22 Tex. Admin. Code § 163.2 – Full Texas Medical License

(a) Graduates of medical schools in the United States or Canada. To be eligible for full licensure, an applicant who is a graduate from a school in the United States or Canada must:
1. (1) be 21 years of age;
2. (2) be of good professional character as defined under §163.1(8) of this title (relating to Definitions);
3. (3) have completed 60 semester hours of college courses as defined under §163.1(10) of this title;
4. (4) be a graduate of:
  1. (A) an acceptable approved medical school as defined under §163.1(1) of this title; or
  2. (B) any medical school and at the date of application to the Board or prior to approval for licensure by the Board hold a certificate from a specialty board that is a member of the American Board of Medical Specialties or the Bureau of Osteopathic Specialists;
5. (5) have successfully completed a one-year training program of graduate medical training in the United States or Canada as defined under §163.1(9) of this title;
6. (6) submit evidence of passing an examination accepted by the board for licensure as defined under §163.6(a) of this title (relating to Examinations Accepted for Licensure); and
7. (7) pass the Texas Medical Jurisprudence Examination.
(b) Graduates of medical schools outside the United States or Canada. To be eligible for full licensure, an applicant who is a graduate from a school outside the United States or Canada must:
1. (1) be 21 years of age;
2. (2) be of good professional character as defined under §163.1(8) of this title;
3. (3) have completed 60 semester hours of college courses as defined under §163.1(10) of this title;
4. (4) be a graduate of:
  1. (A) an acceptable unapproved medical school as defined under §163.1(2) of this title; or
  2. (B) any medical school and at the date of application to the Board or prior to approval for licensure by the Board hold a certificate from a specialty board that is a member of the American Board of Medical Specialties or the Bureau of Osteopathic Specialists.
5. (5) have successfully completed a two-year training program of graduate medical training in the United States or Canada as defined under §163.1(13) of this title;
6. (6) submit evidence of passing an examination accepted by the board for licensure as defined under §163.6 of this title;
7. (7) pass the Texas Medical Jurisprudence Examination;
8. (8) possess a valid certificate issued by the Educational Commission for Foreign Medical Graduates (ECFMG);
9. (9) have the ability to communicate in the English language; and
10. (10) have supplied all additional information that the board may require concerning the applicant's medical school.
(c) Fifth Pathway Program. To be eligible for licensure, an applicant who has completed a Fifth Pathway Program must:
1. (1) be at least 21 years of age;
2. (2) be of good professional character as defined under §163.1(8) of this title;
3. (3) have completed 60 semester hours of college courses as defined under §163.1(10) of this title;
4. (4) hold a certificate from:
  1. (A) an acceptable unapproved medical school as defined under §163.1(2) of this title; or
  2. (B) any medical school and at the date of application to the Board or prior to approval for licensure by the Board hold a certificate from a specialty board that is a member of the American Board of Medical Specialties or the Bureau of Osteopathic Specialists.
5. (5) have successfully completed a two-year training program of graduate medical education in the United States or Canada as defined under §163.1(13) of this title;
6. (6) submit evidence of passing an examination, that is acceptable to the board for licensure;
7. (7) pass the Texas Medical Jurisprudence Examination;
8. (8) submit a sworn affidavit that no proceedings, past or current, have been instituted against the applicant before any state medical board, provincial medical board, in any military jurisdiction or federal facility;
9. (9) have attained a passing score on the ECFMG examination;
10. (10) have the ability to communicate in the English language;
11. (11) have attained a satisfactory score on a qualifying examination and have completed one academic year of supervised clinical training for foreign medical students as defined by the American Medical Association Council on Medical Education (Fifth Pathway Program) in a United States medical school; and
12. (12) have supplied all additional information that the board may require, concerning the applicant's medical school, before approving the applicant.
(d) Applicants who are not U.S. citizens or permanent residents.
1. (1) An applicant for full licensure who is not a U.S. citizen or an alien lawfully admitted for permanent residence in the United States, must present proof satisfactory to the board that the applicant has practiced medicine full-time in Texas, in medically underserved areas and health professional shortage areas as designated by the U.S. Department of Health and Human Services, for at least three years, or has signed an agreement to practice medicine full-time in Texas, in medically underserved areas (MUAs) and health professional shortage areas (HPSAs) as designated by the U.S. Department of Health and Human Services, for at least three years. Full-time practice shall mean at least 20 hours per week for 40 weeks duration during a given year. Agreement to practice medicine for three years in qualifying HPSAs and MUAs may be evidenced by an Affidavit of Agreement submitted by the applicant to the Board.
