02-373 C.M.R. ch. 1, § 3 - REQUIREMENTS FOR MEDICAL LICENSURE

To qualify for licensure as a physician, an applicant must meet all of the following criteria:

1. Medical Education

A. Graduate from a medical school designated as accredited by the Liaison Committee on Medical Education.

B. Graduate from an unaccredited medical school and:

(1) Be evaluated by the Educational Commission for Foreign Medical Graduates and receive a permanent certificate from the Educational Commission for Foreign Graduates; or

(2) Achieve a passing score on the Visa Qualifying Examination (VQE) or another comprehensive examination determined by the Board to be substantially equivalent to the VQE.

2. Medical Examinations

A. U.S. National Examinations

(1) An applicant must attain passing scores on each examination in ONE of the following examination sets separately or in a combination specified in the United States Medical Licensing Exam (USMLE) instructions:

(a) United States Medical Licensing Examination (USMLE), which includes step 1, step 2 and step 2C (clinical skills with standardized patients), and step 3; or

(b) Federation Licensing Examination (FLEX);or

(c) National Board of Medical Examiners Examination (NBME).

(2) Time and Attempt Limits for Examinations

The applicant must:

(a) Complete the examination series (FLEX, NBME, USMLE) within seven (7) years of passing the first examination, with an automatic exception allowed for dual M.D./PhD. candidates.

(b) Complete the first two steps of the USMLE examination (USMLE 1, USMLE 2 including USMLE 2C) or approved combinations with unlimited attempts. Steps 1, 2, and 2C may be retaken after successfully passing them ONLY for the purpose of accomplishing or maintaining the seven (7) year limitation named immediately above.

(c) Complete the final examination in the series (i.e. FLEX 2, NBME 3, USMLE 3) in no more than three (3) attempts. Step 3 may not be retaken once passed with a minimum passing score.

(d) Attain a minimum passing score of seventy-five (75)- on the two number scoring system- for each examination in the set. For FLEX examinations administered before December 1, 1985, the score must be a minimum of seventy-five(75) on the composite FLEX weighted average scoring system.

(e) Request for Waiver

An applicant may apply to the Board for a waiver of the time and attempt limits. The Board may grant a waiver based upon unusual or extenuating circumstances as determined by the Board in its sole discretion.

B. Non-U.S. National Examinations

As an alternative to the U.S. National Examinations requirement above the Board may accept passing scores in one of the following examination sets:

(1) A licensing examination administered by any medical board which is a member of the Federation of State Medical Boards;

(2) Licentiate of Medical Council of Canada (LMCC);

(3) British Isles Credentialing - General Medical Council of United Kingdom, or Republic of Ireland, or Scotland.

3. State of Maine Jurisprudence Examination

A. Except for applicants for and/or registrants with an Interstate Telemedicine Consultation Registration, every applicant for licensure must attain a passing score of at least seventy-five (75) on the jurisprudence examination administered by the Board.

B. If a candidate fails to attain a score of seventy-five (75) on the jurisprudence examination, the applicant may be required to appear for an interview before a committee of the Board.

4. Personal Interview

A. In addition to all other qualifications, the Board may require a personal interview with the applicant to discuss issues identified in the application materials, including but not limited to:

(1) Clinical competence;

(2) Evidence of disruptive behavior which might negatively impact the practice of medicine or safety of patients;

(3) Any conduct that might be grounds for discipline or denial of licensure as provided by law or rule; or

(4) Communication skills.

5. Postgraduate Training

A. Graduates after July 1, 2004 Applicants who graduated from a medical school after this date must satisfactorily complete at least thirty-six (36) months in a graduate educational program or combination of graduate educational programs accredited by the Accreditation Council on Graduate Medical Education, the Canadian Medical Association, the Royal College of Physicians and Surgeons of Canada, or the Royal Colleges of England, Ireland and Scotland.

