Current through Register Vol. 50, No. 9, September 20, 2024
A. In
General. The board may issue a Graduate Education Temporary Permit (GETP) to an
international medical graduate (a graduate of a medical school located outside
of the United States, Canada, and Puerto Rico) for the purpose of enrolling and
participating in an accredited program of postgraduate medical education
(residency or fellowship) at a Louisiana medical school, college, or other
accredited medical institution, upon documentation of the qualifications,
satisfaction of the procedural requirements and compliance with the conditions
and limitations prescribed by this Section.
B. Qualifications for Permit. To be eligible
for a GETP, an international medical graduate (IMG) shall:
1. be at least 21 years of age;
2. be a citizen of the United States or
possess valid and current legal authority to reside and work in the United
States duly issued by the commissioner of the INS of the United States pursuant
to the Immigration and Nationality Act and the commissioner's regulation
thereunder, as evidenced by an exchange visitor (J-1), temporary worker (H-1B)
or immigrant visa, or INS-issued or approved work permit or by a pending
application for such visa or permit;
3. be of good moral character, as defined by
§303 A;
4. possess a doctor of medicine or equivalent
degree duly issued and conferred by a medical school or college listed, at the
time the degree was awarded, in the then-current edition of the World
Directory of Medical Schools published by the World Health
Organization; and
5. possess the
standard certificate of the (ECFMG), provided it was issued on the basis of
examination taken in accordance with the standards, restrictions and
limitations prescribed by
§387 of these rules; and
6. have received a written commitment from an
accredited Louisiana medical school, college, or other accredited medical
institution formally appointing the IMG to a postgraduate medical education
training program which is conducted by such medical school, college, or other
medical institution and which is fully accredited by (and not on probational
status with) the ACGME, subject only to the board's issuance of a GETP to the
applicant; and agreeing to furnish to the board the periodic reports required
by §411.
F 2-3; and
7. satisfy the applicable fees prescribed in
these rules and the Medical Practice Act.
C. Procedural Requirements. An application
form will be supplied by the board only after the qualifications prescribed by
§411. B.6 have been
documented by an original letter, signed by the director of the postgraduate
training program of the Louisiana medical school, college, or other accredited
medical institution at which the IMG will train, certifying that the
qualifications and conditions of such Subsection have been met.
D. Restrictions and Limitations. An IMG
holding a GETP issued by the board shall not participate in postgraduate
medical training or engage in the practice of medicine within the state of
Louisiana other than as follows.
1. During
the 12 months following the effective date of an initial GETP, an IMG may
participate in postgraduate medical training and engage in the practice of
medicine solely at the principal location of the sponsoring medical school,
college, or medical institution and shall not participate in clinical rotations
to or serve at institutions at any other location.
2. An IMG who is enrolled and participating
in a first postgraduate year (PGY-1) medical education training program shall
not assume independent responsibility for patient care or otherwise engage in
the practice of medicine.
3. An IMG
shall not engage in the practice of medicine, or participate in any
postgraduate medical training program within the state of Louisiana, other than
within the scope of the postgraduate medical training program for which such
person has been approved by the board, nor other than at the medical school,
college, or other accredited medical institution from which such IMG holds his
or her appointment, or at medical facilities affiliated with such
program.
4. An IMG holding a GETP
shall be subject to supervision by the supervising physicians designated by the
medical school, college, or medical institution at which the postgraduate
medical education training program is conducted.
E. Term of Permit. Each GETP issued under
this Section shall expire 12 months from the date on which it is issued. A GETP
shall also expire, and automatically become null and void, effective on any
date that the permittee's appointment to the designated postgraduate training
program is terminated.
