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Free Articles - Texas Medical Board

Texas State Board of Medical Examiners

The Texas process use to be the longest licensure processes in the 50 States. However now most applicants can expect a 3 to 6 month process to occur before the license is issued. Foreign Medical Graduates will have to wait even longer. Application reviews are taking between 2 to 5  months to complete with the Texas Medical Board.

 All applications have to go through two different reviews. The first occurs once the application and all Applications are received by the Screen-CIC department. CIC clears the application to be assigned to a Licensure Specialist on the Texas Board. It typically takes 4 to 8 weeks to have all of the Applications forwarded to the Texas Board. Once all have been received then the application is then forwarded to the Licensure Specialist. The Licensure Specialist will then review the Applications to determine if they are properly completed by the third party. The Specialist typically will find one or two that are not properly completed and thus will require that the third party complete them again. At the same time the doctor is instructed to set up and take the Jurisprudence Examination. It typically takes 2 to 4 weeks for the application to be cleared by the Specialist if everything is in order.  The Board meets once every two months. The process listed above entails everything being completed without any issues, mistakes, or errors.

The Jurisprudence Examination is a formal exam which does require some preparation by the Doctor.

Texas does have a 3 attempt limit and 7 year rule concerning the USMLE. However there are some exemptions and waivers which might apply.

If you haven't taken a Board Specialty Examination  in the past 10 years or a written board examination, SPEX, USMLE, LMCC, then you will be required to pass the SPEX examination.

This is a list of all required Applications and processes which are required to be submitted to the Texas Medical Board in order that the application might be deemed complete:

All Applicants:

-ECFMG CVS Report (Foreign Medical School Graduates)
-Medical School Transcripts & Form D from School
-NPDB-HIPDB Report
-5 Years employment, training, and privilege history
-Fingerprint Cards/Background checks
-Malpractice certification if Claims are present
- Jurisprudence Examination
 

The specific credentials which are required to be in place are as follows:

 
- 1 year PGT Domestic Graduates
- 3 years PGT International Graduates
- USMLE step 3 has to be passed in 3 attempts
- USMLE has to be passed in a 7 year time frame. 10 if the physician is board certified
- SPEX examination required if a board examination has not been taken within the past 10 years.

The Texas Medical Board does have a long process but unlike other State Medical Boards, they do have some requirements in place which make sense. The first is the fact that they do not verify State Medical Licenses. Why? All adverse actions with any State Medical License is automatically reported by the FSBM Board Action Report and the National Practitioner Data Bank. So requesting direct certification of a State Medical License is unnecessary. Second, the Texas Medical Board does not require certification of any Employment, Privilege, or Internship – Residency – Fellowship that falls outside of the 5 year window from the date of the application. This really makes sense. Any adverse action taken against the physician will be reported to the HIPDB data bank. To request these items is unnecessary. Texas use to be one of the worst Boards to apply to. Now it is in the middle of the pack due to its' recent changes.

 
 
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We service all 50 States. Simply fill out our form and we will handle the rest. The licensure process is time consuming and requires knowledge of each state's regulatory board. Whether you are applying for a license with the Florida Medical Board, New York Medical Board, Texas Medical Board, California Medical Board or all the State Medical Boards in between, MedLicense.com can expedite your licensing process by applying our knowledge of the licensure requirements.

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New Texas Medical Board Telemedicine Rules

 

TMB Telemedicine FAQs
 

The Texas Medical Board adopted amendments and additions to its telemedicine rules at its August 2010 meeting.

1.  What types of telemedicine models are allowed under the rules?  

In general, two models for telemedicine have been identified, each for a different situation: either from an established medical site or from the patient’s home.
     
A.  Established Medical Site:    
In the first model, a patient receives care through telemedicine at an “established medical site,” such as a hospital or clinic or other site that has the required medical professionals and equipment.  There are no specific limitations on the types of care that a patient may receive at an established site, and both initial visits and follow up visits may be done at this type of site.   

