STATE OF WISCONSIN
Medical Examining Board
IN THE MATTER OF RULEMAKING
PROCEEDINGS BEFORE THE
MEDICAL EXAMINING BOARD
ORDER OF THE
MEDICAL EXAMINING BOARD
ADOPTING RULES
(CLEARINGHOUSE RULE 15-022)
ORDER
The Medical Examining Board proposes an order to repeal Med 1.06 (4), 1.09 (4), and 3.06; to amend Med 1.06 (1) (a) (intro.), (b), and (c), 1.08 (2), 1.09 (1), 1.09 (6), Chapter
3
(title), 3.01, 3.02, 3.04, Chapter
5
(title), 5.01, 5.02, 5.04, and 5.05; to repeal and recreate Med 1.02 (3), 3.05, and 5.06; and to create Med 23, relating to physician licensure.
Analysis prepared by the Department of Safety and Professional Services.
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ANALYSIS
S
Statutes interpreted:
448.04 (1)
and
448.05 (2), Stats.
Statutory authority:
Explanation of agency authority:
Sections
15.08 (5) (b)
and
227.11 (2) (a)
, Stats., provide general authority from the
legislature
to the Medical Examining Board (Board) to promulgate rules that will provide guidance within the profession and interpret the statutes it administers. Section
448.40 (1)
,
Stats.,
allows the Board to draft rules that will carry out the purposes of
ch.
448
, Stats. With the passage of
2013 Wisconsin Act 240
, the legislature granted specific rule-making authority to the Board to draft rules to address the new physician licensure classifications created by the Act.
Related statute or rule:
Wis. Admin. Code
ch.
Med 1
,
3
, and
5
Plain language analysis:
These rules address the changes instituted by the passage of
2013 Wisconsin Act 240
regarding physician licensure. The Act changed the postgraduate training requirement for all applicants seeking physician licensure from 12 months to 24 months. Both U.S. and foreign trained medical school graduates must complete 24 months of postgraduate training or must be currently enrolled and have successfully completed 12 months of a postgraduate training program, and have an unrestricted endorsement from the postgraduate training director that the applicant is expected to complete at least 24 months of postgraduate training.
Act 240 repealed the visiting professor license and created the restricted license to practice medicine and surgery as a visiting physician. The visiting physician license is open to any physician licensed outside of Wisconsin who is invited to serve on the academic staff of a medical school in this state. The holder of a visiting physician license may only practice in the education facility, research facility or medical school where the license holder is teaching, researching, or practicing medicine and surgery. The license is valid for one year and remains valid as long as the license holder is actively engaged in teaching, researching, or practicing medicine and surgery and is lawfully entitled to work in the U.S.
The temporary educational permit to practice medicine and surgery was also repealed and replaced with the resident educational license to practice medicine and surgery (REL). The REL allows the license holder to pursue postgraduate training under the direction of a Wisconsin licensed physician. The holder of a REL may practice online in the postgraduate training program in which the person is being trained. The REL is valid for one year and may be renewed for additional one year terms as long as the license holder is enrolled in a postgraduate training program.
The Act created the administrative physician license. The administrative physician license allows the license holder to pursue administrative or professional managerial functions but does not allow the license holder to treat patients. The administrative physician license holder must comply with all of the same application requirements as a regular license to practice medicine and surgery.
Summary of, and comparison with, existing or proposed federal regulation:
None.
Analysis and supporting documents used to determine effect on small business or in preparation of economic impact report:
The rule was posted for public comment on the economic impact of the proposed rule, including how this proposed rule may affect businesses, local government units, and individuals, for a period of 14 days. No comments were received.
Fiscal Estimate and Economic Impact Analysis:
The Fiscal Estimate and Economic Impact Analysis
document
is attached.
Effect on small business
:
These proposed rules do not have an economic impact on small businesses, as defined in s.
227.114 (1)
, Stats. The Department’s Regulatory Review Coordinator may be contacted by email at
Eric.Esser@wisconsin.gov
, or by calling (608) 267-2435.
Agency contact person
:
Katie Vieira
,
Administrative Rules Coordinator
,
Department of Safety and Professional Services
, Division of
Policy Development
, 1400 East Washington Avenue, Room 151, P.O. Box
8366
, Madison, Wisconsin 53708; telephone
(608) 261-4472
; email at
Kathleen.Vieira@wisconsin.gov
.
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TEXT OF RULE
Section
1
.
