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Key: (1) language to be deleted (2) new language

  
    Laws of Minnesota 1993 

                         CHAPTER 21-H.F.No. 203 
           An act relating to occupations and professions; board 
          of medical practice; modifying requirements for 
          licensing United States, Canadian, and foreign medical 
          school graduates; providing for temporary permits; 
          providing for residency permits; adding a requirement 
          for students exempt from penalties for practicing 
          without a license; adding to licensed professionals 
          subject to reporting obligations; indemnifying board 
          members, consultants, and persons employed by the 
          board; adding registration requirements for physical 
          therapists from other states and foreign-trained 
          physical therapists; amending Minnesota Statutes 1992, 
          sections 62A.46, subdivision 7; 147.02, subdivision 1, 
          and by adding a subdivision; 147.03; 147.037, 
          subdivision 1, and by adding a subdivision; 147.09; 
          147.111, subdivision 4; 147.121, subdivision 2; and 
          148.71, subdivision 2, and by adding a subdivision; 
          proposing coding for new law in Minnesota Statutes, 
          chapter 147. 
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
    Section 1.  Minnesota Statutes 1992, section 62A.46, 
subdivision 7, is amended to read: 
    Subd. 7.  [PHYSICIAN.] "Physician" means a medical 
practitioner licensed or holding a temporary permit under 
sections 147.02, 147.03, 147.031, and 147.037, or holding a 
residency permit under section 147.0391. 
    Sec. 2.  Minnesota Statutes 1992, section 147.02, 
subdivision 1, is amended to read: 
    Subdivision 1.  [UNITED STATES OR CANADIAN MEDICAL SCHOOL 
GRADUATES.] The board shall, with the consent of six of its 
members, issue a license to practice medicine to a person who 
meets the following requirements: in paragraphs (a) to (h).  
    (a) An applicant for a license shall file a written 
application on forms provided by the board, showing to the 
board's satisfaction that the applicant is of good moral 
character and satisfies the requirements of this section.  
    (b) The applicant shall present evidence satisfactory to 
the board of being a graduate of a medical or osteopathic school 
located in the United States, its territories or Canada, and 
approved by the board based upon its faculty, curriculum, 
facilities, accreditation by a recognized national accrediting 
organization approved by the board, and other relevant data, or 
is currently enrolled in the final year of study at the school.  
    (c) The applicant must have passed an examination as 
described in paragraph (1) or (2). 
    (1) The applicant must have passed a comprehensive 
examination for initial licensure prepared and graded by the 
National Board of Medical Examiners or the Federation of State 
Medical Boards.  The board shall by rule determine what 
constitutes a passing score in the examination.  
    (2) The applicant taking the United States Medical 
Licensing Examination (USMLE) must have passed steps one, two, 
and three within a seven-year period.  This seven-year period 
begins when the applicant first passes either step one or two, 
as applicable.  The applicant must pass each of steps one, two, 
and three with passing scores as recommended by the USMLE 
program within three attempts.  The applicant taking 
combinations of Federation of State Medical Boards, National 
Board of Medical Examiners, and USMLE may be accepted only if 
the combination is approved by the board as comparable to 
existing comparable examination sequences and all examinations 
are completed prior to the year 2000.  
    (d) The applicant shall present evidence satisfactory to 
the board of the completion of one year of graduate, clinical 
medical training in a program accredited by a national 
accrediting organization approved by the board or other graduate 
training approved in advance by the board as meeting standards 
similar to those of a national accrediting organization.  
    (e) The applicant shall make arrangements with the 
executive director to appear in person before the board or its 
designated representative to show that the applicant satisfies 
the requirements of this section.  The board may establish as 
internal operating procedures the procedures or requirements for 
the applicant's personal presentation.  
    (f) The applicant shall pay a fee established by the board 
by rule.  The fee may not be refunded.  
    (g) The applicant must not be under license suspension or 
revocation by the licensing board of the state or jurisdiction 
in which the conduct that caused the suspension or revocation 
occurred.  
    (h) The applicant must not have engaged in conduct 
warranting disciplinary action against a licensee, or have been 
subject to disciplinary action other than as specified in 
paragraph (g).  If the applicant does not satisfy the 
requirements of stated in this paragraph, the board may refuse 
to issue a license unless it determines only on the applicant's 
showing that the public will be protected through issuance of a 
license with conditions and limitations the board considers 
appropriate. 