F. Renewal,
Reissuance. A GETP which has expired may be renewed or reissued by the board
for one or more successive 12-month period, provided that:
1. not later than 24 months following the
effective date of an initial GETP, permit holder has taken and successfully
passed Step 3 of the United States Medical Licensing Examination (USMLE) or had
previously passed both components of the FLEX;
2. not less than five months nor more than
seven months following the effective date of an initial GETP, the director of
the postgraduate program in which the permit holder is enrolled has submitted
to the board written reports on the IMG's performance in such program,
certifying to the board that the permit holder has performed successfully and
competently in such postgraduate program;
3. not less than two months prior to the
annual expiration of a GETP, the director of the postgraduate program in which
the permit holder is enrolled has submitted to the board written reports on the
IMG's performance in such program, certifying to the board that:
a. the permit holder has performed
successfully and competently in such postgraduate program;
b. the medical school, college, or other
medical institution will renew the IMG's appointment for an additional year;
and
c. no grounds are known which
would provide cause for the board to refuse to renew or to revoke the permit
holder's GETP pursuant to
§411. H
hereof.
G.
Causes for Refusal to Issue or Renew. Notwithstanding an IMG's eligibility for
a GETP, or for renewal of a GETP, under the standards and criteria set forth in
this Section, the board may nonetheless deny issuance or renewal of a GETP for
any of the causes for which it may deny licensure under
R.S.
37:1285.A or for which it may revoke a GETP
pursuant to
§411 H
H. Causes for Revocation. Upon prior notice
and an opportunity to be heard in accordance with the Louisiana Administrative
Procedure Act, a GETP may be revoked by the board:
1. for any of the causes specified by
R.S.
37:1285.A;
2. upon a finding by the board that the
permittee has failed to maintain, or did not possess at the time of
application, any of the qualifications requisite to eligibility for a GETP as
prescribed by this Section; or
3.
upon a finding by the board that the permittee has exceeded the scope of
authority accorded by the GETP or otherwise violated any of the conditions,
restrictions, and limitations prescribed by
§411. D
hereof.
I. Effect of
Revocation. An IMG whose GETP has been revoked by the board pursuant to
§411. H shall not
thereafter be eligible for a GETP or license to practice medicine in the state
of Louisiana.
J. Short-Term IMG
Training Permit. The board may, in its discretion, issue an institutional
temporary permit for the purpose of participating in a short-term residency or
other postgraduate training program (short-term training
permit) conducted by a Louisiana medical school or a major teaching
hospital, as defined herein, to an IMG applicant who possesses the
qualifications prescribed by B.1-4 of this Section, provided that:
1. the applicant has not held any permit
issued under this Chapter within one year prior to the date of
application;
2. the postgraduate
training program is approved in advance by the board;
3. the applicant presents, or causes to be
presented to the board:
a. a completed
application upon a form provided by the board, together with the fees
prescribed by Chapter 1 of these rules. An application form will be supplied by
the board only after receipt of a written commitment signed by the program
director under whom the applicant will train in the postgraduate training
program describing the capacity in which the applicant will be training and the
inclusive dates of such training; and
b. satisfactory documentation that the
applicant possesses the qualifications required by this Subsection;
4. an IMG holding a permit under
this Subsection shall not assume independent responsibility for patient care in
the state of Louisiana, and shall only receive postgraduate training in this
state:
a. within the postgraduate training
program for which he or she is approved by the board; and
b. under the immediate supervision
(e.g., in the physical presence) of a Louisiana licensed
physician who has been appointed or designated by the medical school or major
teaching hospital;
5. a
permit issued under this Subsection shall expire and thereby become null, void
and to no effect on the date specified by such permit or three months from the
date of its issuance, whichever period is the shortest. Such permit shall also
expire on any date that the permittee's appointment to the designated
postgraduate training program is terminated;
6. a short-term training permit which has
expired may, at the board's discretion, be renewed or reissued for not more
than one successive three month period commencing without interruption
immediately following the initial expiring permit, provided all requirements
prerequisite to initial permit issuance have been met to the board's
satisfaction;
7. the board may
refuse to issue or revoke a short-term training permit for any of the causes
that it may deny issuance of licensure under
R.S.
37:1285 A, or for which it may revoke a
permit pursuant to 411J.8 of this Subsection;
8. a short-term training permit may be
revoked by the board:
a. for any of the
causes specified by
R.S.
