1-1     By:  Madla                                             S.B. No. 680
 1-2           (In the Senate - Filed February 24, 1999; February 25, 1999,
 1-3     read first time and referred to Committee on Health Services;
 1-4     April 8, 1999, reported adversely, with favorable Committee
 1-5     Substitute by the following vote:  Yeas 5, Nays 0; April 8, 1999,
 1-6     sent to printer.)
 1-7     COMMITTEE SUBSTITUTE FOR S.B. No. 680                    By:  Madla
                                A BILL TO BE ENTITLED
 1-8                                   AN ACT
 1-9     relating to the licensure of physicians.
1-10           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-11           SECTION 1.  Section 3.05, Medical Practice Act (Article
1-12     4495b, Vernon's Texas Civil Statutes), is amended to read as
1-13     follows:
1-14           Sec. 3.05.  EXAMINATIONS ADMINISTERED OR ACCEPTED
1-15     [EXAMINATION].  (a)  The board may administer or accept the
1-16     following examinations for licensure as determined by rule:
1-17                 (1)  a state board licensing examination;
1-18                 (2)  the Medical Council of Canada Examination (LMCC)
1-19     or its successor;
1-20                 (3)  the National Board of Osteopathic Medical
1-21     Examiners (NBOME) examination or its successor;
1-22                 (4)  the National Board of Medical Examiners (NBME)
1-23     examination or its successor;
1-24                 (5)  the Federation Licensing Examination (FLEX) with a
1-25     weighted average in one sitting before June 1985;
1-26                 (6)  the Federation Licensing Examination (FLEX) after
1-27     May 1985;
1-28                 (7)  the United States Medical Licensing Examination
1-29     (USMLE) or its successor;
1-30                 (8)  a combination of the examinations described by
1-31     Subdivisions (3) and (6) as determined by board rule; or
1-32                 (9)  a combination of the examinations described by
1-33     Subdivisions (4), (6), and (7) as determined by board rule.
1-34           (b)  Each examination used by the board for licensure to
1-35     practice medicine must be in writing in the English language and
1-36     shall be entirely fair and impartial to all individuals and to
1-37     every school or system of medicine.  An applicant who wishes to
1-38     request reasonable accommodations due to a disability shall submit
1-39     the request on filing the application.
1-40           (c)  Examinations must include subjects generally taught by
1-41     medical schools, a knowledge of which is commonly and generally
1-42     required of candidates for the degree of doctor of medicine or
1-43     doctor of osteopathy conferred by schools in this state.
1-44           (d)  The board shall also administer the Texas medical
1-45     jurisprudence examination to all applicants.
1-46           (e)  The minimum passing grade for each examination used by
1-47     the board shall be determined by rule.
1-48           (f)  Examinations administered to evaluate basic medical
1-49     knowledge and clinical competency shall be prepared by a national
1-50     testing service or the board and validated by qualified independent
1-51     testing professionals.
1-52           (g)  All questions, answers, and grades shall be preserved
1-53     for one year as directed by the board by rule.
1-54           (h)  All applicants shall be given notice of the date and
1-55     place of the examination if the examination is administered by the
1-56     board.
1-57           (i)  Not later than the 120th day after the date on which an
1-58     examination is administered by the board, each examinee shall be
1-59     notified of the results of the examination.  However, if an
1-60     examination is graded or reviewed by a national testing service,
1-61     the board shall notify each examinee of the results of the
1-62     examination not later than the 30th day after the date the board
1-63     receives the results from the testing service.
1-64           (j)  An applicant must pass each part of an examination
 2-1     described by Subsection (a)(2), (3), (4), (6), or (7) within seven
 2-2     years.
