West Virginia Code of State Rules › Agency 11 - Medicine › Title 11 - LEGISLATIVE RULE WEST VIRGINIA BOARD OF MEDICINE › Series 11-01A - Licensing of Physicians and Podiatric Physicians and Disciplinary Procedures for Applicants, Licensees, Credential Holders › Section 11-1A-6 - Qualification and Application for a License to Practice Podiatric Medicine and Surgery

Current through Register Vol. XLI, No. 28, July 12, 2024
6.1. Minimum
				qualifications for initial licensure as a podiatric physician and surgeon are
				set forth in West Virginia Code §
									30-3-10(d).
6.2. An application for a license to practice
				podiatric medicine and surgery for an applicant seeking initial licensure, or
				licensure by endorsement pursuant to West Virginia Code §
									30-3-11(a), shall
				be completed on a Board-approved application.
6.3. A completed application is considered by
				the Board at regular Board meetings. The Board will not consider an application
				until the complete application, including all third-party documentation and/or
				verification, is on file with the Board and the Board has had at least fifteen
				days to review the application.
6.4. An application for licensure must be
				accompanied by payment of a nonrefundable application fee in an amount
				established by 11 CSR 4.
6.5. An
				applicant must provide the following information:
6.5.a. The applicant's name, e-mail address,
				home address, preferred mailing address and primary practice location
				address(es) and telephone numbers;
6.5.b. Demographic information of the
				applicant, such as date of birth, place of birth, sex, etc.;
6.5.c. A photograph taken within the previous
				twelve months which substantially resembles the applicant;
6.5.d. Evidence of graduation and receipt of
				the degree of doctor of podiatric medicine or its equivalent from a school of
				podiatric medicine which is approved by the Council of Podiatric Education or
				by the board;
6.5.e. Information as
				determined by the Board which relates to whether the applicant is mentally and
				physically able to engage safely in the practice of podiatric medicine and
				surgery;
6.5.f. Evidence of
				completion of:
6.5.f.1. One year of graduate
				clinical training in a program approved by the CPME or the CPM; or
6.5.f.2. Two years of graduate podiatric
				clinical training in the U.S. armed forces; or
6.5.f.3. Three years of private podiatric
				clinical experience satisfactory to the Board;
6.5.g. A list of, and requested information
				regarding, training programs, including postgraduate training, in which the
				applicant ever participated;
6.5.h.
				A list of jurisdictions in which the applicant has applied for licensure, the
				disposition of such applications, and a list of all licenses the applicant
				holds or has ever held and the current status of each license;
6.5.i. A copy of the individual's birth
				certificate, certificate of naturalization, or passport to be used in
				identifying the applicant and the appropriate spelling of his or her
				name;
6.5.j. A copy of legal
				documentation satisfactory to the Board which verifies any name
				change;
6.5.k. A criminal history
				record check as set forth in section 8;
6.5.l. Evidence that the applicant has
				received passing scores on all required examinations as set forth in section 7
				of this rule;
6.5.m. A report from
				the National Practitioner Data Bank; and
6.5.n. Other documents as may be required by
				the Board to evaluate the qualifications and fitness of an applicant to
				practice podiatric medicine and surgery in West Virginia.