North Carolina Administrative Code › Title 21 - OCCUPATIONAL LICENSING BOARDS AND COMMISSIONS › Chapter 32 - NORTH CAROLINA MEDICAL BOARD › Subchapter B - LICENSE TO PRACTICE MEDICINE › Section .1500 - FACULTY LICENSE › Section 32B .1502 - APPLICATION FOR MEDICAL SCHOOL FACULTY LICENSE

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The Medical
				  School Faculty License is limited to physicians who have expertise that can be
				  used to help educate North Carolina medical students, post-graduate residents,
				  and fellows but who do not meet the requirements for physician
				  licensure.
(b) In order to obtain a
				  Medical School Faculty License, an applicant shall:
(1) submit a completed application, attesting
				  under oath or affirmation that the information on the application is true and
				  complete, and authorizing the release to the Board of all information
				  pertaining to the application;
(2)
				  submit the Board's form, signed by the Dean or the Dean's appointed
				  representative, stating that the applicant has received a full-time paid
				  appointment as either an instructor, lecturer, assistant professor, associate
				  professor, or full professor at a medical school in the state of North
				  Carolina;
(3) submit documentation
				  of a legal name change, if applicable;
(4) submit a photograph, two inches by two
				  inches, affixed to the oath or affirmation that has been attested to by a
				  notary public;
(5) submit proof on
				  the Board's Medical Education Certification form that the applicant has
				  completed at least 130 weeks of medical education. However, the Board shall
				  waive the 130-week requirement if the applicant has been certified or
				  recertified by an ABMS, FRCP, or FRCS approved specialty board within the past
				  10 years;
(6) supply a certified
				  copy of applicant's birth certificate or a certified copy of a valid and
				  unexpired U.S. passport if the applicant was born in the U.S. If the applicant
				  does not possess proof of U.S. citizenship, the applicant must provide
				  information about applicant's immigration and work status which the Board will
				  use to verify applicant's lawful presence in the U.S.;
(7) submit proof of satisfactory completion
				  of at least one year of GME approved by ACGME, CFPC, RCPSC, or AOA; or evidence
				  of other education, training or experience, determined by the Board to be
				  equivalent;
(8) submit reports from
				  all medical or osteopathic boards from which the applicant has ever held a
				  medical or osteopathic license, stating the status of the applicant's license
				  and whether or not any action has been taken against the license;
(9) submit an AMA Physician Profile; and, if
				  applicant is an osteopathic physician, also submit an AOA Physician
				  Profile;
(10) submit a NPDB report
				  dated within 60 days of applicant's oath;
(11) submit a FSMB Board Action Data Bank
				  report;
(12) submit two completed
				  fingerprint record cards supplied by the Board;
(13) submit a signed consent form allowing a
				  search of local, state, and national files to disclose any criminal
				  record;
(14) provide two original
				  reference letters from persons with no family or marital relationship to the
				  applicant. These letters must be:
(A) from
				  physicians who have observed the applicant's work in a clinical environment
				  within the past three years;
(B) on
				  forms supplied by the Board;
(C)
				  dated within six months of the applicant's oath; and
(D) bearing the original signature of the
				  writer;
(15) pay to the
				  Board a non-refundable fee pursuant to
				  G.S.
				  90-13.1(a), plus the cost of
				  a criminal background check; and
(16) upon request, supply any additional
				  information the Board deems necessary to evaluate the applicant's competence
				  and character.