based on a required examination, if that license was issued prior to January 1, 1959. 20 CSR 2150-2

1. (D) An applicant must have been successfully examined (by passing the Federation Licensing Examination (FLEX) within three

1. (3) attempts or by passing the United States Medical Licensing Examination (USMLE) within seven (7) years and without having made more than three (3) attempts at passing any one Step) by any professional board of any state or territory of the United States, recognized by the Missouri State Board of Registration for the Healing Arts and having received grades not less than those required by the Missouri board and possess a valid and current license from that state or territory of the United States.

2. (2) As used in this rule, the term fifth pathway shall mean a candidate for licensure who has successfully completed four (4) years of medical education in Mexico and then completes a training program in the United States at a medical college approved and accredited by the AMA or its Liaison Committee on Medical Education or an osteopathic college approved and accredited by the American Osteopathic Association (AOA) in lieu of completing a year of internship and social service work in Mexico.

   1. (A) A fifth pathway candidate may be eligible for licensure to practice the healing arts in this state if s/he satisfies the following requirements:

      1. 1. An applicant must have completed all

of the prescribed curriculum at his/her school of medicine and the curriculum in this state and the applicant must have completed training at a medical school whose curriculum has been approved by the proper Mexican government agency;

1. 2. An applicant must meet the academic

requirements for licensure in Mexico; and

1. 3. An applicant must be either American

Specialty Board-eligible or have completed three (3) years of postgraduate training in one (1) recognized specialty area of medicine in a program which is approved and accredited to teach postgraduate medical education by the accreditation council on graduate medical education of the AMA or the education committee of the AOA.

AUTHORITY: sections 334.031, 334.040 and 334.125, RSMo Supp 1999 and 334.035, RSMo 1994.* This rule originally filed as 4 CSR 150-2.100. Original rule filed July 12, 1984, effective Jan. 1, 1987. Amended: Filed Sept. 5, 1990, effective Feb. 14, 1991. Emergency amendment filed July 17, 1992, effective Aug. 1, 1992, expired Nov. 28, 1992. Emergency amendment filed Nov. 16, 1992, effective Nov. 29, 1992, expired March 28, FINANCIAL INSTITUTIONS AND PROFESSIONAL REGISTRATION 1993. Amended: Filed July 17, 1992, effective April 8, 1993. Amended: Filed Oct. 4, 1993, effective April 9, 1994. Amended: Filed July 25, 2000, effective Dec. 30, 2000. Moved to 20 CSR 2150-2.100, effective Aug. 28, 2006. *Original authority: 334.031, RSMo 1959, amended 1981, 1997; 334.035, RSMo 1987; 334.040, RSMo 1939, amended 1941, 1945, 1951, 1959, 1981, 1993, 1997; 334.125, RSMo 1959, amended 1993, 1995.