At these sites, patient site presenters are available to assist in the interface between the patient and the physician (or PA or APN), who is located at a distant site, and sufficient diagnostic equipment must be available.  One exception is to the requirement of a patient site presenters is that if the health care provided is related to mental health, a patient site presenter is not required unless patients may be a danger to themselves or others.  

B.  At Home:   
In the second model, patients can access health care via telemedicine (video conferencing with a live feed) from their homes. The basic requirement for an in home evaluation is that the patient must be a pre-existing patient previously seen in person either by the physician or PA with whom the patient is teleconferencing or by another physician who has referred the patient to the physician providing telemedicine care and the referral is documented in the medical record.  Once that initial diagnosis is made in person or at an established site, the patient may receive follow-up care for that pre-existing condition via telemedicine in their homes.

In addition to the above, distant site providers can treat pre-existing patients in their homes for new symptoms that appear unrelated to the pre-existing condition based on the following criteria and clarifications: 

  • Distant site providers may treat patients at home for up to 72 hours as long as the patient is advised to see a physician in a face-to-face visit within 72 hours if the symptoms do not resolve.
     
  • Distant site providers may not provide continuing telemedicine medical services for new symptoms to a patient who is not seen within 72 hours.
     
  • The rule intends that for a patient presenting minor symptoms , a provider may prescribe a course of treatment that runs longer than 72 hours, such as a 10 day course of antibiotics or a 30 day course of medication to relieve allergy symptoms. It is intended that this option be used judiciously and within the standard of care.  It is not intended that ongoing prescriptions for new diagnoses made from the patient’s home would be issued.

A physician may not:

  • Make an initial diagnosis of a new patient via telemedicine at a patient’s home (or other non-established medical site) unless the physician has conducted a prior face-to-face initial consultation or the patient has been referred to the distant site provider by a physician who evaluated the patient in-person.
      
  • Provide ongoing medical treatment to a preexisting patient with a new chronic condition unless a physician conducts a timely in-person evaluation after the diagnosis of the new condition. 

Finally, the patient being seen via teleconferencing from his or her home must be seen by a treating physician for an in-person evaluation at least once a year and no chronic pain treatment with scheduled drugs may occur through this treatment model.  

2.  What are some examples of facilities that meet the definition of an “established medical site?”  

In addition to a hospital or clinic, a site could be a facility such as a nurse’s station in a public or private school, a volunteer fire department, an EMS station, a residential or institutional care facility, or even a pharmacy.  The key criteria are the availability and presence of: 

  1. a patient site presenter who is a licensed or certified health care professional, such as a nurse, emergency medical technician (EMT), or pharmacist; and 
     
  2. sufficient technology and medical equipment to allow for an adequate physical evaluation. 

The rule also intends that an established site be sufficient in size to accommodate patient privacy and to facilitate the presentation of the patient to the distant site provider.  

Any location that meets these requirements will be considered an established site.

3.  Is there anything that cannot be an established site?

Generally, anyplace that does not meet the requirements in #2 is not considered an established site.  Additionally, A private home is not considered an established medical site.  Hospice facilities and nursing homes are not considered to be private homes.

     
4.  Do the rules accommodate the use of Skype or similar forms of web 
videoconferencing as a means for a distant site provider to provide telemedicine medical care in a patient’s home? 

Yes, this would be allowed as long as all the other requirements for home treatment (Sec. 174.7) are met.

5.  What is the definition of a “face-to-face visit?”  

The definition of a “face-to-face visit” is an evaluation performed on a patient where the provider and patient are both at the same physical location or where the patient is at an established medical site.   For example:

  • Provider (physician, PA, or APN) performs in-person evaluation of patient while both are physically present in the same location.
     
  • Provider (physician, PA, or APN) performs an evaluation of patient where the patient is located at an established medical site but the provider is located elsewhere with the ability to visually interface with the patient.

 

 
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