Texas Medical Board Makes Progress in Reducing Application Processing Times
Now that 2008 has come to a close, it has become clear that the Texas Medical Board has made significant strides in reducing the amount of time it takes to process first-time applicants for a state medical license. A combination of far-reaching medical malpractice reform and a growing population, has led to a large influx of new doctors seeking to practice in Texas during the past few years. Initially, the Board’s licensure department had trouble coping with the new strain leading to a long waiting period for physicians, even those who did not encounter any eligibility issues during the licensing process. As an attorney for many physicians who did face eligibility problems- such as a prior disciplinary or criminal history-, I remember waiting for a year and sometimes even more for the Medical Board to complete their initial processing of an application let along the initiation of their investigation or the scheduling of an appearance before the licensing committee.
Through the hiring of new licensing analysts and the streamlining of the application process, however, the Medical Board has cut down the amount of time a doctor spends in the licensing process, particularly those who lack any eligibility issues. One such innovation is the Board’s new Licensure Inquiry System of Texas (LIST). LIST allows each physician to obtain an online status page for their application. It lists each item required as part of their application and notes whether or not they have been received. This is a welcome change as in my experience a big part of the problem was the large number of different documents needed by the Board and the difficulty for both myself and applicants in learning exactly what was still needed and confirming when it was in receipt.
For example, I recently represented a physician who had been trying for over three years to obtain a Texas medical license. Prior to seeing me she had submitted her application three times and had even hired an attorney at one point to assist her in the process. Unfortunately, this attorney was not entirely familiar with the Texas Medical Board’s procedures and had been unsuccessful. Part of the problem for my client was that she had some eligibility issues which meant the Board was requiring her to submit various documents and letters from her medical school, residency program, and employers. The Board mandated that these be sent directly to them from their authors in a special sealed format. Each time my client had dutifully requested that the relevant parties send them in the specified format only to be frustrated when they were either sent incorrectly or the Board failed to either confirm or deny their receipt. Even with numerous extensions she would invariably fail to have her entire application completed by the deadline and therefore have to completely restart the application procedure.
Thankfully I was recently able to help this physician through the process and obtain her license. Hopefully, the new procedures such as LIST system will help avoid such situations in the future. Regardless the Board still needs to transfer its progress on the processing of applications from problem-free applicants to those from physicians with eligibility challenges.
As you can perhaps tell from the above example, the licensing process can sometimes be a Byzantine and daunting process for physicians, especially those who can expect to confront eligibility issues. Physicians who anticipate or who are already confronting such obstacles should seriously consider seeking the aid of an attorney familiar with navigating the Texas Medical Board’s licensing procedures. The hand of an experienced counsel can significantly cut down on the stress and confusion attendant with the application process and help ensure that you come out the other end with a state medical license.
Physician in Training Permit Applications: A Guide to the Basics
The Texas Medical Board issues Physician-in-Training permits (PIT Permits) pursuant to Texas Medical Practice Act section 155.105 and Texas Medical Board rules found in the Texas Administrative Code under 22 TAC Section 9 Chapter 163. The PIT permit is required for graduates of a United States or Foreign Medical School who wish to pursue a residency or post-graduate fellowship in Texas who do not possess a Texas Medical License due to ineligibility or a pending application. Although the application for a Physician-in-Training permit is not as cumbersome, tedious or labor intensive as a full physician registration, medical doctors often find themselves needing to go before the Texas Medical Board’s Licensure Committee to explain their good professional character or clinical competence due to:
- Academic difficulties in medical school including poor performance or discipline as evidenced by the applicant’s academic transcript from the third or fourth year of medical school;
- Problems in a post-graduate residency program including failing grades, poor performance, or discipline by the medical faculty;
- Physician discipline from a medical staff, denial by a credentialing committee or other discipline by another state licensing board;
- Criminal convictions involving dishonesty, moral turpitude, controlled substances or alcohol;
- Mental illness which rises to the level of requiring the Applicant to demonstrate their ability to practice medicine with reasonable skill and safety;
- Falsification of information on the Physician-in Training application;
- Malpractice claims, lawsuits and judgments
- Perceived statutory ineligibility.
Arguably, the most critical factor for physician applicants to be aware of is the need for complete and thorough honesty and candor as lying or falsification on the application is a basis for denial. The Texas Medical Board’s Licensure Division carefully scrutinizes each application and often sends lacking letters and requests for clarifying information to the applicant. During this process Board Staff accesses criminal information through the Federal Bureau of Investigation as well as medical school and residency evaluations and performance assessments not readily available to the applicant. If a falsification issue arises when the file is reviewed by the Executive Director he may issue a letter or order denying the application. Denials that become final are reported to the National Practitioner Data Bank (NPDB) and become a part of the medical doctor’s permanent disciplinary history. If you are uncertain about whether or not to include information on your application it is prudent to err on the side of caution. Genuine disputes or personality differences between the applicant and medical school faculty or medical staff member can be successfully explained away, but a perceived effort to conceal information may mar your record indefinitely.
If you are a medical doctor applying for a Physician-in-Training Permit and are uncertain how to proceed with your application you should seek guidance from your training program and an experienced attorney. If your application for a PIT permit has been denied or you have been invited to appear before the Texas Medical Board’s Licensure Committee you are in need of effective legal representation immediately. Once the letter of denial is received the applicant has twenty days to act before it is made a part of their permanent disciplinary history at the NPDB. An initial presumption of ineligibility can be successfully overcome through good legal representation by an experienced lawyer who is familiar with the application process.
