These regulations apply to all: Chiropractic externs, chiropractic extern applicants, and licensed chiropractors who are extension faculty members of a chiropractic college accredited by the Council on Chiropractic Education or its successor; and Licensed chiropractors approved by the Board to provide an externship. In this chapter, the following terms have the meanings indicated. Terms Defined. “Accredited Board-approved educational institution” means a chiropractic school, college, or university accredited by the Council on Chiropractic Education or its successor. “Approved program” means a program that has been approved by the Board and the Council on Chiropractic Education or its successor. “Board” means the Maryland Board of Chiropractic Examiners. “Chiropractic extern program” means: A 2-semester clinical program: In which a chiropractic student, that has completed all requirements to graduate, participates under the direct supervision of a licensed chiropractor who has been approved by the Board to serve as a preceptor; and That operates in a facility where chiropractic services have been approved by the Board; or A 6-month clinical program in which an individual has: Begun the process of applying for licensure, but has not met certain requirements set forth under COMAR 10.43.04; Graduated from an accredited Board-approved educational institution; Taken and passed the examination of the National Board of Chiropractic Examiners (NBCE); Been approved for an extern license by the Board; and Agreed to practice under the direct supervision of a preceptor who is a Board-approved licensed chiropractor while the extern license is in effect. “Direct supervision” means a licensed chiropractor: Remains on the premises at all times; Directly supervises and continuously monitors the extern’s performance within the practice; and Is immediately available to offer assistance. “Extern” means: An individual who has: Enrolled in an accredited Board-approved educational institution and has completed all requirements for the Doctor of Chiropractic program except for the final clinical phase of the program; or Graduated from an accredited Board-approved educational institution and is in the process of applying to the Board for a license to practice chiropractic, but has yet to meet certain requirements set forth under COMAR 10.43.04 to qualify for a license; or A chiropractor licensed in another state who is in the process of applying to the Board for a license to practice chiropractic, but has yet to meet certain requirements set forth under COMAR 10.43.04 to qualify for a license. “Extern applicant” means an individual who applies to the Board to be approved for the chiropractic externship program. “Licensed chiropractor” means a chiropractor who is licensed by the Board to practice chiropractic or to practice chiropractic with the right to practice physical therapy, and whose license is in good standing. “Preceptor or extension faculty member” means a licensed chiropractor actively practicing in the State in good standing who has been appointed to the extension faculty of an accredited Board-approved educational institution. “Preceptor sponsor” means a licensed chiropractor approved by the Board to supervise the following who are in the process of applying for licensure: A recent graduate that has completed a preceptorship program; or A chiropractor licensed in another state, whose license is in good standing. An extern applicant is eligible for approval in the chiropractic extern program if the applicant is: Currently enrolled in an approved program that is recognized by the Board as: Requiring adequate clinical training; and Maintaining an acceptable course of chiropractic instruction; A recent graduate that has completed a preceptorship program; or A chiropractor licensed in another state, whose license is in good standing. An extern applicant shall: Meet all the qualifications as set forth in Health Occupations Article, §§3-302 and 3-303, Annotated Code of Maryland; Be in good standing: At the accredited Board-approved educational institution; or In the state currently licensed; Submit the completed application forms as required by the Board; Pay the application fee as set forth in COMAR 10.43.06; Submit to a criminal background check; Have three letters of recommendation sent directly to the Board: From clinical science professors at the extern’s accredited Board-approved educational institution attesting to the applicant’s good moral character and clinical abilities; or Two of which shall be from chiropractors attesting to the applicant’s good moral character and one letter from the licensing board of the state in which the applicant is currently licensed attesting that the license is in good standing; and Be withdrawn from the program if the applicant has not obtained a license to practice chiropractic within 6 months from the date the externship is approved. A preceptor who is a Board-approved licensed chiropractor or an extension faculty member may delegate duties within the scope of one’s license, which constitute the practice of chiropractic, to an extern in accordance with COMAR 10.43. A preceptor may permit an extern to perform chiropractic duties as part of a clinical program, subject to the following conditions: The preceptor shall maintain direct supervision of the extern; The clinical training program shall be governed by a written agreement between the extern’s accredited Board-approved educational institution and the preceptor that: Has been approved by the Board; Describes the specific program; Enumerates the functions the extern may perform; and Indicates the legal responsibilities assumed by the extern’s accredited Board-approved educational institution; The accredited Board-approved educational institution shall submit to the Board the names of those doctors selected as extension faculty members. The Board shall notify the educational institution of those approved for the program; A licensed chiropractor may not supervise more than one extern during the same period; A licensed chiropractor may delegate or permit only duties and functions which are established as part of the clinical training program; The extern may not supervise chiropractic assistants or trainees; and An extern applicant that is a licensed chiropractor in another state shall have a preceptor sponsor. A preceptor may permit a licensed extern to perform chiropractic duties as part of the chiropractic practice providing the preceptor: Maintains direct supervision of the extern; and Ensures the compliance of the extern to the conditions set forth under Regulation .03B(7) of this chapter. A preceptor with a license to practice chiropractic with physical therapy privileges may supervise an applicant applying for a license to practice chiropractic: With physical therapy privileges; and Without physical therapy privileges. A preceptor with a license to practice chiropractic without physical therapy privileges may only supervise an extern applying for a license to practice chiropractic without physical therapy privileges. Malpractice insurance in an amount defined by the Council on Chiropractic Education shall be obtained: Before the clinical program begins, by the extern’s: Accredited Board-approved educational institution; and Extension faculty member participating in the clinical program; or By the preceptor sponsor of an extern applicant. A licensed chiropractor seeking preceptor status shall: Submit a completed written application to the Board; Pay the fee as set forth in COMAR 10.43.06; Provide written evidence of malpractice insurance as requested by the Board; and Agree to an administrative inspection of the chiropractic office spaces, equipment, and records as directed by the Board. Health Occupations Article, §§3-205 and 3-301, Annotated Code of Maryland Effective date: June 17, 1985 (12:12 Md. R. 1165) Regulation .02 amended effective June 13, 2011 (38:12 Md. R. 705) Regulation .02B amended effective August 6, 2001 (28:15 Md. R. 1398); October 22, 2007 (34:21 Md. R. 1915) Regulation .03A amended effective June 13, 2011 (38:12 Md. R. 705) Regulation .03B amended effective August 6, 2001 (28:15 Md. R. 1398) Regulation .04B amended effective October 22, 2007 (34:21 Md. R. 1915); June 13, 2011 (38:12 Md. R. 705) Regulation .04D adopted effective August 6, 2001 (28:15 Md. R. 1398) Subtitle name amended to be, Board of Chiropractic Examiners, Chiropractic Externship Program, effective January 2, 2017 (43:26 Md. R. 1446) Regulation .01 amended effective May 20, 2019 (46:10 Md. R. 490) Regulation .02B amended effective January 2, 2017 (43:26 Md. R. 1446); May 20, 2019 (46:10 Md. R. 490) Regulation .03 amended effective May 20, 2019 (46:10 Md. R. 490) Regulation .03A amended effective January 2, 2017 (43:26 Md. R. 1446) Regulation .04 amended effective May 20, 2019 (46:10 Md. R. 490)