Tenn. Comp. R. & Regs. 0880-02-.08 - EXAMINATION

All persons intending to apply for licensure as a physician in Tennessee must successfully complete a written examination pursuant to this rule. Such written examination must be completed prior to application for licensure. Certification of successful completion must be submitted by the examining agency directly to the Board Administrative Office as part of the application process contained in Rules 0880-02-.03, 0880-02-.04 and 0880-02-.05.

(1) The Board adopts FLEX, USMLE and the National Board of Medical Examiners (NBME) examination as its written licensure examinations. Successful completion of one of those examinations is a prerequisite to licensure according to the following:
(a) After December 31, 1999, with the exception of applicants applying pursuant to Rule 0880-02-.05, the only examination acceptable for licensure is the USMLE Steps 1, 2 and 3.
(b) The Board will accept any of the following examinations or combinations of examinations if completed prior to December 31, 1999:
1. The NBME Parts I, II and III; or
2. FLEX Components I and II; or
3. Predecessor FLEX Days I, II and III; or
4. NBME Part I or USMLE Step 1 plus

NBME Part II or USMLE Step 2 plus

NBME Part III or USMLE Step 3; or

5. FLEX Component I plus USMLE Step 3; or
6. NBME Part I or USMLE Step 1 plus

NBME Part II or USMLE Step 2 plus

FLEX Component II

7. Combinations of the Predecessor FLEX Days I, II and III are not allowed with any other examination.
(2) Passing Scores - The Board accepts the following scores as constituting successful completion of the licensure examinations:
(a) The Board adopts the NBME's and the USMLE's determination of the passing scores for each Part or Step of their examinations.
(b) The passing scores adopted by the Board for the FLEX examinations are as follows:
1. FLEX I and II

Component I = 75

Component II = 75

2. Predecessor FLEX Days I, II and III - A FLEX weighted average (FWA) of 75 or greater.
(c) If an applicant fails any step of the USMLE or FLEX examinations more than four (4) times, then the Board shall require proof of board-certification by an ABMS-recognized specialty board and proof of meeting requirements for Maintenance of Certification prior to application before consideration for licensure.
(3) Oral examination may be required pursuant to Rule 0880-02-.07(4). The Board may also, in its discretion, require an applicant for licensure to take and pass the SPEX examination prepared by the FSMB. The circumstances under which the Board may require the SPEX examination include, but are not limited to, applicants for licensure who have been disciplined in another state; applicants who would be subject to discipline in Tennessee based on their conduct or condition; or applicants who have not engaged in the clinical practice of medicine for more than two (2) years.
(4) Deadlines - An applicant must have achieved passing scores on the licensure examinations within the following time frames:
(a) FLEX and Predecessor FLEX and NBME - Ten (10) years from the date on which either the Day I or Component I or Part I of the examinations was taken.
(b) USMLE - Ten (10) years from the date of whichever step of the examination was successfully completed first.
(c) The deadlines in subparagraphs (a) and (b) apply regardless of the combination of examinations utilized to apply for licensure. Provided however, if the ten (10) year limitation set forth in subsections (a) and/or (b) are not met, the applicant will be subsequently considered for licensure once it can be documented that the applicant has retaken and successfully completed the necessary steps or parts of the examination(s) in such a manner that all steps or parts of the examination(s) have been successfully completed within a ten (10) year time period.
(d) The ten (10) year limitation for the USMLE contained in subparagraph (4)(b) of this rule will not apply to applicants who:
1. Are or have been working towards both an M.D. and Ph.D. degree in an institution or program accredited by the Association of American Medical Colleges' Liaison Committee on Medical Education and regional university accrediting body; and
2. Was or is a student in good standing, who was or is enrolled in the institution or program; and
3. Ph.D. studies are in a field of biological sciences tested on Step 1 of the USMLE. (These fields include but are not limited to anatomy, biochemistry, physiology, microbiology, pharmacology, pathology, genetics, neuroscience, and molecular biology. Fields explicitly not included are business, economics, ethics, history, and other fields not directly related to biological science); and
4. Presents a verifiable and rational explanation for the fact that he or she was unable to meet the ten (10) year limit.
(e) Extensions - The amount of time an applicant has actively served while in continuous training and practice in the armed forces of the United States shall not be counted in calculating the ten (10) year limitation for the USMLE contained in subparagraph (4)(b) of this rule. Further, the ten (10) year limitation for the USMLE will not apply to applicants who:
1. Are board-certified at the time of application by a board recognized by the American Board of Medical Specialties; or
2. Have been and are at the time of application currently in active clinical practice in a single state or territory for a period of at least one year and have held a full, unencumbered license in that state for at least one year since successfully completing the USMLE; or
3. Present satisfactory evidence of extraordinary circumstances as determined by the Board which prevented the applicant from timely completing the steps.
(5) All applicants for the USMLE shall submit all application inquiries, applications, fees and all necessary admission documentation, including evidence satisfactory to the USMLE administering agency of successful completion of a one (1) year post graduate medical educational training program for applicants for Step 3 of that examination, directly to the USMLE administering agency. The Board does not distribute or process applications for the USMLE.
(6) Submission of any document or set of documents required by this rule or submission of verification of the authenticity, validity and accuracy of the content of any document or set of documents required by this rule directly from the FCVS to the Board Administrative Office shall be deemed to be submission of originals of those documents or sets of documents by the issuing institution(s).


Tenn. Comp. R. & Regs. 0880-02-.08
Original rule filed February 26, 1991; effective April 12, 1991. Amendment filed January 10, 1992; effective February 24, 1992. Amendment filed April 14, 1994; effective June 28, 1994. Amendment filed March 29, 1996; effective June 12, 1996. Amendment filed February 3, 1998; effective April 19, 1998. Amendment filed September 4, 1998; effective November 11, 1998. Amendment filed August 25, 2000; effective November 8, 2000. Amendment filed December 5, 2003; effective February 18, 2004. Amendment filed December 28, 2004; effective March 13, 2005. Amendment filed July 27, 2006; effective October 10, 2006. Amendment filed April 17, 2007; effective July 1, 2007. Amendment filed May 27, 2008; effective August 10, 2008. Amendments filed January 26, 2015; effective April 26, 2015. Amendments filed February 1, 2017; effective May 2, 2017. Amendments filed March 8, 2022; effective 6/6/2022.

Authority: T.C.A. ยงยง 4-5-202, 4-5-204, 63-6-101, and 63-6-207.

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