    Sec. 3.  Minnesota Statutes 1992, section 147.02, is 
amended by adding a subdivision to read: 
    Subd. 2a.  [TEMPORARY PERMIT.] The board may issue a 
temporary permit to practice medicine to a physician eligible 
for licensure under this section only if the application for 
licensure is complete, all requirements in subdivision 1 have 
been met, and a nonrefundable fee set by the board has been 
paid.  The permit remains valid only until the meeting of the 
board at which a decision is made on the physician's application 
for licensure.  
    Sec. 4.  Minnesota Statutes 1992, section 147.03, is 
amended to read: 
    147.03 [LICENSURE BY ENDORSEMENT; RECIPROCITY; TEMPORARY 
PERMIT.] 
    Subdivision 1.  [ENDORSEMENT; RECIPROCITY.] (a) The board 
may issue a license to practice medicine to any person who 
satisfies the requirements in paragraphs (b) to (f).  
    (b) The applicant shall satisfy all the requirements 
established in section 147.02, subdivision 1, paragraphs (a), 
(b), (d), (e), and (f).  
    (c) The applicant shall: 
    (1) within ten years prior to application have passed an 
examination prepared and graded by the Federation of State 
Medical Boards, the National Board of Medical Examiners, the 
United States Medical Licensing Examination program, the 
National Board of Osteopathic Examiners, or the Medical Council 
of Canada; or 
    (2) have a current license from the equivalent licensing 
agency in another state or Canada and either: 
    (i) pass the Special Purpose Examination of the Federation 
of State Medical Boards with a score of 75 or better within 
three attempts; or 
    (ii) have a current certification by a specialty board of 
the American Board of Medical Specialties, of the American 
Osteopathic Association Bureau of Professional Education, or of 
the Royal College of Physicians and Surgeons of Canada. 
    (d) The applicant shall pay a fee established by the board 
by rule.  The fee may not be refunded.  
    (e) The applicant must not be under license suspension or 
revocation by the licensing board of the state or jurisdiction 
in which the conduct that caused the suspension or revocation 
occurred. 
    (f) The applicant must not have engaged in conduct 
warranting disciplinary action against a licensee, or have been 
subject to disciplinary action in another state other than as 
specified in paragraph (e).  If an applicant does not satisfy 
the requirements stated in this paragraph, the board may issue a 
license only on the applicant's showing that the public will be 
protected through issuance of a license with conditions or 
limitations the board considers appropriate. 
    Subd. 2.  [TEMPORARY PERMIT.] The board may issue a 
temporary permit to practice medicine to a physician eligible 
for licensure under this section upon payment of only if the 
application for licensure is complete, all requirements in 
subdivision 1 have been met, and a nonrefundable fee set by the 
board has been paid.  The permit remains valid only until 
the next meeting of the board at which a decision is made on the 
physician's application for licensure. 
     Subd. 3.  [EXCEPTION.] Notwithstanding subdivision 2, the 
board may issue a temporary permit to practice medicine to an 
applicant who has not satisfied the requirements of subdivision 
1, paragraph (c), clause 2, item (i) or (ii), but has satisfied 
all other requirements for licensure under this section, and has 
paid a nonrefundable fee set by the board.  The permit remains 
valid for six months. 
    Sec. 5.  Minnesota Statutes 1992, section 147.037, 
subdivision 1, is amended to read: 
    Subdivision 1.  [REQUIREMENTS.] The board shall, with the 
consent of six of its members, issue a license to practice 
medicine to any person who satisfies the following requirements: 
in paragraphs (a) to (g). 
    (a) The applicant shall satisfy all the requirements 
established in section 147.02, subdivision 1, paragraphs (a), 
(e), (f), and (g), and (h).  
    (b) The applicant shall present evidence satisfactory to 
the board that the applicant is a graduate of a medical or 
osteopathic school approved by the board as equivalent to 
accredited United States or Canadian schools based upon its 
faculty, curriculum, facilities, accreditation, or other 
relevant data.  
