(a) As used in this section,
(1) "specialty board" means a board or
association which certifies physicians in a specialty or subspecialty area of
medicine.
(2) "Specialty or
subspecialty area of medicine" means a distinct and well-defined field of
medical practice. It includes special concern with diagnostic and therapeutic
modalities of patients' health problems, or it may concern health problems
according to age, sex, organ system, body region, or the interaction between
patients and their environment. A medical specialty promotes the standards of
practice within its specialty association.
(b) If a physician advertises that he or she
is certified by a specialty board or association in a specialty or subspecialty
area of medicine and that specialty board or association is not a member board
of the American Board of Medical Specialties (ABMS) or does not have a
postgraduate training program approved by the Accreditation Council for
Graduate Medical Education (ACGME) or the Royal College of Physicians and
Surgeons of Canada (RCPSC), then the specialty board or association shall be
approved by the Division of Licensing and shall comply with all of the
following requirements:
(1) The primary
purpose of the specialty board shall be certification in a medical specialty or
subspecialty. The specialty board shall encompass the broad areas of the
specialty or subspecialty.
(2) The
specialty board shall not restrict itself to a single modality or treatment
which may be part of a broader specialty or subspecialty.
(3) If the specialty board certifies
professionals other than physicians, the specialty board shall not represent
either that (i) the criteria set forth in these regulations or (ii) the medical
board's approval of the specialty board's certification program is applicable
to nonphysicians.
(4) The specialty
board shall be a nonprofit corporation or association, and it shall have at
least a total of 100 members located in at least one-third of the states who
shall possess a clear and unrestricted license to practice medicine.
(5) The specialty board shall have articles
of incorporation, a constitution, or a charter and bylaws which describe its
operation. The bylaws shall:
(A) provide for
an independent and stable governing body with staggered, limited terms of not
more than six years that is internally-appointed or selected by the
members.
(B) set forth the
requirements and policies for certification by the specialty board.
(C) require that the specialty board promote
the public interest by contributing to improvement of medicine by establishing
requirements and evaluating applicants who apply.
(D) require that the specialty board
determine whether applicants have received adequate preparation in accord with
standards established by the specialty board.
(E) require evidence that applicants have
acquired capability in a specialty or subspecialty area of medicine and will
demonstrate special knowledge in that field.
(F) require that the specialty board conduct
comprehensive evaluations of the knowledge and experience of
applicants.
(6) The
specialty board shall have standards for determining that those who are
certified possess the knowledge and skills essential to provide competent care
in the designated specialty or subspecialty area.
(7) More than 80 percent of the specialty
board's revenue for continuing operations shall be from certification and
examination fees, membership fees and interest and investment income.
(8)
(A)
Except as provided in subparagraph (B) or (C) of this paragraph (8), the
specialty board shall require all applicants who are seeking certification to
have satisfactorily completed a postgraduate training program accredited by the
ACGME or the RCPSC that includes identifiable training in the specialty or
subspecialty area of medicine in which the physician is seeking certification.
This identifiable training shall be deemed acceptable unless determined by the
Division of Licensing to be either (1) inadequate in scope, content and
duration in that speciality or subspecialty area of medicine in order to
protect the public health and safety or (2) not equivalent in scope and content
to the residency training required for board certification by any related ABMS
board for the specific conditions, disease processes and surgical procedures
within the scope of the applicant certifying board's examination and
certification.
(B) If the training
required of applicants seeking certification by the specialty board is other
than ACGME or RCPSC accredited postgraduate training, then the specialty board
shall have training standards that include identifiable training in the
specialty or subspecialty area of medicine in which the physician is seeking
certification and that have been determined by the Division of Licensing to be
equivalent in scope, content and duration to those of an ACGME or RCPSC
accredited program in a related specialty or subspecialty area of medicine.
This training shall be evaluated by the Division of Licensing to ensure that
its scope, content and duration are equivalent to those of an ACGME or RCPSC
accredited program and are adequate for training in that specialty or
subspecialty area of medicine in order to protect the public health and
safety.
(C) In lieu of the
postgraduate training required under subparagraph (A) or (B) of this paragraph
(8), the specialty board shall require applicants seeking certification to have
completed (1) a minimum of six years of full time teaching and/or practice in
the specialty or subspecialty area of medicine in which the physician is
seeking certification and (2) a minimum of 300 hours of continuing medical
education in the specialty or subspecialty area of medicine in which the
physician is seeking certification which is approved under Section
1337 and
1337.5 of these regulations. Any
teaching experience acceptable under this subparagraph shall have been in a
postgraduate training program accredited by the ACGME or RCPSC or that meets
the standards set forth in subparagraph (B) that includes identifiable training
in the specialty or subspecialty area of medicine to be certified. This
training shall be evaluated by the Division of Licensing and determined to be
equivalent in scope, content, and duration to those of an ACGME or RCPSC
accredited program in a related specialty or subspecialty area of medicine and
to be adequate for training in that specialty or subspecialty area of medicine
in order to protect the public health and safety. Teaching or practice
experience accepted under this subparagraph shall be evaluated by and
acceptable to the credentials committee of the specialty board pursuant to
standards that are (1) specified in the bylaws of the specialty board and (2)
approved by the Division of Licensing in accordance with criteria set forth in
these regulations.
Physicians applying for certification who qualify under
this subparagraph shall be required by the specialty board to have
satisfactorily completed an ACGME or RCPSC accredited residency training
program. This residency shall have provided training in the conditions and
disease processes that are included in the new specialty.
