<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".04" citation="COMAR 10.32.01.04" title_num="10" subtitle_num="32" chapter_num="01" heading="Licensure — Documentation for Initial Licensure.">
  <paragraph num="A.">
    <text>The applicant shall submit an application on a form supplied by the Board.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Complete Application.</text>
    <paragraph num="(1)">
      <text>A complete application for initial licensure shall include, but is not limited to, proof of the following through documentation on forms supplied by the Board:</text>
      <paragraph num="(a)">
        <text>Verification of medical education;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Written and electronic statements from an authorized official of each of the applicant's accredited training programs which:</text>
        <paragraph num="(i)">
          <text>Summarize the experience and performance of the applicant during training;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Detail all actions taken against the applicant by any training program, hospital, medical board, licensing authority, or court for an act that would be grounds for disciplinary action under Health Occupations Article, §14-404, Annotated Code of Maryland;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Document specifically whether or not the applicant successfully completed the years of training;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Detail any limitations of privileges during the postgraduate training years; and</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Detail any physical and mental health problems of the applicant that affected the applicant's ability to practice during the years of postgraduate training;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(c)">
        <text>Documentation of successful completion of the examination requirements as described in Regulation .03G of this chapter, including submission of all applicant’s scores sent directly to the Board from the examination authority or authorities.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>The Board may waive the requirement of §B(1)(b) of this regulation on a case-by-case basis, if the applicant's education or training occurred in countries with which reasonable efforts to obtain the required information have been unsuccessful.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>If licensure in another state preceded the requirement for ECFMG, the Board may waive the requirement for the ECFMG certificate.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>A complete application which contains a statement from the applicant listing all:</text>
      <paragraph num="(a)">
        <text>Hospitals, following training, at which the applicant has had privileges during the preceding 5 years; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Disciplinary or adverse actions taken against the applicant by a:</text>
        <paragraph num="(i)">
          <text>Hospital,</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Medical board,</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Licensing authority,</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Court, or</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Adjudicatory body.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>A complete application shall include:</text>
      <paragraph num="(a)">
        <text>All application and licensing fees as required in Regulation .12 of this chapter, payable to the Board at the time the application is submitted to the Board; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The applicant's Social Security number which the Board shall use only for evaluation and identification of applicants and licensees, but may not disclose in any other context.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Additional Requirements. Review of an application for licensure shall include:</text>
    <paragraph num="(1)">
      <text>Verification of licensure from all states where the applicant has ever held a license;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Verification of voluntary licensure nonrenewal, or voluntary surrender of license while the applicant was in good standing and not under disciplinary charges or investigation at the time the license was surrendered from states where the applicant no longer holds a license;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Information in the data bank of the Federation pertaining to the qualifications of the applicant;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Information in the National Practitioner Data Bank including but not limited to the following:</text>
      <paragraph num="(a)">
        <text>Medical malpractice judgments against the applicant;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Settlements made by the applicant in medical malpractice actions;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Actions taken against the applicant or the applicant's license by state disciplinary or licensing authorities; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Actions taken against the applicant or the applicant's privileges by a hospital or hospital disciplinary authority which result in a loss, limitation, or suspension of privileges for a period greater than 30 days; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>If reasonable questions regarding an applicant's physical, mental, or professional competency have been raised by the information provided on the application, original letters of reference from all of the hospitals at which the applicant has had privileges, describing the kind of experience received, the performance of the applicant, and explaining under what circumstances those privileges were limited, revoked, or allowed to lapse.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>English Language Competency. The applicant shall demonstrate oral and written competency in English by any of the following:</text>
    <paragraph num="(1)">