    (c) The applicant shall present evidence satisfactory to 
the board that the applicant has been awarded a certificate by 
the educational council for foreign medical graduates, and the 
applicant has a working ability in the English language 
sufficient to communicate with patients and physicians and to 
engage in the practice of medicine.  
    (d) The applicant shall present evidence satisfactory to 
the board of the completion of two years of graduate, clinical 
medical training in a program located in the United States, its 
territories, or Canada and accredited by a national accrediting 
organization approved by the board or other graduate training 
approved in advance by the board as meeting standards similar to 
those of a national accrediting organization.  This requirement 
shall does not apply (1) to an applicant who is admitted as a 
permanent immigrant to the United States as a person of 
exceptional ability in the sciences or (2) to an applicant 
issued a permanent immigrant visa after October 1, 1991, as a 
person of extraordinary ability or as an outstanding professor 
or researcher provided that a person under clause (1) or (2) is 
admitted pursuant to rules of the United States Department of 
Labor and who has completed one year of the graduate, clinical 
medical training required by this paragraph. 
    (e) The applicant must:  
    (1) within ten years prior to application have passed an 
examination prepared and graded by the Federation of State 
Medical Boards, the United States Medical Licensing Examination 
program, or the Medical Council of Canada; or 
    (2) have a current license from the equivalent licensing 
agency in another state or Canada; and 
    (i) pass the Special Purpose Examination of the Federation 
of State Medical Boards with a score of 75 or better within 
three attempts; or 
    (ii) have a current certification by a specialty board of 
the American Board of Medical Specialties., of the American 
Osteopathic Association Bureau of Professional Education, or of 
the Royal College of Physicians and Surgeons of Canada. 
    (f) The applicant must not be under license suspension or 
revocation by the licensing board of the state or jurisdiction 
in which the conduct that caused the suspension or revocation 
occurred.  
    (g) The applicant must not have engaged in conduct 
warranting disciplinary action against a licensee, or have been 
subject to disciplinary action other than as specified in 
paragraph (f).  If an applicant does not satisfy the 
requirements stated in this paragraph, the board may issue a 
license only on the applicant's showing that the public will be 
protected through issuance of a license with conditions or 
limitations the board considers appropriate.  
    Sec. 6.  Minnesota Statutes 1992, section 147.037, is 
amended by adding a subdivision to read: 
    Subd. 1a.  [TEMPORARY PERMIT.] The board may issue a 
temporary permit to practice medicine to a physician eligible 
for licensure under this section only if the application for 
licensure is complete, all requirements in subdivision 1 have 
been met, and a nonrefundable fee set by the board has been 
paid.  The permit remains valid only until the meeting of the 
board at which a decision is made on the physician's application 
for licensure. 
    Sec. 7.  [147.0391] [RESIDENCY PERMIT.] 
    Subdivision 1.  [PERMIT REQUIRED.] A person must have a 
residency permit to participate in a residency program unless 
licensed by the board.  Upon issuance of a license by the board, 
the board will terminate a residency permit.  A person must have 
a license to practice medicine to practice outside of a 
residency program, except as set forth in section 147.09.  An 
applicant for a residency permit must pay a $20 nonrefundable 
fee upon initial application and upon a change in residency 
program a lesser nonrefundable fee set by the board in such 
amount that is necessary to cover administrative costs incurred 
by the board.  The applicant must also have been accepted into 
either: 
    (1) a graduate medical education program accredited by a 
national accrediting organization approved by the board; or 
    (2) other nonaccredited graduate training approved by the 
board as meeting standards comparable to those of a national 
accrediting organization. 
    The approvals required by clauses (1) and (2) must have 
been granted by the board before the applicant enrolls in the 
training. 
    Subd. 2.  [TERMINATING PARTICIPATION IN RESIDENCY PROGRAM.] 
Upon a change in residency programs, a person holding a 
residency permit must notify the board in writing no later than 
30 days after termination of participation in the residency 
program being terminated.  A separate residency permit is 
required for each residency program until licensure is obtained. 
    Subd. 3.  [REPORTING OBLIGATION.] A person holding a 
residency permit and faculty of residency programs are subject 
to the reporting obligations of section 147.111.  The intent of 
this subdivision is not to replace routine academic corrective 
action undertaken by a residency training program. 
