Requirements for a Temporary License:
Upon completing and submitting the “Application For
Temporary License,” you are affirming the following:
“I, _________________________, hereby certify under
oath, that I am at least twenty-one years of age, and; that I am the
person named in this application for a license to practice Podiatric
Medicine in the State of Texas, and; that all statements herein are made
as a basis of consideration for the Texas State Board of Podiatric
Medical Examiners, to accept and consider as facts which concern my
moral character, professional history and physical qualifications for
the rights and privileges of a license to practice Podiatric Medicine in
the State of Texas, all of which are true and correct. I am the person
named in the Diploma (or photostatic copy therof), presented to said
Board for its inspection, and I am the legal and lawful owner of all
credentials submitted to the Board. I voluntarily pledge to refrain from
dishonest or fraudulent methods in taking the examination and to refrain
from unethical, immoral or unprofessional conduct in my practice. I
shall not by any method, or deceptive means make use of
misrepresentations, misleading or untruthful statements to the public or
my patients, or in my advertising, on my professional cards, stationary,
directories or any other medium. I hereby agree, that the violation of
this pledge, or any of the provisions of the Podiatric Medical Practice
Act of Texas (Section 202.253 and Section 202.501), the Penal Code of
Texas (penalty of perjury) shall constitute sufficient cause for the
denial, suspension, cancellation or revocation of the license granted to
me, and I hereby authorize and grant the Texas State Board of Podiatric
Medical Examiners the withdrawal of all rights and privileges accrued to
me thereunder. I request that the Texas State Board of Podiatric Medical
Examiners initiate a review of the records to determine my eligibility
for examination or licensure in Texas. In making this request, I
authorize the release of any information or records held by any
individual or agency, relative to my training and qualifications as a
Doctor of Podiatric Medicine upon request by the Board for use in
evaluating my file.”
NOTE: All items in the application are
MANDATORY; none are
voluntary. Failure to provide any of the requested information will
result in the application being rejected as incomplete. The information
provided will be used to determine qualification for licensure pursuant
to Texas Occupations Code §202.252 which authorizes the collection of
this information. Information regarding the issuance or denial of a
license by the Board may be transmitted to any other podiatric or
medical licensing authority or the National Practitioner Databank –
HIPDB. Applicants must review their application to ensure accuracy to
avoid processing delays.
-
Transcripts from ALL colleges attended (undergraduate plus podiatry)
-
Passing National Board Scores (Part 1 and Part 2; score
of 75 or above for each topic/test). For more
information on National Boards Part 1 and Part 2, please
go/click to:
www.nbpme.info. (Note: Board Rule §371.7(e)
"Qualifications for Licensure" provides that: "All
applicant's shall have successfully passed all sections
of the National Board and provide their scores directly
from the National Board of Podiatric Medical Examiners
to the Texas State Board of Podiatric Medical
Examiners." In addition, Board Meeting "January 29-30,
1992 Minutes" (precedent) provides that: "Discussion was
held on whether to add National Board requirement to our
rules. A motion was made to add this requirement to the
examination rules. A person must pass ALL portions of
the National Board before they can apply for the Texas
Board. Motion-Knecht/2nd-Scioli." Per NBPME criteria,
scores of 75 or above are reported as "Pass." Failing
scores are reported numerically between a scaled range
of 55-74. The TSBPME requires that an applicant obtain a
"Passing" score of 75 or above for each topic/test.)
-
Certification Letters from all States in which a license
has ever been held (i.e. Temporary, Permit, Permanent,
etc.)
-
Copy of podiatry diploma
-
Letter from Residency Director indicating acceptance of the program and the dates of the program
-
Self-Query Report from the
National Practitioner Data Bank-Healthcare Integrity and
Protection Data Bank (NPDB-HIPDB). (Note: Once
logged into the "Self-Query" page, you must list
EVERY state where you have held any kind of
license or permit (e.g. Temporary, Permanent,
Provisional, Etc.). Once you have answered all of the
questions, you will print out an "Individual Self Query"
form. That form must be notarized and then mailed to the
NPDB-HIPDB. See their instructions. Once they receive
it, the NPDB-HIPDB will process the form and then send a
"Self-Query Response" report back to you. You then will
fill out the TSBPME "Affidavit of Non-Falsification of
Records (NPDB-HIPDB)" (form P9) and forward the
NPDB-HIPDB report and affidavit to the Board. We will
not accept a NPDB-HIPDB report without the TSBPME
affidavit nor the TSBPME affidavit without the
NPDB-HIPDB report. Both must be submitted together.)
-
Current C.P.R. training (basic or A.C.L.S.) (Must be
hands-on; NO on-line CPR)
-
Current photo
-
Dean’s signature on page P7 of the application
-
$125 Application Fee + additional $39.00 Fee for F.B.I. Fingerprint
Background Check. Total Temporary Fee = $164.00
- Two (2) FBI finger print cards.