Med 1.02 (3) is repealed and recreated to read:
Med 1.02 (3)
(a) Verification of
satisfactory completion by the applicant of 24 months of postgraduate training in one or more programs accredited by the Accreditation Council for Graduate Medical Education, the American Osteopathic Association or a successor organization; or documentary evidence that the applicant is currently enrolled in a postgraduate training program accredited by the Accreditation Council for Graduate Medical Education, or the American Osteopathic Association or a successor organization and has received credit for 12 consecutive months of postgraduate training in that program and an unrestricted endorsement from the postgraduate training director that the applicant is expected to complete at least 24 months of postgraduate training.
(b) If an applicant is a graduate of a foreign allopathic or osteopathic medical school, then the applicant must provide a verified certificate showing satisfactory completion of 24 months of postgraduate training in one or more programs accredited by the Accreditation Council for Graduate Medical Education, the American Osteopathic Association or a successor organization;
or documentary evidence that the applicant is currently enrolled in a postgraduate training program accredited by the Accreditation Council for Graduate Medical Education, or the American Osteopathic Association or a successor organization and has received credit for 12 consecutive months of postgraduate training in that program and an unrestricted endorsement from the postgraduate training
director that the applicant is expected to complete at least 24 months of postgraduate training.
(c) If the applicant is a graduate of a foreign allopathic or osteopathic medical school and has not completed 24 months of postgraduate training approved by the board and is not currently enrolled in a postgraduate training program but the applicant has other professional experience which the applicant believes has given that applicant the education and training substantially equivalent to 24 months of postgraduate training, then the applicant may submit the documented education and training demonstrating substantially equivalent education and training. The board will review the documented education and training and may make further inquiry, including a personal interview of the applicant, as the board deems necessary to determine whether substantial equivalence in fact exists. The burden of proof of such equivalence shall lie upon the applicant. If the board finds that the documented education and training is substantially equivalent to the required training and experience the board may accept the experience in lieu of requiring the applicant to have completed 24 months of postgraduate training in a program approved by the board.
(d) The board approves of the training programs accredited by the following organizations: the Accreditation Council for Graduate Medical Education, the American Osteopathic Association, the Liaison Committee on Medical Education, the American Association
of
Colleges of Osteopathic Medicine, and the National Joint Committee on Approval of Pre-Registration of Physician Training Programs of Canada, or their successor organizations.
Section
2
.
Med 1.06 (1) (a) (intro.), (b), and (c) are amended to read:
Med 1.06 (1)
(a
)
All
applicants shall complete the computer-based examination under sub. (3) (
b
), and an open book examination on statutes and rules governing the practice of medicine and surgery in Wisconsin. In addition, an applicant may be required to complete an oral
examination
interview
if the applicant:
(b)
An application filed under s.
Med 1.02
shall be reviewed by an application review panel of at least 2 board members designated by the chairperson of the board. The panel shall determine whether the applicant is eligible for a regular license without completing an oral
examination
interview
.
(d)
Written
,
and
computer-based
examinations
and oral
examinations
interviews
as required shall be scored separately and the applicant shall achieve a passing grade on all examinations to qualify for a license.
Section
3
.
Med 1.06 (4) is repealed.
Section
4
.
Med 1.08 (2) is amended to read:
Med 1.08 (2
)
If
an applicant has been examined 4 or more times in another licensing jurisdiction in the United States or Canada before achieving a passing grade in written or computer-based examinations also required under this chapter, the board may require the applicant to submit evidence satisfactory to the board of further professional training or education in examination areas in which the applicant had previously demonstrated deficiencies. If the evidence provided by the applicant is not satisfactory to the board, the board may require the applicant to obtain further professional training or education as the board deems necessary to establish the applicant's fitness to practice medicine and surgery in this state. In order to determine any further professional training or education requirement, the board shall consider any information available relating to the quality of the applicant's previous practice, including the results of the applicant's performance on the oral
examination
interview
required under s.
448.05 (6)
, Stats., and s.
Med 1.06
.
Section
5
.
Med 1.09 (1) is amended to read:
Med 1.09 (1)
An applicant who fails the
oral-practic
al or
statutes and rules examination may request a review of that examination by filing a written request and required fee with the board within 30 days of the date on which examination results were mailed.
Section
6
.
Med 1.09 (4) is repealed.
Section
7
.
Med 1.09 (6) is amended to read:
Med 1.09 (6)
At the beginning of the review, the applicant shall be provided with a copy of the questions, a copy of the applicant's answer sheet
or oral-practical tape
and a copy of the master answer sheet.
Section
8
.
Med 3 (title) is amended to read:
CHAPTER MED 3
VISITING
PROFESSOR
PHYSI
CIAN
LICENSE
Section
9
.
Med 3.01 and 3.02 are amended to read:
Med
3.01
Authority
and purpose
. The rules in this chapter are adopted by the medical examining board pursuant to the authority delegated by ss.
15.08 (5)
,
227.11 (2) (a)
and
448.40
, Stats., and govern application for
a
temporary license to practice medicine and surgery under s.
