Licensure by Endorsement and Temporary and Special Licensure

(a)Licensure Without Examination. The Board is authorized, at its discretion, to issue a license by endorsement to an applicant who:

(1)has complied with all current medical licensing requirements save that for examination;

(2)has passed a medical licensing examination given in English in another state, the District of Columbia, a territory or possession of the United States or Canada, provided the Board determines that examination was equivalent to its own current examination;

(3)has a valid current medical license in another state, the District of Columbia, a territory or possession of the United States or Canada; and

(4)Required to take SPEX if last examination was taken more than ten

(10)years ago.

(5)holds a valid certification issued by the Educational Commission for Foreign Medical Graduates (ECFMG) or its Board approved successor(s), or by an equivalent Board approved entity; and has passed a medical licensing examination comparable to the United States Medical Licensing Examination (USMLE), or another examination approved by the Board.

(b)Endorsement for Certified Applicants: The Board is authorized, at its discretion, to issue a license by endorsement to an applicant who:

(1)has complied with all current medical licensing requirements save that for examination; and

(2)has passed the examination of and been certified by a certifying agency recognized by the Board (e.g., the National Board of Medical Examiners or the National Board of Examiners for CH. 12 MEDICAL PRACTICES - PART I Osteopathic Physicians and Surgeons), provided the Board determines that examination was equivalent to its own current examination and was not a specialty board examination.

(3)has passed an international medical licensing examination comparable to the USMLE, as determined by the Board, and is verified by the ECFMG or its Board approved successor(s), or by an equivalent Board approved entity.

(c)Endorsement Examination: Notwithstanding any other provisions of the act, the Board is authorized to require applicants for full and unrestricted medical licensure by endorsement who have not been formally tested by a United States or Canadian medical licensing jurisdiction, a Board-approved medical certifying agency or a Board-approved medical specialty board within a specific period of time before application (e.g. eight

(8)or ten

(10)years to pass a written and/or oral medical examination approved by the Board for that purpose.)

(d)Provisional License- Foreign Medical Graduates. Notwithstanding subsections

(a)and (b), the Board may require an applicant who completed postgraduate training outside an Accreditation Council for Graduate Medical Education (ACGME)-accredited program, to complete a period of supervised provisional licensure prior to issuance of unrestricted licensure.

(1)A provisional license issued pursuant to this subsection shall be limited to practice under supervision in an approved facility;

(2)During the provisional licensure period, the applicant shall not engage in independent practice and shall practice only within the scope approved by the Board and supervising physician. The Board may impose reasonable limitations on clinical privileges, procedural authority, prescribing authority, on-call responsibilities, and other practice activities as necessary to ensure patient safety;

(3)The applicant shall submit a Board-approved supervision plan identifying the supervising physician(s), scope of practice, and evaluation schedule, a method of oversight, including frequency of review and documentation requirements;

(4)The provisional period shall not exceed twelve

(12)months, renewable once for good cause; and

(5)Conversion to unrestricted licensure shall require documented competency-based evaluations.

(6)The applicant shall demonstrate not less than three

(3)years of independent clinical practice experience in the applicant’s area of specialty, completed after the completion of postgraduate medical training. Such experience shall be verified in a manner prescribed by the Board. Experience obtained solely as a medical officer, intern, or house officer shall not satisfy this requirement unless the Board determines that such experience involved independent clinical responsibility consistent with specialty practice standards. This subsection shall not apply to applicants for, or licenses issued under, §§ 12206.2 through 12206.7.

(7)The applicant shall demonstrate active clinical practice within the five ( 5) years immediately preceding the date of application. The Board may, for good cause shown, waive or modify this requirement if the applicant demonstrates continued clinical competency through additional training, education, or assessment acceptable to the Board. This subsection shall not apply to applicants for, or licenses issued under, §§ 12206.2 through 12206.7.

(e)Temporary Licensure. The Board is authorized to establish regulations for issuance of a temporary medical license for the intervals between Board meetings. Such a license should:

(1)be granted only to an applicant demonstrably qualified for a full and unrestricted medical license under the requirements set by the Medical Practice Act and the regulations of the Board; and CH. 12 MEDICAL PRACTICES - PART I

(2)automatically terminate on the date of the next Board meeting at which the holder could be considered for a full and unrestricted medical license.

(f)Special Purpose License to Practice Medicine Across Guam/State Lines. The Board is authorized, at its discretion, to issue a special purpose license to practice medicine across Guam lines to an applicant who:

(1)holds a full and unrestricted license to practice in at least one

(1)other state or United States jurisdiction;

(2)has not had previous disciplinary or other action taken against him or her by any state or jurisdiction; and

(3)must be at least qualified to be licensed in Guam. Exceptions to the special purpose license to practice medicine across Guam lines include the following:

(A)the practice of medicine across state lines by a licensed physician on an irregular or infrequent basis, provided such practice occurs less than once a week or involves less than one percent (1%) of the physician’s diagnostic or therapeutic practice;

(B)the informal practice of medicine by a licensed physician is without compensation or expectation of compensation. (The practice of medicine conducted within the parameters of a contractual relationship shall not be considered informal and shall be subject to regulation by the Guam Board of Medical Examiners.);

(C)physician specialist, or field of authority is not available locally; and

(D)the practice of medicine in terms of diagnosis and treatment of a patient is under the responsibility of a locally licensed physician.

(g)Special Licensure. The Board is authorized to issue conditional, restricted or otherwise circumscribed licenses as it determines necessary.

(h)Military Limited Volunteer Medical License.

(1)A physician who practices medicine on Guam under a license issued pursuant to this Subsection may only practice at the Department of Public Health and Social Services, the Guam Memorial Hospital Authority, the Community Health Centers, or a clinic or outreach event that primarily provides services for indigent populations, and the physician shall not receive direct or indirect compensation or payment of anything of monetary value in exchange for the medical services rendered by the physician to the indigent patients.

(2)The Board is authorized to issue a Military Limited Volunteer Medical License to an applicant who:

(A)is licensed and in good standing as a physician in another state;

(B)maintains credentials within the military credentialing system and authorizes the Guambased Military Credentialing Office to provide to the Guam Board of Medical Examiners the required verification documents and military commander’s approval; and

(C)agrees to be subject to Board rules and regulations, including those regarding disciplinary action, license registration and renewal, and continuing medical education, throughout the duration of the Military Limited Volunteer Medical licensure.

(3)A Military Limited Volunteer Medical License shall be issued

(A)at no charge to the applicant, CH. 12 MEDICAL PRACTICES - PART I

(B)be valid for a period of two

(2)years, and

(C)may be renewed and maintained according to registration requirements as prescribed by the Board.

(4)The license shall be in effect upon receipt of the application packet by the Guam Board of Medical Examiners subject to final review. This presumptive eligibility for licensure is contingent upon

(A)the appropriate military commander’s authorization allowing the physician to practice in the community, and

(B)the appropriate collaborative sharing of information between the Military Credentialing Office and the Guam Board of Medical Examiners.