Code of Massachusetts Regulations › 243 CMR - BOARD OF REGISTRATION IN MEDICINE › Title 243 CMR 2.00 - Licensing and the practice of medicine › Part 1 - LICENSING › Section 2.03 - Initial License for Graduates of International Medical Schools and Graduates of Fifth Pathway Programs

Current through Register 1525, July 5, 2024
(1)
Full
				License
. The Board shall determine whether an applicant is
				qualified, competent and of good moral character to hold a full active license to
				practice medicine. In order to qualify for a full active medical license as that
				term is defined in M.G.L. c. 112, § 2, and
				243 CMR 2.00, a graduate of an
				international medical school or a graduate of a Fifth Pathway program shall meet
				the prerequisites for licensure as set forth in
				243
				CMR 2.02(1), except as
				otherwise provided, and the standards in 243 CMR 2.03(1)(a) through (e), in
				addition to the standards imposed by M.G.L. c. 112, § 2, and
				243 CMR 2.00:
(a)
Medical Education
.
				Each applicant for a full license shall have received a degree of doctor of
				medicine, or its equivalent from a program determined by the Board to be
				substantially equivalent to the medical school programs accredited by the LCME,
				or the degree of doctor of osteopathy or its equivalent from a program determined
				by the Board to be substantially equivalent to the osteopathic school programs
				accredited by the AOA.
(b)
Substantial Equivalency of Medical Education
. In order
				to be considered substantially equivalent, such medical education shall include:
1. Two academic years of basic science study,
				including:
a. gross anatomy;
b. biochemistry;
c. pathology;
d. physiology;
e. microbiology;
f. immunology; and
g. pharmacology.
2. Two academic years of clinical study
				including:
a. internal medicine;
b. surgery;
c. pediatrics;
d. obstetrics and gynecology;
e. public health and preventive medicine;
				and
f. psychiatry.
3.
Clinical
				Training
. The Board must also be satisfied that all clinical
				training is substantially equivalent to the minimum standards required of United
				States medical school graduates. The applicant shall submit documentation
				satisfactory to the Board that all clinical study was done:
a. Under the direct control and approval of the
				medical school and under on-site supervision and evaluation by the faculty of the
				medical school in which the applicant was enrolled at the time of study, and in
				hospitals which have, in the Board's opinion, programs equivalent to ACGME or AOA
				approved programs in the area of clinical study;
b. Clinical study done in the United States
				shall be in hospitals which have ACGME or AOA approved programs in the area of
				the clinical study. Clinical study done in Canada shall be in hospitals which
				have accredited Canadian postgraduate medical training programs. Supervising
				clinical faculty shall be physicians who are fully licensed by the jurisdiction
				where such study is done.
4. Board staff may request additional
				documentation during the licensure process which may include, but is not limited
				to:
a. A formal evaluation by the faculty of the
				clinical clerkship;
b. A formal
				written agreement between the medical school and the place of clinical study;
				or
c. A course catalog.
5. The Board, in its discretion, may
				determine that any college of medicine that had its accreditation withdrawn by a
				national or regional accreditation organization; or had its authorization,
				certification or licensure revoked or withdrawn by a national governmental
				supervisory agency; or issued a medical degree based entirely on coursework via
				the Internet or via online programs, is inconsistent with quality medical
				education. Such a program of education will not be an approved college of
				medicine for the purpose of fulfilling the medical education requirement of
				243
				CMR 2.02(1).
(c)
ECFMG
				Certificate
. A candidate for licensure shall possess an ECFMG
				certificate which is valid on its face and valid as of the date of licensure.
				Pursuant to M.G.L. c. 112, § 2, an ECFMG certificate is not required for
				graduates of Fifth Pathway programs.
(d)
Postgraduate Medical
				Education
. Each applicant for a full license must have
				satisfactorily completed at least two years of post graduate medical training in
				an ACGME or AOA approved or accredited Canadian program. Effective January 1,
				2014, each applicant for a full license must have satisfactorily completed at
				least three years of post graduate medical training in an ACGME or AOA approved
				or accredited Canadian program. However, in the case of subspecialty clinical
				fellowship programs, the Board may accept post graduate training in a hospital
				that has an ACGME or AOA or accredited Canadian post graduate medical training
				program in the parent specialty.
1. The Board
				may, in its discretion, accept teaching experience as post graduate training,
				when it consists of a faculty appointment at or above the assistant professor
				level at a medical school accredited by the LCME, if the majority of the teaching
				experience documented is clinical teaching with supporting evidence of either
				special honors or awards which the applicant has achieved or articles the
				applicant has published in reputable medical journals or medical textbooks. With
				the same supporting evidence, the Board may accept teaching experience at the
				instructor level with the following consideration: There is a presumption against
				accepting instructor level teaching experience when combined with a waiver
				request for any other section of 243 CMR 2.03. The Board, in its discretion, may
				overcome this presumption only in extraordinary circumstances.
2. In its discretion, the Board may consider
				for licensure an applicant who has completed two years of ACGME or AOA approved
				or accredited Canadian postgraduate training and who:
a. Holds a current, active, unrestricted
				medical license in another state; and
b. Demonstrates continuous clinical activity;
				and
c. Is board certified by either
				ABMS or AOA.
(e)
Waiver of Substantial
				Equivalency
. In situations where an applicant cannot comply with 243
				CMR 2.03 requiring substantial equivalency of medical school education, the
				applicant must submit a waiver request pursuant to 243 CMR 2.03. In order for the
				Board to grant such a waiver request, the Board must determine that the licensure
				of this applicant would not impair the public health, safety and welfare, and
				that the applicant meets the standards of M.G.L. c. 112, §§ 2 through
				9B. It is the applicant's responsibility to demonstrate he or she is qualified
				under these standards. The assessment and determination of the applicant's
				equivalency of complete medical education will include, but not be limited to,
				the following factors:
1. Applicant must be
				qualified, competent and of good moral character;
2. Applicant must have held an unlimited,
				unrestricted medical license in a state or states for a period of two years. Any
				time spent by the applicant in postgraduate training or clinical fellowship shall
				not be included in the calculation of this two-year requirement;
3. Applicant must have satisfactorily completed
				postgraduate training in an ACGME or AOA approved postgraduate training
				program;
4. Applicant must have
				American Specialty Board certification by the ABMS or AOA; and
5. Applicant must have successfully completed
				all three Steps of the USMLE or all three Levels of the COMLEX examination within
				a seven year period. The seven-year period begins on passing the first Step or
				Level of the examination.
(f)
Waiver of Any 243 CMR 2.03
				Requirement
. An applicant for a full license pursuant to 243 CMR
				2.03 may make a written request to the Board for a waiver of any requirement of
				243 CMR 2.03. The Board, in its discretion, may grant the waiver as requested, or
				with modifications thereof, upon finding:
a. The
				applicant meets the standards of M.G.L. c. 112, §§ 2 through 9B;
				and
b. Such a waiver would promote
				the public health, safety or welfare.