10.32.01.04

.04 Licensure — Documentation for Initial Licensure.

A. The applicant shall submit an application on a form supplied by the Board.

B. Complete Application.

(1) A complete application for initial licensure shall include, but is not limited to, proof of the following through documentation on forms supplied by the Board:

(a) Verification of medical education;

(b) Written statements from the program directors of each of the applicant's accredited training programs which:

(i) Summarize the experience and performance of the applicant during training;

(ii) Detail all actions taken against the applicant by any training program, hospital, medical board, licensing authority, or court for an act that would be grounds for disciplinary action under Health Occupations Article, §14-404, Annotated Code of Maryland;

(iii) Document specifically whether or not the applicant successfully completed the years of training;

(iv) Detail any limitations of privileges during the postgraduate training years; and

(v) Detail any physical and mental health problems of the applicant that affected the applicant's ability to practice during the years of postgraduate training;

(c) Documentation of successful completion of the examination requirements as described in Regulation .03F of this chapter including submission of all the applicant's scores sent directly to the Board from the examination authority or authorities.

(2) The Board may waive the requirement of §B(1)(b) of this regulation on a case-by-case basis, if the applicant's education or training occurred in countries with which reasonable efforts to obtain the required information have been unsuccessful.

(3) If licensure in another state preceded the requirement for ECFMG, the Board may waive the requirement for the ECFMG certificate.

(4) A complete application which contains a statement from the applicant listing all:

(a) Hospitals, following training, at which the applicant has had privileges during the preceding 5 years; and

(b) Disciplinary or adverse actions taken against the applicant by a:

(i) Hospital,

(ii) Medical board,

(iii) Licensing authority,

(iv) Court, or

(v) Adjudicatory body.

(5) A complete application shall include:

(a) All application and licensing fees as required in Regulation .11 of this chapter, payable to the Board at the time the application is submitted to the Board; and

(b) The applicant's Social Security number which the Board shall use only for evaluation and identification of applicants and licensees, but may not disclose in any other context.

C. Additional Requirements. Review of an application for licensure shall include:

(1) Verification of licensure from all states where the applicant has ever held a license;

(2) Verification of voluntary licensure nonrenewal, or voluntary surrender of license while the applicant was in good standing and not under disciplinary charges or investigation at the time the license was surrendered from states where the applicant no longer holds a license;

(3) Information in the data bank of the Federation pertaining to the qualifications of the applicant;

(4) Information in the National Practitioner Data Bank including but not limited to the following:

(a) Medical malpractice judgments against the applicant;

(b) Settlements made by the applicant in medical malpractice actions;

(c) Actions taken against the applicant or the applicant's license by state disciplinary or licensing authorities; and

(d) Actions taken against the applicant or the applicant's privileges by a hospital or hospital disciplinary authority which result in a loss, limitation, or suspension of privileges for a period greater than 30 days; and

(5) If reasonable questions regarding an applicant's physical, mental, or professional competency have been raised by the information provided on the application, original letters of reference from all of the hospitals at which the applicant has had privileges, describing the kind of experience received, the performance of the applicant, and explaining under what circumstances those privileges were limited, revoked, or allowed to lapse.

D. English Language Competency. The applicant shall demonstrate oral and written English language competency as follows:

(1) Graduation from a high school or undergraduate college or university where English was the language of instruction throughout the applicant's inclusive dates of attendance, after at least 3 years of enrollment;

(2) Graduation from a professional school where English was the language of instruction throughout the applicant's inclusive dates of attendance; or

(3) Successful completion of the following examination requirements:

(a) Achieve a score of at least 550 on the Test of English as a Foreign Language (TOEFL) or a passing score on the ECFMG (Educational Commission for Foreign Medical Graduates) English test taken beginning January, 1974, or an equivalent score on an equivalent examination as determined by the Board; and

(b) Achieve a passing score as determined by the Board on one of the following examinations:

(i) The Test of Spoken English (TSE) with a score of either at least 220 on tests taken before July, 1995, or at least 50 on tests taken beginning July, 1995, as determined by the Board;

(ii) The Oral Proficiency Interview (OPI) with a score of at least 2 or advanced for examinations taken after October 1, 1994, as determined by the Board; or

(iii) An equivalent examination with an equivalent passing score, as determined by the Board.

E. Claims of Speech Impairment.

(1) Applicants wishing to claim a speech impairment after failing either the Test of Spoken English or the Oral Proficiency Interview shall submit documentation of this impairment on forms supplied by the Board.

(2) Documentation of a speech impairment shall be submitted from a:

(a) Licensed physician; and

(b) Speech-language pathologist who is currently licensed to practice speech pathology in the United States.

(3) Documentation should be submitted with the applicant's initial application but, in all cases, shall be submitted before the applicant's second attempt at passing the Test of Spoken English or its equivalent.

(4) After the second examination, documentation of an impairment may not be submitted or accepted unless there has been an intervening medical/surgical event which has created the impairment.

(5) The applicant shall be allowed to claim the impairment only if:

(a) This event was reported to the Board before a third examination; and

(b) The Board determines that the medical/surgical event did indeed create the impairment.

(6) If the applicant has properly claimed and documented a speech impairment, the Board shall accept the documentation if the applicant is able to prove the ability to communicate with allied health personnel and patients. Proof shall include:

(a) Documentation from 3 licensed physicians that the applicant can communicate in a professionally competent manner with patients and health care providers; or

(b) A hearing before the Board where the applicant is asked to describe the manner in which the applicant would obtain a history and physical examination from a typical patient.

F. The certifying or verifying authority shall send all certificates and verifications directly to the Board for applicants. The Board may not accept certificates and verifications sent to, or by, the applicant.

G. If any of the documents required under this chapter are in a language other than English, the applicant shall submit the certified translation and bear the expense of translation by a certified translator.

H. The Board has designated a 4-month period for acting upon applications as follows:

(1) Within 60 days after receipt of an application, the Board or its Executive Director will determine whether an application is complete;

(2) If the Board or the Executive Director determines that the application is not complete, the Executive Director or the Executive Director's designee shall send a notice of deficiency to the applicant;

(3) Upon receipt of the notice, the applicant shall correct the deficiency within 60 days or other period specified in the notice;

(4) If the applicant fails to correct the deficiency within the required period, the application may lapse and the applicant shall be required to submit a new application and pay the required fees.

I. Withdrawal of Application.

(1) An applicant may not withdraw an application for initial licensure, renewal of a license, or reinstatement of a license without permission of the Board, if:

(a) The applicant is currently charged in another jurisdiction with conduct which would be grounds for discipline under the Health Occupations Article, §14-404, Annotated Code of Maryland, if the applicant were licensed in this State;

(b) The applicant is under investigation in another jurisdiction for an allegation concerning conduct that would be grounds for discipline under Health Occupations Article, §14-404, Annotated Code of Maryland, if the applicant were licensed in this State; or

(c) The Board is investigating the applicant or application or has issued a notice of intent to deny licensure.

(2) In determining whether to allow the withdrawal of a licensure application, the Board may consider such factors as the following:

(a) Issues of competence or conduct which caused the matter to be investigated;

(b) Duty to protect the public in other jurisdictions from duplicative expenditures on investigation of licensure applications; and

(c) Truthfulness of the applicant during the application process.

J. The Board may accept documentation from the FCVS as evidence of having met some of the requirements of Regulations .03 and .04 of this chapter.