 2-3           (k)  An applicant may not take an examination more than three
 2-4     times, except that an applicant who has passed all but one part of
 2-5     an examination after taking the examination three times may take
 2-6     that part one additional time as determined by board rule. [All
 2-7     examinations for license to practice medicine shall be conducted in
 2-8     writing in the English language and in a manner as to be entirely
 2-9     fair and impartial to all individuals and to every school or system
2-10     of medicine.  Examinations shall be conducted on and cover those
2-11     subjects generally taught by medical schools, a knowledge of which
2-12     is commonly and generally required of candidates for the degree of
2-13     doctor of medicine or doctor of osteopathy conferred by schools or
2-14     colleges of medicine approved by the board, and the examinations
2-15     shall also be conducted on and cover the subject of medical
2-16     jurisprudence.  Examinations shall be prepared by a national
2-17     testing service or prepared by the board and validated by qualified
2-18     independent testing professionals.  On satisfactory examination
2-19     conducted as required by this Act under rules of the board,
2-20     applicants may be granted licenses to practice medicine.  All
2-21     questions and answers, with the grades attached, shall be preserved
2-22     for one year in the executive office of the board or such other
2-23     repository as the board by rule may direct.  All applicants
2-24     examined at the same time shall be given identical questions.  All
2-25     certificates shall be attested by the seal of the board.  The board
2-26     in its discretion may give the examination for license in two or
2-27     more parts.]
2-28           [(b)  In addition to the requirements prescribed by this Act,
2-29     the board may require applicants to comply with other requirements
2-30     that the board considers appropriate and establish reasonable fees
2-31     for examination.]
2-32           [(c)  All applicants for license to practice medicine in this
2-33     state not otherwise licensed under the provisions of law must
2-34     successfully pass a uniform examination approved by the board as
2-35     determined by rule.  The board is authorized to adopt and enforce
2-36     all rules of procedure not inconsistent with statutory
2-37     requirements.  All applicants shall be given due notice of the date
2-38     and place of the examination.  If any applicant, because of failure
2-39     to pass the required examination, is refused a license, the
2-40     applicant, at a time as the board may fix, shall be permitted to
2-41     take a subsequent examination not more than two additional times as
2-42     the board may prescribe on the payment of a fee as the board may
2-43     determine to be reasonable.  In the event satisfactory grades shall
2-44     be made on the subjects prescribed and taken on the reexamination,
2-45     the board may grant the applicant a license to practice medicine.
2-46     The board shall determine the credit to be given examinees on
2-47     answers turned in on the subjects of complete and partial
2-48     examination, and its decision is final.]
2-49           [(d)  Examination questions that may be used in the future,
2-50     examinations other than the one taken by the person requesting it,
2-51     and deliberations and records relating to the professional
2-52     character and fitness of applicants are exempted from the Open
2-53     Meetings Law and the Open Records Law.  The records, however, shall
2-54     be disclosed to individual applicants upon written request, unless
2-55     the person supplying the information to the board requests that it
2-56     not be disclosed.]
2-57           [(e)  Within 90 days after the day on which an examination is
2-58     administered under this Act, the board shall notify each examinee
2-59     of the results of the examination.  However, if an examination is
2-60     graded or reviewed by a national testing service, the board shall
2-61     notify each examinee of the results of the examination not later
2-62     than the 30th day after the date the board receives the results
2-63     from the testing service.  If the notice of the examination results
2-64     will be delayed for longer than 90 days after the examination, the
2-65     board shall notify the examinee of the reason for the delay before
2-66     the 90th day.]
2-67           [(f)  If requested in writing by a person who fails the
2-68     examination administered under this Act, the board shall furnish
2-69     the person with a summarized analysis of the person's performance
 3-1     on the examination consisting of the person's score on each portion
 3-2     of the examination.]
 3-3           SECTION 2.  The importance of this legislation and the
 3-4     crowded condition of the calendars in both houses create an
 3-5     emergency and an imperative public necessity that the
 3-6     constitutional rule requiring bills to be read on three several
 3-7     days in each house be suspended, and this rule is hereby suspended,
 3-8     and that this Act take effect and be in force from and after its
 3-9     passage, and it is so enacted.
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