2. (2) Upon completion of the requirements of paragraph (1) of this subsection, a physician must provide documentation that is acceptable to the Board to demonstrate compliance with paragraph (1) of this subsection. Documentation acceptable to the Board as proof of having completed the three-year service requirement includes:
  1. (A) Individual Federal income tax returns, including copies of the International Medical Graduate's (IMG) W-2 forms and/or pay stubs covering the three-year period (showing employment in a qualifying underserved location);
  2. (B) Letter(s) from the applicant's employer(s) attesting to the full-time medical service rendered during the required aggregate period; and
  3. (C) If the applicant established his or her own practice, documents confirming establishment of the practice, e.g., documentation showing incorporation of the medical practice (if incorporated), the business license, and the business tax returns and tax withholding documents submitted for the entire three-year period.
3. (3) A physician licensed under this subsection, must notify any individual or entity with whom the physician contracts to practice medicine, that the physician is fulfilling a service requirement to practice full-time in Texas, in medically underserved areas and health professional shortage areas as designated by the U.S. Department of Health and Human Services, for at least three years.
4. (4) For the purpose of this subsection, federally designated underserved areas include Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) with facility HPSA designation.
5. (5) This subsection shall not be interpreted to apply to:
  1. (A) applicants for full licensure under this chapter who have been offered employment at an institution that maintains a graduate medical training program in this state, and:
    1. (i) the employment is not for the purpose of obtaining postgraduate training; or
    2. (ii) the employment is for postgraduate training that is located in a MUA or HPSA;
  2. (B) applicants for postgraduate training permits as described under Chapter 171 of this title (relating to Postgraduate Training Permits);
  3. (C) applicants for temporary or limited licenses as described under Chapter 172 of this title (relating to Temporary and Limited Licenses);
  4. (D) physicians who practiced medicine, prior to September 1, 2012, for at least one year under a postgraduate training permit, temporary license, or limited license; or
  5. (E) physicians who had an active application for full licensure on August 31, 2012.
6. (6) Applicants determined exempt under paragraph (5)(B) of this subsection and who subsequently apply for full licensure are subject to the requirements of this subsection, and any employment completed while in postgraduate training shall not be applied toward the requirements set out in paragraph (1) of this subsection unless the training program was located in an MUA or HPSA.
7. (7) Applicants determined exempt under paragraph (5)(A) of this subsection at time of application, but who subsequently discontinue employment before passage of three years from the date of issuance of a license, shall no longer be exempt from the requirements set out in this section. However, the applicant may count all employment obtained while practicing medicine under a full license or a temporary or limited license at an institution that maintains a graduate medication education program in this state toward the service requirement set out in paragraph (1) of this subsection.
(e) Alternative License Procedure for Military Spouse.
1. (1) An applicant who is the spouse of a member of the armed forces of the United States assigned to a military unit headquartered in Texas may be eligible for alternative demonstrations of competency for certain licensure requirements. Unless specifically allowed in this subsection, an applicant must meet the requirements for licensure as specified in this chapter.
2. (2) To be eligible, an applicant must be the spouse of a person serving on active duty as a member of the armed forces of the United States and meet one of the following requirements:
  1. (A) holds an active unrestricted medical license issued by another state that has licensing requirements that are substantially equivalent to the requirements for a Texas medical license; or
  2. (B) within the five years preceding the application date held a medical license in this state that expired and was cancelled for nonpayment while the applicant lived in another state for at least six months.
3. (3) Applications for licensure from applicants qualifying under this subsection shall be expedited by the board's licensure division as if they meet the provisions of §163.13 of this title (relating to Expedited Licensure Process).
4. (4) Alternative Demonstrations of Competency Allowed. Applicants qualifying under this subsection:
  1. (A) are not required to comply with §163.7 of this title (relating to Ten Year Rule); and
  2. (B) in demonstrating compliance with §163.11(a) of this title (relating to Active Practice of Medicine), must only provide sufficient documentation to the board that the applicant has, on a full-time basis, actively diagnosed or treated persons or has been on the active teaching faculty of an acceptable approved medical school, within one of the last three years preceding receipt of an Application for licensure.

Source Note:The provisions of this §163.2 adopted to be effective November 10, 1999, 24 TexReg 9835; amended to be effective March 7, 2002, 27 TexReg 1487; 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 June 28, 2006, 31 TexReg 5098; amended to be effective January 4, 2007, 31 TexReg 10797; amended to be effective July 3, 2007, 32 TexReg 3991; amended to be effective November 29, 2009, 34 TexReg 8530; amended to be effective December 4, 2011, 36 TexReg 8026; amended to be effective July 4, 2012, 37 TexReg 4925; amended to be effective September 30, 2012, 37 TexReg7485; amended to be effective December 23, 2012, 37 TexReg 9772; amended to be effective March 18, 2013, 38 TexReg 1873.