448.04 (1) (b) 2.
, Stats.,
restricted
license to practice medicine and surgery as a visiting physician under 448.04 (1) (
bg
),
Stats., (hereinafter “visiting
professor
physician
license
”), and also govern practice thereunder.
Med
3.02
Applications
, credentials, and eligibility
.
An applicant who is a graduate of
a
foreign
an allopathic
medical school
located outside of the United States or
Canada
or an osteopathic medical school that is approved by the board
and who is invited to
serve on the academic staff of a
teach, conduct research, or practice medicine and surgery at a medical education facility, medical research facility,
or
medical school in this state as a visiting
professor
physician
may
apply to the board for a
temporary visiting professor license
visiting physician license
and shall submit to the board
all of
the following
:
(1)
A completed and verified application
for this purpose as required in s.
Med 1.02 (1)
,
which includes proof
that the applicant has graduated from and possesses a diploma from a
n allopathic
medical or osteopathic
medical school
that is approved by the board
.
(1m
)
Documentary
evidence of licensure to practice medicine and surgery
.
(2)
A
signed
letter from the
appointing authority
president or dean or delegate of the president or dean
of a medical school
, or facility
in this state indicating that the applicant
has been invited to serve on the academic staff of such medical
school
as a visiting professor
intends to teach, conduct research, or practice medicine and surgery at a medical education facility, medical research facility, or medical school in this state
.
(3)
A curriculum vitae setting out the applicant's education and qualifications
and a verified photographic copy of the diploma (with translation) conferring the degree of doctor of medicine grante
d to the applicant by such college
.
(4)
A photograph of the applicant as required in s.
Med 1.02 (4)
.
(5)
A verified statement that the applicant is familiar with the state health laws and the rules of the department of health services as related to communicable diseases
.
(6)
Documentary evidence of noteworthy attainment in a specialized field of medicine.
(7)
Documentary evidence of
post-graduate
postgraduate
training completed in the United States
and/or
or
foreign
countries
.
(8)
Oral interview conducted
by
at the discretion of
the board.
(9)
Documentary evidence that the applicant teaches medicine, enga
g
es in medical research, or practices medicine and surgery outside of
Wisconsin
.
Section
10
.
Med 3.04 is amended to read:
Med
3.04
Practice
limitations
.
The holder of a
temporary
visiting
professor
physician
license may practice medicine and surgery as defined in s.
448.01 (9)
, Stats.,
providing such practice is
full-time
and is
entirely limited to
the medical education facility, medical research facility, or medical school where the license holder is teaching, conducting research, or practicing medicine and surgery, and is limited to the terms and restrictions established by the board.
the
duties of the academic position to which the holder of such license is appointed
.
Section
11
.
Med 3.05 is repealed and recreated to read:
Med
3.05
Expiration
and renewal
. A visiting physician license is valid for one year and remains valid only while the license holder is actively engaged in teaching, conducting research, or practicing medicine and surgery and is lawfully entitled to work in the United States. The visiting physician license may be renewed at the discretion of the board.
Section
12
.
Med 3.06 is repealed.
Section
13
.
Med 5 (title) is amended to read:
CHAPTER MED 5
TEMPORARY EDUCATIONAL PERMIT
RESIDENT EDUCATIONAL LICENSE
TO PRACTICE MEDICINE AND SURGERY
Section
14
.
Med 5.01 and 5.02 are amended to read:
Med
5.01
Authority
and purpose
.
The rules in this chapter are adopted by the medical examining board pursuant to the authority delegated by ss.
15.08 (5)
,
227.11
and
448.40
, Stats., and govern application for
temporary educational permit
the resident
educational license
to
practice medicine and surgery under
s.
448.04 (1) (c)
, Stats.,
s.
448.04 (1) (
bm
)
, Stats.,
(
hereinafter "
temporary
resident
educational
permit
license
"), and also govern practice thereunder
.
Med
5.02
Applications
, credentials, and eligibility
.
An applicant who has been
appointed to
accepted into
a postgraduate training program in a facility in this state approved by the board under the provisions of s.
Med 1.02 (3)
and accredited by the Accreditation Council for Graduate Medical Education, the American Osteopathic Association, or a successor organization
may apply to the board for
a
temporary educational permit
resident educational license
to practice medicine and surgery
and
. The applicant
shall submit to the board
all of
the following:
(1)
A completed and verified application
form
supplied by the board for this purpose
.
These application forms are furnished by the board to the directors of training programs in approved facilities in this state and are available to the applicant from such directors
.
(1m
)
Documentary
evidence that the applicant
is a graduate of
and possesses a diploma from
a
n
allopathic or osteopathic medical school
approved by the board.