    Sec. 8.  Minnesota Statutes 1992, section 147.09, is 
amended to read: 
    147.09 [EXEMPTIONS.] 
    Section 147.081 does not apply to, control, prevent or 
restrict the practice, service, or activities of:  
    (1) A person who is a commissioned medical officer of, a 
member of, or employed by, the armed forces of the United 
States, the United States Public Health Service, the Veterans 
Administration, any federal institution or any federal agency 
while engaged in the performance of official duties within this 
state, if the person is licensed elsewhere.  
    (2) A licensed physician from a state or country who is in 
actual consultation here.  
     (3) A licensed or registered physician who treats the 
physician's home state patients or other participating patients 
while the physicians and those patients are participating 
together in outdoor recreation in this state as defined by 
section 86A.03, subdivision 3.  A physician shall first register 
with the board on a form developed by the board for that 
purpose.  The board shall not be required to promulgate the 
contents of that form by rule.  No fee shall be charged for this 
registration.  
     (4) A student practicing under the direct supervision of a 
preceptor while the student is enrolled in and regularly 
attending a recognized medical school.  
     (5) A student who is in continuing training and performing 
the duties of an intern or resident or engaged in postgraduate 
work considered by the board to be the equivalent of an 
internship or residency in any hospital or institution approved 
for training by the board, provided the student has a residency 
permit issued by the board under section 147.0391. 
    (6) A person employed in a scientific, sanitary, or 
teaching capacity by the state university, the state department 
of education, or by any public or private school, college, or 
other bona fide educational institution, or the state department 
of health, whose duties are entirely of a public health or 
educational character, while engaged in such duties. 
    (7) Physician's assistants registered in this state.  
    (8) A doctor of osteopathy duly licensed by the state board 
of osteopathy under Minnesota Statutes 1961, sections 148.11 to 
148.16, prior to May 1, 1963, who has not been granted a license 
to practice medicine in accordance with this chapter provided 
that the doctor confines activities within the scope of the 
license. 
    (9) Any person licensed by a health related licensing 
board, as defined in section 214.01, subdivision 2, or 
registered by the commissioner of health pursuant to section 
214.13, including psychological practitioners with respect to 
the use of hypnosis; provided that the person confines 
activities within the scope of the license.  
    (10) A person who practices ritual circumcision pursuant to 
the requirements or tenets of any established religion. 
    (11) A Christian Scientist or other person who endeavors to 
prevent or cure disease or suffering exclusively by mental or 
spiritual means or by prayer. 
     (12) A physician licensed to practice medicine in another 
state who is in this state for the sole purpose of providing 
medical services at a competitive athletic event.  The physician 
may practice medicine only on participants in the athletic 
event.  A physician shall first register with the board on a 
form developed by the board for that purpose.  The board shall 
not be required to adopt the contents of the form by rule.  The 
physician shall provide evidence satisfactory to the board of a 
current unrestricted license in another state.  The board shall 
charge a fee of $50 for the registration.  
    Sec. 9.  Minnesota Statutes 1992, section 147.111, 
subdivision 4, is amended to read: 
    Subd. 4.  [LICENSED PROFESSIONALS.] A licensed health 
professional and persons holding a residency permit under 
section 147.0391, shall report to the board personal knowledge 
of any conduct which the professional person reasonably believes 
constitutes grounds for disciplinary action under sections 
147.01 to 147.22 by any physician or person holding a residency 
permit under section 147.0391, including any conduct indicating 
that the physician person may be medically incompetent, or may 
have engaged in unprofessional conduct or may be medically or 
physically unable to engage safely in the practice of medicine.  
No report shall be required if the information was obtained in 
the course of a physician-patient relationship if the patient is 
another a physician or person holding a residency permit under 
section 147.0391, and the treating physician successfully 
counsels the other physician person to limit or withdraw from 
practice to the extent required by the impairment. 
    Sec. 10.  Minnesota Statutes 1992, section 147.121, 
subdivision 2, is amended to read: 
    Subd. 2.  [INVESTIGATION; INDEMNIFICATION.] (a) Members of 
the board and, persons employed by the board or engaged in the, 
and consultants retained by the board for the purpose of 
investigation of violations and in or the preparation and 
management of charges of violations of sections 147.01 to 147.22 
on behalf of the board are immune from civil liability and 
criminal prosecution for any actions, transactions, or 
publications in the execution of, or relating to, their duties 
under sections 147.01 to 147.22.  