37:1285 A;
b. upon a finding by the board that the
permittee has failed to maintain, or did not possess at the time of
application, any of the qualifications requisite to eligibility for a permit as
prescribed by this Subsection; or
c. upon a finding by the board that the
permittee has exceeded the scope of authority accorded by the permit or
otherwise violated any of the conditions, restrictions, and limitations
prescribed by this Subsection;
9. an IMG whose short-term training permit
has been revoked by the board shall not thereafter be eligible for any other
permit or a license to practice medicine in this state.
K. The term major teaching hospital,
as used in Subsection J of this Section, means a facility that:
1. has a documented affiliation agreement
with a Louisiana medical school accredited by the Liaison Committee on Medical
Education. The facility must be a major participant in at least four approved
medical residency programs. At least two of the programs must be in medicine,
surgery, obstetrics/gynecology, pediatrics, family practice, emergency medicine
or psychiatry. For purposes of recognition as a major teaching hospital, a
facility shall be considered a
major participant in a graduate
medical education program if it meets both of the following criteria:
a. the facility must pay for the costs of the
training program in the non-hospital or hospital setting including the
residents' salaries and fringe benefits attributable to direct graduate medical
education and other direct administrative costs of the program; and
b. the facility must participate in residency
programs that:
i. require residents to rotate
for a required experience, or
ii.
require explicit approval by the appropriate Residency Review Committee of the
medical school with which the facility is affiliated prior to utilization of
the facility, or
iii. provide
residency rotations of more than one-sixth of the program length or more than a
total of six months at the facility and are listed as part of an accredited
program in the Graduate Medical Education Directory of the Accreditation
Council for Graduate Medical Education.
2. maintains an intern and resident full time
equivalency of at least 15 filled positions.
L. Fellowship Training Permit;
Qualifications. The board may, in its discretion, issue a temporary permit for
the purpose of participating in unaccredited postgraduate fellowship training
at a minimum level of postgraduate year four (PGY-4), that is conducted by a
Louisiana medical school or major teaching hospital, as defined herein,
provided such school or major teaching hospital sponsors a fully accredited
ACGME residency training program in the same specialty in which the fellowship
is offered. To qualify for such a permit an applicant:
1. shall:
a. have completed a residency training
program accredited by the ACGME, AOA or the Commission on Dental Accreditation
(CODA) of the American Dental Association in the same specialty as the
fellowship; and
b. possess all of
the qualifications for licensing prescribed by
§323 of these rules;
2. present, or cause to be presented, to the
board:
a. a completed application in a manner
specified by the board, together with the fees prescribed by Chapter 1 of these
rules;
b. satisfactory
documentation that the applicant possesses the qualifications required by this
Section; and
c. a letter from the
program director under whom he or she will be serving in the fellowship,
describing the capacity in which the applicant will be serving and the
inclusive dates of such service.
3. Restrictions, Limitations. The holder of a
permit issued under this Section shall not engage in the practice of medicine
in any respect in the state of Louisiana, or receive medical education or
training, other than within the fellowship training program for which he or she
is approved by the board.
4. Term.
A permit issued under this Section shall expire, and thereby become null and
void and to no effect on the date specified by the permit or twelve months from
the date of issuance, whichever is the shorter period. Such permit shall also
expire on any date that the permittee's appointment to the designated
fellowship training program is terminated.
5. Renewal. A fellowship training permit
which has expired may, at the boards discretion, be renewed or reissued for not
more than one successive twelve month period commencing without interruption
immediately following the initial expiring permit, provided all requirements
prerequisite to initial permit issuance have been met to the boards
satisfaction.
6. Revocation. A
fellowship training permit may be revoked by the board:
a. for any of the causes specified by
R.S.
37:1285 A;
b. upon a finding by the board that the
permittee has failed to maintain, or did not possess at the time of
application, any of the qualifications prerequisite to eligibility for a permit
as prescribed by this Subsection; or
c. upon a finding by the board that the
permittee has exceeded the scope of authority accorded by the permit or
otherwise violated any of the terms, conditions, restrictions, or limitations
prescribed by this Section.
AUTHORITY NOTE:
Promulgated in accordance with
R.S.
37:1270(A), 37:1270(B)(6),
37:1275, 37:1277 and 37:1281.
