McDonald, Mackay and White, LLP

Texas Medical License - Licensure Process

Are you thinking about applying for a license in Texas or getting a training license (known in Texas as a Physician in Training Permit or PIT) and are just now starting the application process? Do you have a job offer and they want you to start soon? Well, bad news…. be prepared to wait because it is taking several months for applicants to get through the licensure process.

Officially, the Board is saying that it takes four months to get a license. The truth of the matter is it takes considerably longer. Only upon receipt of all of your material does the Board staff begin to process your documents, review the material and even ask for additional information. If you have to answer “yes” to anything on the application, such as malpractice history, past criminal record, etc., it will take even longer.

The application is on-line. For many people, just filling out the application can take an hour or more. Once the application is submitted, it is routed to a “screening process.” Your application will not be assigned to an individual at this time. Only once all the “required” documents are received are you assigned a Licensure Investigator. That individual will review your application and associated information, and determine if additional information is required.

The vast majority of communication is handled by e-mail. Due to the huge volume of applications, when the Board staff accepts telephone calls, it is on a very limited basis within set hours. In essence, it is next to impossible to get through on the phone. Moreover, they very rare accept in person appointments and do not even attempt to show-up without an appointment.

If you are thinking about applying, we suggest a couple of things:

  • Be organized. Get your material together before you apply.
  • Apply early. If you think you might want to work in Texas, start the process as soon as possible.
  • Read the directions carefully. A minor mistake will derail your application for months.
  • Follow-up. The application requires documents be sent by third parties. Follow-up on people and entities to ensure that documents have been submitted. It is also critical to follow-up with the Board on a regular basis.
  • Retain Documents. Keep a copy of your application, material submitted to the Board and all the correspondence between you and the Board.
  • If you have a problem, get help. If you have significant issues, you need to get professional legal assistance from someone with licensure experience before the Board. Some of the rules, the process, and just getting prepared, require the time and attention of an attorney who has expertise with the system.

The Board does have the power to issue “temporary licenses.” Some people get confused that this means the Board will provisionally allow you to practice once you file an application. This is incorrect. Only once all your material has been received, you have passed the Texas Jurisprudence Exam, and your application has been evaluated and approved by Board staff, can they issue a temporary license. This will permit you to work in Texas until the full license is granted at the next full Board meeting.

Do not think of attempting to mislead the Board or to try to hide information. Answering “no” when you should answer “yes” will lead to very serious issues should the Board discover the inaccuracy. Generally speaking, the Board will refuse to license a person when it believes that it has been misled. Answering “yes” will take more time and will require additional explanation and documentation; however, explaining a “yes” response is much easier than explaining a “No” response that the Board believes should have been answered affirmatively.

If there is a “yes” response on the application, the application under goes a staff review consisting of the Executive Director, the Director of Customer Affairs, the Assistant General Counsel, and the Manger of Licensure. They can determine whether to grant a license, or refer the individual to the Licensure Committee.

The Licensure Committee is made up of one-half of the Board membership. They only meet during scheduled board meetings, which usually only occurs five to six times per year. The meetings are “cattle calls,” meaning all the applicants are invited to attend at one time, and the applicants are called at the will of the Board. The applicant meets with the Committee, usually in private, where the public is not permitted in the room. The Committee will only make a decision once they are in full session. Sometimes these meetings only take a few minutes, and sometimes they are very prolonged. Some Applicants have spent an entire day waiting to be heard before the Committee.

Denial of a license is a reportable event to the various data banks, including the National Practitioners Data Bank and the Federation of State Medical Boards. If you have a license in another state, a denial in Texas could affect your license in the other state.

However, the Board has the authority to issue a license under an Agreed Order. This means you have been granted a license, but it will be deemed a restricted licensed. The Board could issue a fine, to limiting one’s practice, or to all points in-between. Unless you have an issue which qualifies you for a non-public action, any action by the Board will be public – meaning it will be on the Board’s website, likely given to the National Practitioners Data Bank and the Federation of State Medical Boards, and could impact any licenses you hold in other states.