      <text>Documentation of graduation from a recognized English-speaking high school or undergraduate school after at least 3 years of enrollment;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Documentation of graduation from a recognized English-speaking professional school;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Documentation of a passing score on the USMLE step 2 Clinical Skills; or</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Documentation of receiving:</text>
      <paragraph num="(a)">
        <text>A score of at least 26 on the “Speaking Section” of the Internet-Based TOEFL; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>A score of Advanced or higher on the OPI.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Claims of Speech Impairment.</text>
    <paragraph num="(1)">
      <text>Applicants wishing to claim a speech impairment after failing either the TOEFL or the OPI shall submit documentation of this impairment on forms supplied by the Board.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Documentation of a speech impairment shall be submitted from a:</text>
      <paragraph num="(a)">
        <text>Licensed physician; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Speech-language pathologist who is currently licensed to practice speech pathology in the United States.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Documentation should be submitted with the applicant’s initial application but, in all cases, shall be submitted before the applicant’s second attempt at passing the TOEFL or the OPI.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>After the second examination, documentation of an impairment may not be submitted or accepted unless there has been an intervening medical/surgical event which has created the impairment.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>The applicant shall be allowed to claim the impairment only if:</text>
      <paragraph num="(a)">
        <text>This event was reported to the Board before a third examination; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The Board determines that the medical/surgical event did indeed create the impairment.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(6)">
      <text>If the applicant has properly claimed and documented a speech impairment, the Board shall accept the documentation if the applicant is able to prove the ability to communicate with allied health personnel and patients. Proof shall include:</text>
      <paragraph num="(a)">
        <text>Documentation from 3 licensed physicians that the applicant can communicate in a professionally competent manner with patients and health care providers; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>A hearing before the Board where the applicant is asked to describe the manner in which the applicant would obtain a history and physical examination from a typical patient.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="F.">
    <text>The certifying or verifying authority shall send all certificates and verifications directly to the Board for applicants. The Board may not accept certificates and verifications sent to, or by, the applicant.</text>
  </paragraph>
  <paragraph num="G.">
    <text>If any of the documents required under this chapter are in a language other than English, the applicant shall submit the certified translation and bear the expense of translation by a certified translator.</text>
  </paragraph>
  <paragraph num="H.">
    <text>The Board has designated a 4-month period for acting upon applications as follows:</text>
    <paragraph num="(1)">
      <text>Within 60 days after receipt of an application, the Board or its Executive Director will determine whether an application is complete;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>If the Board or the Executive Director determines that the application is not complete, the Executive Director or the Executive Director's designee shall send a notice of deficiency to the applicant;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Upon receipt of the notice, the applicant shall correct the deficiency within 60 days or other period specified in the notice;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>If the applicant fails to correct the deficiency within the required period, the application may lapse and the applicant shall be required to submit a new application and pay the required fees.</text>
    </paragraph>
  </paragraph>
  <paragraph num="I.">
    <text>Withdrawal of Application.</text>
    <paragraph num="(1)">
      <text>An applicant may not withdraw an application for initial licensure, renewal of a license, or reinstatement of a license without permission of the Board, if:</text>
      <paragraph num="(a)">
        <text>The applicant is currently charged in another jurisdiction with conduct which would be grounds for discipline under the Health Occupations Article, §14-404, Annotated Code of Maryland, if the applicant were licensed in this State;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The applicant is under investigation in another jurisdiction for an allegation concerning conduct that would be grounds for discipline under Health Occupations Article, §14-404, Annotated Code of Maryland, if the applicant were licensed in this State; or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The Board is investigating the applicant or application or has issued a notice of intent to deny licensure.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>In determining whether to allow the withdrawal of a licensure application, the Board may consider such factors as the following:</text>
      <paragraph num="(a)">
        <text>Issues of competence or conduct which caused the matter to be investigated;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Duty to protect the public in other jurisdictions from duplicative expenditures on investigation of licensure applications; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Truthfulness of the applicant during the application process.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="J.">
    <text>The Board may accept documentation from the FCVS as evidence of having met some of the requirements of Regulations .03 and .04 of this chapter.</text>
  </paragraph>
</regulation>