MEDICAL EDUCATION
Testing the limits TMA evaluates new policy on medical licensing tests
BY AMY LYNN SORREL Three tests, three chances per test, and a total of seven years. Those are the general rules and time- frames physicians must follow in passing the necessary exams to get licensed to practice medicine in Texas, most commonly the U.S. Medical Licensing Examination (USMLE). Almost every legislative session, state lawmakers intro-
duce a handful of bills to expand those limits, most of which fail. And almost every legislative session, lawmakers call upon the Texas Medical Association for ad- vice on how they should weigh in on the legislation, which TMA typically shies away from. The problem? The bills tend to be crafted around solving the needs of a single physician who can’t meet current licensure laws, instead of solving Texas’ overall need for a qualified physician workforce, says Temple oncologist Christian T. Cable, MD, a mem- ber of TMA’s Council on Medical Education and director of the hematology/oncology fellowship at Baylor Scott & White Health. Three such bills surfaced in 2013 alone; one of them passed. The other problem? “TMA
Young said. The council recognizes that no test is perfect. Still,
“while the USMLE is one measure of knowledge achievement, it is not designed to figure out who are the best doctors; it’s designed to establish a minimum threshold of knowledge. We need doctors, and we want people to pass this test. But we have to make sure they have adequate knowledge and can demonstrate it in some way.”
“If the legislature is in session, there are going to be
efforts to amend these testing limits. … What we want is to have a
doesn’t have current policy on it,” adds council member Rodney B. Young, MD, a family physician and chair of the Department of Family and Community Medicine at Tex- as Tech University Health Sciences Center in Amarillo. “If the legislature is in session, there are going to be efforts to amend these [testing limits]. And since this is a problem that won’t go away until those seeking to amend the law are satisfied, we are always going to be asked for our opinion.” That is why the council is evaluating whether to recom- mend new policy for the TMA House of Delegates to consider in May. “What we want is to have a stable standard in place,” Dr.
stable standard in place.”
Seeking a stable standard Texas law generally gives physi- cians three chances to pass each of the three steps of the USMLE to get licensed, and they have seven years to do it. A few exceptions apply. For example, the time limit is extended to 10 years for phy- sicians who are specialty board- certified, and doctors pursuing an additional PhD degree are given an extra two years to pass. More details on state licen-
sure requirements is available on the TMA website at http://bit .ly/1fhOTZv. Over the years, the Texas Legis-
lature attempted to carve out ad- ditional exceptions to Texas’ licen- sure law. In 2013, Senate Bill 580 would have raised the attempt limit to five for each level of the licensing exam, with a cap of nine attempts for the entire exam. Sen- ate Bill 1744 and its companion,
House Bill 1482, would have increased that attempt limit to five for applicants who are licensed and in good standing for at least five years in another state, and board certified, and who commit to practice for three years in an underserved area. The bills, which mimicked similar carve-outs from past legislative sessions, did not pass.
Senate Bill 949, on the other hand, cleared the 2013 Leg-
islature. The law gives out-of-state physicians willing to prac- tice in an underserved area in Texas more time to pass the li-
February 2014 TEXAS MEDICINE 27
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