Tenn. Comp. R. & Regs. 0880-03-.05 - PROCEDURES FOR LICENSURE
To become licensed as a physician assistant in Tennessee, a person must comply with the following procedures and requirements:
(1) Physician Assistant - Licensure by
examination:
(a) An application packet shall
be requested from the Committee's administrative office.
(b) An applicant shall respond truthfully and
completely to every question or request for information contained in the
application form and submit it along with all documentation and fees required
by the form and rules to the Committee's Administrative Office. It is the
intent of this rule that activities necessary to accomplish the filing of the
required documentation be completed prior to filing an application and that all
documentation be filed simultaneously.
(c) An applicant shall submit with his
application a signed and notarized passport type photograph taken within the
preceding 12 months and the photo must be affixed to the proper page of the
application.
(d) It is the
applicant's responsibility to request that a graduate transcript, from an
education program approved by the C.A.H.E.A., C.A.A.H.E.P. or A.R.C.-P.A., be
submitted directly from the program to the Committee's Administrative Office.
The transcript must show that graduation has been completed and carry the
official seal of the institution.
(e) An applicant shall submit evidence of
good moral character. Such evidence shall be two recent (within the preceding
12 months) original letters from medical professionals, attesting to the
applicant's personal character and professional ethics on the signatory's
letterhead.
(f) If the applicant
intends to immediately commence practice upon licensure he or she must
designate a primary supervising physician. Any change in the primary
supervising physician must be reported in writing submitted directly to the
Committee's Administrative Office by the physician assistant.
(g) An applicant shall disclose the
circumstances surrounding any of the following:
1. Conviction of any criminal law violation
of any country, state or municipality, except minor traffic
violations.
2. The denial of
professional licensure/certification application by any other state or the
discipline of licensure/certification in any state.
3. Loss or restriction of
licensure/certification.
4. Any
civil suit judgment or civil suit settlement in which the applicant was a party
defendant including, without limitation, actions involving malpractice, breach
of contract, antitrust activity or any other civil action remedy recognized
under the country's or state's statutory common or case law.
5. Failure of any licensure or certification
examination.
(h) An
applicant shall cause to be submitted to the Committee's administrative office
directly from the vendor identified in the Committee's licensure application
materials, the result of a criminal background check.
(i) If an applicant holds or has ever held a
license/certificate to practice any profession in any other state, the
applicant shall cause to be submitted the equivalent of a Tennessee Certificate
of Endorsement (verification of licensure/certification) from each such
licensing board which indicates the applicant holds or held an active
license/certificate and whether it is in good standing presently or was at the
time it became inactive.
(j) An
applicant shall submit the Application Fee and State Regulatory Fee as provided
in Rule 0880-03-.06.
(k) All
applicants shall cause to be submitted documentation of successful completion
of the examination for licensure as governed by Rule 0880-03-.08 once the exam
has been successfully completed. This verification must be submitted by the
examining agency directly to the Committee's Administrative Office.
(I) When necessary, all required documents
shall be translated into English and such translation and original document
certified as to authenticity by the issuing source. Both versions must be
submitted.
(m) Personal resumes are
not acceptable and will not be reviewed.
(n) Application review and licensure
decisions shall be governed by Rule 0880-03-.07.
(o) All documents submitted for qualification
of licensure become the property of the State of Tennessee and will not be
returned.
(p) The application form
is not acceptable if any portion has been executed and dated prior to one year
before filing with the Committee. As used in this part, application means the
application form approved by the Committee and shall include, as appropriate:
1. Attached current, notarized passport
photograph;
2. Official transcript
from physician assistant training program;
3. Verification of N.C.C.P.A. exam;
4. Two (2) original letters of professional
recommendation;
5. Result of a
criminal background check;
6.
Certificate of completion or diploma from an approved physician assistant
program; and
7.
Certification/licensure from other state boards.
(q) All applications shall be sworn to and
signed by the applicant and notarized.
(2) Physician Assistant - Licensure by
Reciprocity:
(a) An application packet shall
be requested from the Committee's Administrative Office.