(2)
The documentary
Documentary
evidence
that
and credentials required und
er s.
Med 1.02 (2)
,
(4)
and
(5)
the
applicant has been accepted into a postgraduate training program accredited by the Accreditation Council for Graduate Medical Education, the American Osteopathic Association, or a successor organization
.
(3)
A signed letter
from
the president or dean
or the delegate of the president or dean of the institution sponsoring the postgraduate training program
into which the applicant has been accepted
confirming that the applicant has been
or will be
accepted into a postgraduate training
program
.
(4)
A verified statement that the applicant is familiar with the state health laws and rules of the department of health services as related to communicable diseases.
Section
15
.
Med 5.04 and 5.05 are amended to read:
Med
5.04
Practice
limitations
.
The
holder of a
temporary
educational permit
to practice medicine and surgery
r
esident
educational
licens
e
may, under the direction of a person licensed to practice medicine and surgery in this state, perform services requisite to the
postgraduate
training program in which
that holder
the licensee
is serving. Acting under such direction,
the holder of such
temporary educational permit
the resident educational license
e
shall also have the right to prescribe drugs
other than narcotics
and controlled substances
and to sign any certificates, reports or other papers for the use of public authorities which are required of or permitted to persons licensed to practice medicine and surgery. The
holder of such
temporary educational permit
resident educational license
e
shall confine
his or
her
the
training and entire practice to the
facility
postgraduate training program
in which
the
permit holder
the resident educational license
e
i
s taking
the
training
and to the duties of such training
.
Med
5.05
Revocation
.
Violation by
the h
older of a temporary educational permit
a
resident educational licensee
to practice medicine and surgery
of any of the provisions of this chapter or of any of the provisions of the Wisconsin Administrative Code or of
ch.
448
, Stats., which apply to persons licensed to practice medicine and surgery shall be cause for the revocation of such
temporary educational permit
resident
educational license
.
Section
16
.
Med 5.06 is repealed and recreated to read:
Med
5.06
Expiration
and renewal
. A resident educational license to practice medicine and surgery granted under this chapter is valid for one year from the date of issuance and may be renewed for additional one-year terms as long as the license holder is enrolled in the postgraduate training program.
Section
17
.
Ch.
Med 23
is created to read:
CHAPTER MED 23
ADMINISTRATIVE PHYSICIAN LICENSE
Med
23.01
Authority
and purpose
.
The rules in this chapter are adopted by the medical examining board pursuant to the authority delegated by ss.
15.08 (5)
,
227.11
,
and
448.40
,
Stats.,
and govern application for
licensure as an administrative physician
under s.
448.04 (1) (ac)
, Stats., and also govern practice thereunder.
Med 23.02
Application, credentials and eligibility
.
An applicant for an administrative physician license must provide a completed and verified application which includes proof that the applicant has graduated from and posses
ses a diploma from an allopathic or
osteopathic
medical
school approved by the board
; and documentary evidence of completion of a postgraduate training program approved by the board
. Applicants
for an administrative physician license
must
also
meet the same qualifications for licensure as applicants applying under s.
448.05 (2) (a)
or
(b)
, Stats
.
Med
23.03
Fees
.
The required fees must accompany the application, and must be made payable to the Wisconsin department of safety and professional services
.
Med
23.04
Practice
limitations
.
The Board may issue an administrative
physician
license to an applicant whose primary responsibilities are those of an ad
ministrative or academic nature,
such as professional managerial, administrative, or supervisory activities. The holder of an administrative physician license may not examine, care for
,
or treat patients. An administrative physician license do
es not include the authority to
prescribe drugs or controlled substances, delegate medical act
s
, issue opinions regarding medical necessity
,
or conduct clinical trials on humans.
Med
23.05
Registration
and renewal
. Each administrative physician licensee shall register biennially
with the board. Administrative physicians who possess the degree of doctor of osteopathy must register by March 1
st
of each even-numbered year. Administrative physicians who possess the degree of doctor of medicine must register on or before November 1 of each odd-numbered year. The department shall mail to each licensee at his or her last known address as it appears in the records of the board a notice of renewal for registration. The board shall notify the licensee within 30 business days of receipt of a completed registration form as to whether the application for registration is approved or denied. The administrative physician licensee must comply with all other provisions of s.
448.13
, Stats.
and
of
ch.
Med 13
.
Med
23.0
6 Interview
. A
pplicants may be required to complete an oral
interview
at the discretion of the board
.
Section 18
.
EFFECTIVE DATE.
The rules adopted in this order shall take effect on the first day of the month following publication in the
Wisconsin
Administrative Register, pursuant to s.
227.22 (2) (intro.)
, Stats.
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(END OF TEXT OF RULE)
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