    (b) For purposes of this section, a member of the board or 
a consultant described in paragraph (a) is considered a state 
employee under section 3.736, subdivision 9. 
     Sec. 11.  Minnesota Statutes 1992, section 148.71, 
subdivision 2, is amended to read: 
    Subd. 2.  [TEMPORARY PERMIT.] (a) The board may, upon 
payment of a fee set by the board, issue a temporary permit to 
practice physical therapy under supervision to a physical 
therapist who is a graduate of an approved school of physical 
therapy and qualified for admission to examination for 
registration as a physical therapist.  A temporary permit to 
practice physical therapy under supervision may be issued only 
once and cannot be renewed.  It expires 90 days after the next 
examination for registration given by the board or on the date 
on which the board, after examination of the applicant, grants 
or denies the applicant a registration to practice, whichever 
occurs first.  A temporary permit expires on the first day the 
board begins its next examination for registration after the 
permit is issued if the holder does not submit to examination on 
that date.  The holder of a temporary permit to practice 
physical therapy under supervision may practice physical therapy 
as defined in section 148.65 if the entire practice is under the 
supervision of a person holding a valid registration to practice 
physical therapy in this state.  The supervision shall be 
direct, immediate, and on premises. 
    (b) A physical therapist from another state who is licensed 
or otherwise registered in good standing as a physical therapist 
by that state and meets the requirements for registration under 
section 148.72 does not require supervision to practice physical 
therapy while holding a temporary permit in this state.  The 
temporary permit remains valid only until the meeting of the 
board at which the application for registration is considered. 
    Sec. 12.  Minnesota Statutes 1992, section 148.71, is 
amended by adding a subdivision to read: 
    Subd. 3.  [FOREIGN-TRAINED PHYSICAL THERAPISTS; TEMPORARY 
PERMITS.] (a) The board of medical practice may issue a 
temporary permit to a foreign-trained physical therapist who: 
    (1) is enrolled in a supervised physical therapy 
traineeship that meets the requirements under paragraph (b); 
    (2) has completed a physical therapy education program 
equivalent to that under section 148.705 and Minnesota Rules, 
part 5601.0800, subpart 2; 
    (3) has achieved a score of at least 550 on the test of 
English as a foreign language or a score of at least 85 on the 
Minnesota battery test; and 
    (4) has paid a nonrefundable fee set by the board. 
    A foreign-trained physical therapist must have the 
temporary permit before beginning a traineeship. 
    (b) A supervised physical therapy traineeship must: 
    (1) be at least six months; 
    (2) be at a board-approved facility; 
    (3) provide a broad base of clinical experience to the 
foreign-trained physical therapist including a variety of 
physical agents, therapeutic exercises, evaluation procedures, 
and patient diagnoses; 
    (4) be supervised by a physical therapist who has at least 
three years of clinical experience and is registered under 
subdivision 1; and 
    (5) be approved by the board before the foreign-trained 
physical therapist begins the traineeship. 
    (c) A temporary permit is effective on the first day of a 
traineeship and expires 90 days after the next examination for 
registration given by the board following successful completion 
of the traineeship or on the date on which the board, after 
examination of the applicant, grants or denies the applicant a 
registration to practice, whichever occurs first. 
    (d) A foreign-trained physical therapist must successfully 
complete a traineeship to be registered as a physical therapist 
under subdivision 1.  The traineeship may be waived for a 
foreign-trained physical therapist who is licensed or otherwise 
registered in good standing in another state and has 
successfully practiced physical therapy in that state under the 
supervision of a licensed or registered physical therapist for 
at least six months at a facility that meets the requirements 
under paragraph (b), clauses (2) and (3). 
    (e) A temporary permit will not be issued to a 
foreign-trained applicant who has been issued a temporary permit 
for longer than six months in any other state. 
    Sec. 13.  [REVISOR'S INSTRUCTION.] 
    The revisor shall add "; TEMPORARY PERMIT" to the headnote 
to section 147.037. 
    Presented to the governor April 8, 1993 
    Signed by the governor April 12, 1993, 10:27 a.m.

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