(b) An applicant shall respond truthfully and
completely to every question or request for information contained in the
application form and submit it along with all documentation and fees required
by the form and rules to the Committee's Administrative Office. It is the
intent of this rule that activities necessary to accomplish the filing of the
required documentation be completed prior to filing an application and that all
documentation be filed simultaneously.
(c) An applicant shall submit with his
application a signed and notarized passport type photograph taken within the
preceding 12 months and the photo must be affixed to the proper page of the
application.
(d) It is the
applicant's responsibility to request that a graduate transcript, from an
education program approved by the C.A.H.E.A., C.A.A.H.E.P. or A.R.C.-P.A., be
submitted directly from the program to the Committee's Administrative Office.
The transcript must show that graduation has been completed and carry the
official seal of the institution.
(e) An applicant shall submit evidence of
good moral character. Such evidence shall be two recent (within the preceding
12 months) original letters from medical professionals, attesting to the
applicant's personal character and professional ethics on the signatory's
letterhead.
(f) If the applicant
intends to immediately commence practice upon licensure he or she must
designate a primary supervising physician. Any change in the primary
supervising physician must be reported in writing submitted directly to the
Committee's Administrative Office by the physician assistant.
(g) An applicant shall disclose the
circumstances surrounding any of the following:
1. Conviction of any criminal law violation
of any country, state or municipality, except minor traffic
violations.
2. The denial of
professional licensure/certification application by any other state or the
discipline of licensure/certification in any state.
3. Loss or restriction of
licensure/certification.
4. Any
civil suit judgment or civil suit settlement in which the applicant was a party
defendant including, without limitation, actions involving malpractice, breach
of contract, antitrust activity or any other civil action remedy recognized
under the country's or state's statutory common, or case law.
5. Failure of any licensure or certification
examination.
(h) An
applicant shall cause to be submitted to the Committee's administrative office
directly from the vendor identified in the Committee's licensure application
materials, the result of a criminal background check.
(i) If an applicant holds or has ever held a
license/certificate to practice any profession in any other state, the
applicant shall cause to be submitted the equivalent of a Tennessee Certificate
of Endorsement (verification of licensure/certification) from each such
licensing board which indicates the applicant holds or held an active
license/certificate and whether it is in good standing presently or was at the
time it became inactive. An applicant must hold a current physician assistant
license/certificate in a state to apply by reciprocity.
(j) An applicant shall submit the Application
Fee and State Regulatory Fee as provided in Rule 0880-03-.06.
(k) All applicants shall cause to be
submitted documentation of successful completion of the examination for
licensure as governed by Rule 0880-03-.08. This verification must be submitted
by the examining agency directly to the Committee's Administrative Office.
(I) When necessary, all required
documents shall be translated into English and such translation and original
document certified as to authenticity by the issuing source. Both versions must
be submitted.
(m) Personal resumes
are not acceptable and will not be reviewed.
(n) Application review and licensure
decisions shall be governed by Rule 0880-03-.07.
(o) All documents submitted for qualification
of licensure become the property of the State of Tennessee and will not be
returned.
(p) The application form
is not acceptable if any portion has been executed and dated prior to one year
before filing with the Committee. As used in this part, application means the
application form approved by the Committee and shall include, as appropriate:
1. Attached current, notarized passport
photograph;
2. Official transcript
from physician assistant training program;
3. Verification of N.C.C.P.A. exam;
4. Two (2) original letters of professional
recommendation;
5. Result of a
criminal background check;
6.
Certificate of completion or Diploma from an approved physician assistant
program; and
7.
Certification/licensure from other state boards.
(q) All applications shall be sworn to and
signed by the applicant and notarized.
(3) 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 Committee's
Administrative Office shall be deemed to be submission of originals of those
documents or sets of documents by the issuing institution(s).
Notes
Authority: T.C.A. ยงยง 4-5-202, 4-5-204, 63-6-101, 63-6-214, 63-19-104, 63-19-105, 63-19-106, and 63-19-107.
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