Physicians who are certified by specialty boards under this
subparagraph which are incorporated, or organized as an association on the
effective date of these regulations, may advertise their board certification
for three years from the effective date of these regulations. During that time,
the specialty board shall demonstrate to the satisfaction of the Division of
Licensing that there is in existence one or more postgraduate training programs
that include identifiable training in the specialty or subspecialty area of
medicine to be certified that meet the requirements of subparagraph (A) or (B)
of this paragraph (8); then the specialty board's approval shall be permanent
unless withdrawn under subsection (c). This training shall be evaluated by the
Division of Licensing and determined to be equivalent in scope, content, and
duration to those of an ACGME or RCPSC accredited program in a related
specialty or subspecialty area of medicine and to be adequate for training in
that specialty or subspecialty area of medicine in order to protect the public
health and safety. If a specialty board cannot demonstrate its equivalency to
ABMS boards in the three years following the effective date of these
regulations, its members may not thereafter advertise certification by that
board. This period may be extended for a year if the Division of Licensing
determines that the specialty board is making a good faith effort towards
achieving equivalency to ABMS boards.
Physicians who are certified by specialty boards under this
subparagraph which are incorporated, or organized as an association after the
effective date of these regulations, may not advertise their certification
until the specialty board is determined by the Division of Licensing to be
equivalent to ABMS boards. The specialty board shall demonstrate to the
satisfaction of the Division of Licensing that there is in existence one or
more postgraduate training programs that include identifiable training in the
specialty or subspecialty area of medicine to be certified that meet the
requirements of subparagraph (A) or (B) of this paragraph (8). This training
shall be evaluated by the Division of Licensing and determined to be equivalent
in scope, content, and duration to those of an ACGME or RCPSC accredited
program in a related specialty or subspecialty area of medicine and to be
adequate for training in that specialty or subspecialty area of medicine in
order to protect the public health and safety.
(9) Except as provided in subparagraph (8)(C)
above, at the time of application for approval to the Division of Licensing, a
specialty board shall demonstrate that one or more postgraduate training
programs are in existence and that these programs provide identifiable training
in the specialty or subspecialty area of medicine in which physicians are
seeking certification. This training shall be evaluated by the Division of
Licensing and determined to be equivalent in scope, content and duration to
those of an ACGME or RCPSC accredited program in a related specialty or
subspecialty area of medicine and to be adequate for training in that specialty
or subspecialty area of medicine in order to protect the public health and
safety.
The specialty board shall submit a plan that (A) estimates
the number of physicians to be certified through subsection (b)(8)(C), above;
(B) specifies the number and location of post graduate training programs
developed and to be developed; the number of trainees completing the training
annually; (C) demonstrates the equivalency of those programs, as provided for
in subsection (b)(8)(B), above; (D) provides for monitoring to evaluate the
quality of existing programs; and (E) allows for upgrading of the parameters of
the specialty or subspecialty area of medicine to accommodate new
developments.
Every year the specialty board shall report to the Division
of Licensing its progress in implementing the plan for postgraduate training
programs in the specialty or subspecialty area of medicine in which physicians
are seeking certification. Failure to so report shall be grounds for withdrawal
of approval by the division. Failure of a specialty board to establish to the
satisfaction of the division that it is in compliance with its plan, as stated
in its original submission to the division, shall be grounds for withdrawal of
the division's approval of the specialty board. Failure of a specialty board to
provide evidence that the postgraduate training programs are equivalent in
scope, content and duration to those of ACGME or RCPSC accredited programs
shall be grounds for withdrawal of the approval.
(10) The specialty board shall require all
physicians who are seeking certification to successfully pass a written or an
oral examination or both which tests the applicants' knowledge and skills in
the specialty or subspecialty area of medicine. All or part of the examinations
may be delegated to a testing organization. All examinations shall be subject
to a psychometric evaluation. The examinations shall be a minimum of sixteen
(16) hours in length. Those specialty boards which require as a prerequisite
for certification, prior passage of an ABMS examination in a related specialty
or subspecialty area, may grant up to eight hours credit for the ABMS
qualifying board examination toward the sixteen (16) hour testing
requirement.
(11) The specialty
board shall issue certificates to those physicians who are found qualified
under the stated requirements of the specialty board.
(12) The specialty board shall assist in
maintaining and elevating the standards of graduate medical education and
facilities for specialty training in medicine in collaboration with other
concerned organizations and agencies, and have a mechanism for assisting
accrediting agencies in the evaluation of training
programs.
(c)
(1) Upon request the Division of Licensing
will approve a specialty board if it meets the criteria set forth in these
regulations. The division may withdraw the approval of a specialty board if the
division finds that it fails to meet the criteria set forth in these
regulations.
(2) Within 30 working
days of receipt of an application for specialty board approval, the division
shall inform the applicant in writing that it is either complete and accepted
for filing and referral to a medical consultant selected by the division or
that it is deficient and what specific information or documentation is required
to complete the application.
(3)
Within 918 calendar days from the date of filing of a completed application,
the division shall inform the applicant in writing of its decision regarding
the applicant's approval as a specialty board.
(4) The division's time periods for
processing an application from the receipt of the initial application to the
final decision regarding approval or disapproval based on the division's actual
performance during the two years preceding the proposal of this section were as
follows:
(A) Minimum - 646 days.
(B) Median - 714 days.
(C) Maximum - 918
days.
