McDonald, Mackay and White, LLP

Physician Assistant Licensure Process

If you are planning on getting your Texas Physician Assistant license, you may want to start now if you are facing any time constraints like a pending job or meeting expenses related to moving. The licensing process can be slow and frustrating.

It often takes many months to obtain a PA license and it may even require a trip to Austin to appear before a licensure committee of the Texas Physician Assistant Board. If you are poorly organized or have something unusual in your record (i.e., criminal record, mental health issues, etc.), you can expect the process to drag out considerably and it could take well over a year.

If you have to answer “yes” to anything on the application, such as your malpractice history, past criminal record, or substance abuse, you should plan for a marathon and not a sprint.

The actual application form is not that difficult and can be handled on-line. The basic form can be completed in a matter of an hour or so; however, once the application is submitted, it is screened and reviewed by agency staff. It is not uncommon for an application to sit for some time before it actually gets assigned to a particular licensure analyst or investigator. More often than not, additional information is requested.

Most of the communication with agency staff is handled by email. Since the staff is shared with the Texas Medical Board and the Texas State Board of Acupuncture Examiners, they are frequently inundated with large numbers of applications. Consequently, the Board staff limits the time they receive and return phone calls. Email is probably the most effective means of communication.

If you are thinking about applying, there are a few steps you can take to keep delays to a minimum:

  • 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 assistance from someone with experience before the Texas State Board of PA Examiners. Some of the rules, the process, and just getting prepared require the time and attention of someone who has expertise with the system.

Don’t even consider trying to fool or mislead the Board. Answering “no” to a question when you should answer “yes” can lead to long delays, embarrassing apologies, costly committee appearances, possible fines and restrictions, and even denial of your application. If you are not sure about an answer, you are best advised to find out before submitting an incorrect application. If you are still unsure after trying to determine how you should answer, you may want to answer “yes” and explain as best you can rather than run the risk of appearing to be untruthful. The Board will typically refuse to grant a license to a person who they believe was untruthful or omitted important information. 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 in the affirmative.

If there is a “yes” response on the application, the application under goes through a senior staff review. They can determine whether to grant a license or refer the applicant to a Licensure Committee meeting.

The Licensure Committee is made up of only a portion of the Board membership. They only meet during scheduled board meetings, which usually only take place four times per year. The meetings involve lots of wait time and can mean a very long day. The applicants are not assigned specific times for their appearance, but instead are told to show up at the same time and are brought in for an interview based on the preferences of the committee.

The applicant meets with the Licensure Committee, usually in private. Members of the general public, including other applicants, are excluded from the room. The committee will only make a decision once they are in open session. The decision is only a recommendation and must be approved by the full Board. An applicant can be seen and interviewed very quickly or wait for several hours for an interview that may take a few minutes or over an hour. The application can be denied, granted, granted with restrictions, or the applicant can be told to withdraw the application and start over. This last scenario is often associated with inaccurate information on the application.

If an applicant is unhappy with a denial or a proposed granting of a license under restrictions or with terms and conditions, the applicant has the right to seek reconsideration by the committee based on additional information and possibly other grounds, or appeal the matter as a contested case at the State Office of Administrative Hearings (SOAH). A contested hearing is much like a trial before a judge alone. SOAH uses attorneys who are administrative law judges (ALJs). Eventually, the ALJs recommendation is brought back to the Board for final consideration. At that time, agency staff may argue to deny the application or grant with restrictions. The ALJ explains their recommendation and answers questions. The applicant, usually through counsel, is allowed to argue for issuance of an unrestricted license. A denial or restrictions on a Texas license can have a negative impact on other state licenses or efforts to obtain a license in another state. Great care should be taken in applying for a Texas license.