1. (a) Institutional permits may be issued to postgraduate training programs approved by the Accreditation Council for Graduate Medical Education, American Osteopathic Association, or the Texas State Board of Medical Examiners for interns, residents, and postresidency fellows.

   1. (1) An intern is a physician who is in a clearly defined and delineated first postgraduate year program.
   2. (2) A resident is a physician who is in a specialized, clearly defined, and delineated postgraduate program.
   3. (3) A postresidency fellow is a physician who is in a specialized, clearly defined, and delineated program, following completion of a delineated residency program, for additional training in a medical specialty or subspecialty delivered in a program approved by the Accreditation Council for Graduate Medical Education, the American Osteopathic Association, or in a program approved by the Texas State Board of Medical Examiners.
2. (b) The executive director may, upon written request, approve training programs. If the executive director does not recommend approval, the program director may appeal to the full board for its consideration of the request.

3. (c) Applicants who have graduated from a medical school approved by the Accreditation Council for Graduate Medical Education or American Osteopathic Association must submit:

   1. (1) a completed application and fee 45 days prior to the beginning date of the program; and
   2. (2) certification by the director of medical education of the program that the internship, residency, or fellowship meets the appropriate definition.

4. (d) Applicants who have graduated from a medical school outside the United State or Canada must submit:

   1. (1) a completed application and fee 45 days prior to the beginning date of the program;

   2. (2) a notarized copy of medical school diploma or 5th Pathway Certificate;

      1. (A) copies should be notarized as being a true copy of the original document. The notary public must sign, date, and affix his or her notary seal to the document;
      2. (B) if the document is in a foreign language, an official word-for-word translation must be furnished. The board's definition of an official translation is one prepared by a government official, official translation agency, or a college or university official, on official letterhead. The translator must certify that it is a true translation to the best of his or her knowledge, that he or she is fluent in the language, and is qualified to translate. He or she must sign the translation with his or her signature notarized by a notary public. The translator's name and title must be typed/printed under the signature;

   3. (3) a notarized copy of a valid ECFMG document, or:

      1. (A) proof of an unrestricted license from another state in the United States or Canada; or
      2. (B) proof of citizenship in the United States and residency of the State of Texas prior to entering medical school as provided in Texas Civil Statutes, Article 4437(g);
   4. (4) certification by the director of medical education that the internship, residency, or fellowship program meets the appropriate definition; and
   5. (5) certification by the director of medical education that the original medical school diploma, certified medical school transcript from each medical school, valid ECFMG document, and an original dean's certification has been inspected.
5. (e) The board's executive director may, on a case-by-case basis, allow substitute documents where exhaustive efforts have been made to secure the required documents.
6. (f) Initial institutional permits are issued for 14 months. The permit may be renewed for a one-year period up to seven times, depending upon the requirements of the physician's specialty training program.
7. (g) Physicians holding an institutional permit must confine their practice of medicine to the designated teaching program. The permit may be cancelled if §3.08 or any other provision of the Medical Practice Act is violated; or if the permit is used to practice medicine outside the teaching program.
8. (h) If the training is terminated for any reason other than illness or other reasons acceptable to the board, the permit is void and no additional permit will be issued.
9. (i) Denial of a permanent Texas license is grounds for revoking or not issuing an institutional permit.
10. (j) Failure of any hospital or medical institution to comply with these provisions shall be grounds for the denial of the institutional permit and any future permits for persons wishing to serve at that institution.

Source Note:The provisions of this §171.1 adopted to be effective February 26, 1992, 17 TexReg 1232; amended to be effective December 24, 1993, 18 TexReg 9191.