B. Graduates before July 1, 2004 and after January 1, 1970

Applicants who graduated from an accredited medical school within this date range must have satisfactorily completed at least twenty-four (24) months in a graduate educational program or combination of graduate educational programs accredited by the Accreditation Council on Graduate Medical Education, the Canadian Medical Association, or the Royal College of Physicians and Surgeons of Canada.

C. Graduates before January 1, 1970

Applicants who graduated from an accredited medical school before January 1, 1970 must have satisfactorily completed at least twelve (12) months in a graduate educational program accredited by the Accreditation Council on Graduate Medical Education, the Canadian Medical Association, or the Royal College of Physicians and Surgeons of Canada.

D. Residents training in Maine

(1) When the applicant for licensure is in an Accreditation Council on Graduate Medical Education accredited post-graduate training program in this State and has completed twenty-four (24) months of postgraduate training (in this State) and has received an unrestricted endorsement from the graduate educational program director, and it is confirmed that the applicant will continue in the program and complete thirty-six(36) months of postgraduate training, and if otherwise qualified, a full license of normal duration may be issued.

(2) If the applicant who is issued a permanent license pursuant to subparagraph (D)(1) subsequently discontinues the graduate educational program or must postpone completing the last twelve (12) months of the graduate educational program, both the licensee and the graduate educational program director shall promptly notify the Board in writing, providing full details of the issue(s) and plan for program completion, if any. The Board will review the information provided, and take any action permitted by law, including but not limited to revoking the license.

E. Waiver for Foreign Medical School Graduates

(1) To be considered for a waiver of the postgraduate training requirement, an applicant must meet all of the following criteria:

(a) The applicant is a graduate of a foreign medical school, not including a medical school in Canada or Great Britain;

(b) The applicant is licensed in another U.S. state; and

(c) The applicant has at least three (3) years of clinical experience in the area of expertise.

(2) If the applicant meets the foregoing criteria, the Board may grant a waiver using the following qualifications:

(a) The applicant demonstrates completion of a three (3) year clinical fellowship in the United States in the area of expertise.

(b) The applicant demonstrates completion of a three (3) year clinical non-accredited fellowship that is equivalent to an Accreditation Council on Graduate Medical Education accredited fellowship and provides the Board with the following information:

(i) Detailed procedure/patient logs.

(ii) Attestations from at least three (3) teaching physicians, senior residents, or other senior fellows, and nursing staff regarding the applicant's level of responsibility and supervision. The attestations shall include the name and contact address of the attester.

(iii) Detailed list of conferences conducted and academic papers produced by applicant during the fellowship.

(iv) Monthly rotation schedule and the daily schedule detail for each, if available.

(v) Fellowship conference schedule and list of those attended by the applicant.

(vi) Attestation by the fellowship program director of how the following six core competencies are taught in the program: patient care; medical knowledge; interpersonal and communication skills; professionalism; practice-based learning and improvement; and systems-based practice.

(vii) Reference letters as to competency and character from the department chief and from the fellowship program director.

(viii) Proof that the fellowship is hospital-based and the hospital is accredited by The Joint Commission or the fellowship is medical school based and the school is accredited by the Liaison Committee on Medical Education (LCME).

(c) The applicant has been appointed to a clinical academic position at a licensed medical school in the United States.

(d) The applicant has articles published in peer-reviewed clinical medical journals recognized by the Board.

(e) The number of years the applicant has been in clinical practice.

(f) Other criteria indicative of expertise such as awards or recognition for professional accomplishments.

(g) Not more than three (3) medical malpractice claims shall have been filed against the applicant in a ten(10) year period, nor shall there have been any one medical malpractice settlement resulting in a settlement amount of greater than $300,000.

(3) The Board may assess an applicant for a waiver with the actual costs for investigating and determining the validity of information provided by the applicant for the waiver request.

6. Demonstrates continued clinical competency as required by this rule.

Notes

02-373 C.M.R. ch. 1, § 3