(Note: If you have ever been arrested, convicted
of, or pled nolo contendere to any offense, misdemeanor
or felony of any city, state, the United States, or a
foreign country, except for violations of traffic laws
resulting in fines of $500.00 or less, you
MUST
fully disclose this on the license application by
answering "Yes" to the appropriate question and provide
a written statement explaining/detailing the matter. You
must also submit with your application any law
enforcement/criminal justice agency/court/judicial
documents affirming the status, whether pending, final,
deferred, probated, dismissed, etc. of the
arrest/conviction/probation/compliance. Responsiveness
may include additional supporting documentation such as
arrest/police reports, court adjudication documents and
attorney statements. The Board will conduct a full
FBI/DPS background check on each applicant. Any criminal
history application deficiencies or errant reporting of
the same will result in delays
in processing your application or rejection for failure
to comply/report. If you answered "No" when in fact the
FBI/DPS return yields a criminal history, you will be required to update/correct
your application. These errant situations can occur for minor misdemeanor
offenses or confusion regarding the dismissal or expungement of a charge. License applications/files can be
updated/corrected at any time by completing the
following
Criminal History Self-Report Form.)
*NOTE:
All Temporary licenses expire annually by June 30th.
Licenses not applied for or not renewed by this deadline are subject
to all administrative and criminal penalties of "Practicing Without
A License." Renewal notices are mailed at the beginning of May of
each year to your last known address of record. We recommend that
licensees keep their addresses current by notifying the Board in
writing. It is YOUR RESPONSIBILITY to
renew your license on time! A temporary licensee (i.e. Podiatry Resident) granted a temporary license for the purpose
of pursuing a GPME program in the State of Texas
shall not engage in the practice of
podiatric medicine, whether for compensation or free
of charge, outside the scope and limits of the GPME program in which
he or she is enrolled. A temporary license holder shall not be considered to be a fully
"Active" licensed podiatrist as provided under §378.13 of the Board
Rules who independently practices podiatric medicine without
supervision. A temporary license holder is a person in training and
is limited by the GPME program in which he or she is enrolled for
residency based supervised patient encounters, supervision of which
is designed to protect patients and the citizens of Texas. Podiatry Residents
enrolled in an accredited GPME residency (training) program who hold
a "Temporary" license (i.e. No. "T##-####") may prescribe Controlled
Substances under the (training) facility's DPS/DEA registration and
remain subject to the supervision of the (training) program and
residency director. Under no
circumstances are residents allowed to prescribe controlled
substances for purposes outside of the approved residency (training)
program. A temporary license granted by the Board for the purpose of
pursuing a GPME program in the State of Texas shall terminate by
operation of law and under the Board rules at the time and on the
day that said temporary licensee leaves or is terminated from said
GPME program. Any successive entry into a second or further GPME
program shall be subject to all laws and rules and application
requirements set forth herein. Board Rule §371.25 "Residency Program Responsibilities and
Temporary Licensure" provides that:
(a) All residency programs requesting temporary licenses for the
podiatric physicians participating in the program must meet all
American Podiatric Medical Association/Council on Podiatric Medical
Education (APMA/CPME) requirements for accreditation.
(b) The residency director will be held
responsible for the entire program including but not limited to:
(1) ensuring that the temporary licensee is practicing within the
scope of the residency program requirements;
(2) ensuring that the temporary licensee has read and understood the
Act and Rules governing the practice of podiatric medicine; and
(3) ensuring that all residency program attendees are properly
licensed with the Board prior to participation in the program
pursuant to §371.5(g) of this title (Applicant for
License--Temporary License). A temporary license to practice
podiatric medicine expires on June 30 of each year.
(c) Within thirty (30) days of the start date of the program each
year, the residency director must report to the Board a list of all
residents enrolled in the program, the names of all of the directors
in the program and which program each individual is enrolled in.
(d) Licensure.
(1) All initial residency applicants shall complete the entire
application for Temporary License for enrollment in an accredited
graduate podiatric medical education (GPME) program.
(2) On application, an established Texas resident who has been
initially enrolled and licensed in an accredited GPME program
pursuing a second or third year residency shall renew his unexpired
license by:
(A) paying to the Board before the expiration date of the license
the required renewal fee;
(B) submitting proof of having successfully completed a course in
cardiopulmonary resuscitation and provide a current certification to
that effect;
(C) completing the "Memorandum of Understanding for Approved
Residence Program" (form P6);
(D) completing the "Certificate of Acceptance for Postgraduate
Training Program" (form P10).
(3) An applicant who fails to renew a temporary license prior to
expiration will be required to submit an entirely new application
for renewal.
(4) Established Texas Residents pursuing a second or third year
residency will be issued a new license number upon annual renewal.
(e) The annual renewal application notification will be deemed to be
written notice of the impending license expiration forwarded to the
person at the person's last known address according to the records
of the Board." *NOTE: All applicants for licensure are subject to (fingerprint)
criminal background checks through the Federal Bureau of
Investigation and the Texas Department of Public Safety. You will be
mailed a set of fingerprint cards to be completed at any local law
enforcement agency. Once completed, those cards are to be returned
to the Board for processing. To prevent unnecessary processing
delays, it is imperative you complete your fingerprints in a timely
manner and submit them to the Board for final processing. Incomplete
or poor quality fingerprints will result in rejections and the
process will restart to obtain quality fingerprints. Criminal
history matches may subject the applicant to further investigation.
For more information on the types of criminal offenses subject to
Board investigation, please visit the Board's "Complaints" page and
click on "Item #3: Guidelines on Board Investigations/Criminal
Convictions/Penalty Schedules." All persons have a right to obtain a
copy of their own criminal history report and to challenge its
accuracy, completeness and to request corrections. For more
information, please contact the
Texas Department of Public Safety - Crime Records Service by
clicking on that link.
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