**Exhibit 10.3**

**FIRST AMENDMENT TO THEUNITED SURGICAL PARTNERS INTERNATIONAL, INC.EMPLOYEE STOCK PURCHASE PLAN**

                THIS FIRST AMENDMENT iseffective June 7, 2001 and is made by United Surgical Partners International,Inc., a Delaware corporation (the “Corporation”).

**WITNESSETH:**

                **WHEREAS,** the Corporation sponsors the United Surgical PartnersInternational, Inc. Employee Stock Purchase Plan (the “ESPP”) for the benefitof its eligible employees;

                **WHEREAS,** pursuant to paragraph 15 of the Plan the Board ofDirectors of the Corporation (the “Board”) in its discretion shall have theright to alter or amend the ESPP or any part thereof from time to time withoutthe approval of the stockholders of the Corporation, except that the Board maynot make any alteration or amendment which would increase the aggregate numberof shares which may be purchased pursuant to the provisions of the ESPP (otherthan as a result of the anti-dilution provisions of the ESPP), change the classof individuals eligible to receive options under the ESPP, or cause options tobe delivered under the ESPP to fail to meet the requirements  for employee stock purchase plans as definedin section 423 of the Internal Revenue Code of 1986, as amended, without approvalof the stockholders of the Corporation;

                **WHEREAS,** pursuant to paragraph 6(a) of the ESPP, the initialoption period under the ESPP will begin on the effective date thereunder andend on the next following June 30 or December 31;

                **WHEREAS,** the Board believes it is in the best interests of theCorporation and the participants under the ESPP for the initial option periodunder the ESPP to begin on June 8, 2001 and end on December 31, 2001;

                **WHEREAS,** pursuant to paragraph 7(b) of the ESPP, the “FairMarket Value” of a share of common stock issued under the ESPP is defined;

                **WHEREAS,** the Board believes it is in the best interest of theCorporation and participants under the ESPP to amend the definition of FairMarket Value under the ESPP;

                **WHEREAS,** pursuant to paragraph 14 of the ESPP, the ESPP willbe effective as of the date of the consummation of a firm commitmentunderwritten public offering of the common stock of the Corporation for cash,provided that the ESPP is approved by the stockholders of the Corporationwithin twelve months of the date of adoption by the Board; and

                **WHEREAS,** the Board believes it is in the best interests of theCorporation and the participants under the ESPP to specify with particularitythe effective date of the ESPP.

                **NOW, THEREFORE,** the ESPP is hereby amended as follows;

                1.             Paragraph 6(a) is hereby amended in its entirety,effective June 7, 2001, to read as follows:

|                 6.             **Grant Of Options.**  (a) * General Statement; “Date of Grant;”  “Option;” “Date of Exercise.”*   Upon the effective date of the Plan, as provided in paragraph 14 and  continuing while the Plan remains in effect, the Company shall offer options  under the Plan to all Eligible Employees to purchase shares of Stock.  Except as otherwise determined by the  Committee and except as provided below, these options shall be granted on the  effective date of the Plan, the next subsequent January 1, and each six month  anniversary of such date (each of which dates is herein referred to as the  “Date of Grant”).  The term of each  option, except as provided below, shall begin on a Date of Grant and shall be  for a period ending on the next subsequent June 30 or December 31 (each such  six month period, or longer period in the case of the first period, shall be  referred to as an “Option Period.”)   The first day of the Option Period shall be a Date of Grant and the  last day of such Option Period shall be a “Date of Exercise.”  Notwithstanding the foregoing, the first  Date of Grant shall be June 8, 2001 and the first Date of Exercise shall be December  31, 2001.  The number of shares subject  to each Option Period shall be the quotient of the sum of the payroll  deductions withheld on behalf of each participant in accordance with  subparagraph 6(b) for the Option Period and any amount carried forward from  the preceding Option Period pursuant to subparagraph 7(a), divided by the  “Option Price” (as defined in subparagraph 7(b)) of the Stock, excluding all  fractions; provided, however, that the maximum number of shares that may be  subject to any option may not exceed 5,000 shares (subject to adjustment as  provided in paragraph 12). |
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                2.             Paragraph 7(b) is hereby amended in its entirety,effective June 7, 2001, to read as follows:

|                 (b)           *“Option Price”  defined.*  The Option Price  per share of Stock to be paid by each Optionee on each exercise of his option  shall be an amount equal to the lesser of the 85% of the Fair Market Value of  the Stock on the Date of Exercise or on the Date of Grant.  For all purposes under the Plan the “Fair  Market Value” of a share of Stock means, for a particular day, the opening  sales price on such business day as reported by the National Association of  Securities Dealers, Inc. Automated Quotations, Inc. (“NASDAQ”) National  Market System or, if no such sale takes place on that day, the opening sales  price so reported on the last business day before the date in question.  If the Board determines in good faith that  such price is not indicative of the fair value of the Stock, then the value  determined in good faith by the Committee shall be the Fair Market Value,  which determination shall be conclusive for all purposes. |
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                3.             Paragraph14 is hereby amended in its entirety, effective June 7, 2001, to read asfollows:

|                 14.           **Term of the Plan.** The effective date of the Plan shall be the  date of a firm commitment underwritten public offering of the stock for cash,  which date is June 7, 2001; provided that the Plan is approved by the  stockholders of the Company within twelve months of the date of adoption by  the Board.  Notwithstanding any provision  in the Plan, no option granted under the Plan shall be exercisable prior to  such stockholder approval, and, if the stockholders of the Company do not  approve the Plan within twelve months after its adoption by the Board, then  the Plan shall automatically terminate. |
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                **NOW, THEREFORE,** be it further provided that, except asprovided above, the ESPP shall continue to read in its current state.

                **IN WITNESS WHEREOF,** this First Amendmenthas been executed by a duly authorized officer of the Corporation as of theeffective date and effective as set forth herein.

 

|   | **UNITED SURGICAL PARTNERS  INTERNATIONAL, INC.,**a Delaware  corporation |
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|   | By:                                                                       | /s/  John J. Wellik |
|   |                                                                      |  |
|   | Name:                                                                     | John J. Wellik |
|   |                                                                      |  |
|   | Title:                                                                    | Vice  President |
|   |                                                                      |  |