Am I Eligible for a Nursing License?: Declaratory Order of Eligibility for Licensure
I often receive calls from nursing students, or even those only considering pursuing a nursing degree, with questions concerning whether or not they will be licensed by the Board of Nursing. Typically, these individuals have a criminal record, history of misuse of controlled substances, or a mental health diagnosis that they fear will present an obstacle to successful licensure.
These persons have already taken best course of action by being proactive and contacting an attorney with experience before the Board and who should therefore be able to estimate the difficulty they may or may not face in applying for their license. Generally speaking most nurses with marks on their record should be able to obtain licensure. A good portion of these may have to do so under the form of a probationary license with restrictions related to whatever it is that concerns the Board.
For example, an applicant with a history of abuse of controlled substances may only receive their license on the condition that submit to random drug screens, attend AA meetings, successfully complete a recovery program, and work in an environment where they can be supervised by a superior nurse. A nurse with a criminal record may have to enter into an Agreed Order that provides for supervised practice and grants them only a provisional license with full licensure dependent on achieving a number of years of violation-free practice. Finally, persons with a serious psychiatric diagnosis may need to agree to an Order mandating that they continue with a specified medical treatment program to keep their condition under control.
The very few nurses who will likely not be issued a license are those with serious criminal convictions or an ongoing and untreated chemical dependency problem. On the issue of serious criminal offenses I am referring to convictions such as rape, sexual assault, kidnapping, injuring a child, or murder. Section 301.4535 of the Nursing Practice Act provides a list of criminal offenses for which the Board may refuse to license an applicant. Other felony convictions fall under this list as well.
Future nurses should note, however, that the Board is typically reluctant to license a nurse even a minor black mark on their record if they are not represented by an attorney. They will usually refuse outright or press a nurse to enter into an order with terms that are more stringent than indicated by their history. As in any disciplinary matter, the Board of nursing generally pursues the severest sanction unless the nurse has a lawyer to fight for their interests.
One option for students unsure of their eligibility for licensure is found in § 301.257 of the Nursing Practice Act. This section provides that a nursing student or even a person only considering attending a nursing school can file a Petition for a Declaratory Order of Eligibility for Licensure. In response, the Board of Nursing will then review that person’s history and assess whether they meet the required good moral and professional character standards. If they do, the Board Staff will issue a Declaratory Order finding that individual conditionally eligible for licensure as long as they graduate and later pass the standard nursing exams.
If you have questions about your eligibility for a Texas nursing license or the declaratory order procedure, please call an experienced administrative law attorney. They should be able to intelligently discuss your case and lay out your options. Don’t wait until after graduating from nursing school to find out that you may not be eligible for a Texas 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.
