Getting a license to practice in the state of Texas is more complicated than in many other places. The bureaucracy behind the procedure can be somewhat of a headache and tends to scare away the weary. Stick with us to learn more about licensing with the Texas medical board
Most states follow a relatively simple set of guidelines, but Texas has a two-step licensing process that involves lots of paperwork and can take months to complete.
Knowing the steps to get a license from the Texas medical board is the first move to attaining one. It will be lengthy and complex.
But understanding the process in advance should help negate much of the frustration, especially if you’re a new doctor or a doctor new to the practice of medicine in Texas.
The key to becoming licensed by the Texas Medical Board (TMB) is to be patient, diligent, and determined.
And to follow the steps outlined below.
Table of Contents
Register with LIST
LIST is the acronym for the Licensure Inquiry System of Texas, an electronic system used by the Texas Medical Board.
It’s used for communications between the licensing staff and all physician applicants.
You’ll get your LIST username and password by email the first business day after you submit your online application. You’ll use that login every time you access LIST.
If you have a question, this is where you submit it and see what the Board needs to process your application. You can also check the progress of your application so far, and upload certain requested documents directly through the “Forms” tab.
All communication is done online and through this portal. It’s recommended that you check LIST often to make sure your license is processed as speedily as possible.
You may get impatient along the way, but you mustn’t submit the same question more than once, or call and message about the same item. This will make the process take longer.
The Texas Medical Board states that it takes 3-5 business days for a response to most questions.
Want to get your medical license in another state? Physicians Thrive answers your FAQs on how to get licensed in other states in our medical licensing library!
Submit Documentation for Pre-Licensure
The very first step is to complete the online application through the TMB website. This application comprises 23 pages of forms.
Submitting it can take you upwards of a couple of hours, so sit in a comfortable chair and be ready to fill in a lot of dates and accreditations.
If you’ve already completed the FSMB Uniform Application, you can enter your UA ID number in the TMB application to cut down on some of the repetition. It doesn’t replace the TMB application, though. You still have to fill that out.
Here’s what you can expect to include in your application:
Training and Work History
The Texas Medical Board will want to know about any post-graduate training you have and professional affiliations you’ve had within the last five years.
If you don’t have professional affiliations, they’ll want referral sources to check your professional background. You will have to fill out an evaluation form for each facility you add in the training and work history section.
They will want to know about periods of unemployment or employment outside the medical field, too.
Professional History
After a few questions about your history with the Texas Medical Board, this section will dive right into your criminal history, past disciplinary actions, and any medical malpractice history you might have.
You must answer all of these questions honestly, as they will screen you through the Texas Department of Public Safety and the FBI database.
Of course, if you do answer “yes” to any of the questions in this section, you will have to explain the circumstances and usually fill out another form.
Mental and Physical Health
This section will require that you answer questions regarding any conditions that currently affect your ability to practice medicine safely.
If you answer “yes,” you will typically have to provide documentation showing you’re being treated or monitored in a way that addresses the condition.
Educational History
In this section, you enter the school(s) that you attended, the degrees awarded, internships completed, and certifications you hold.
You will also be able to provide the results from any exams that you took such as the NBME, FLEX, USMLE, or COMLEX.
Specialty Board Certifications
The Texas Medical Board allows you to enter up to three specialty board certifications that you want to be considered in your application. You will have to provide the board certification and the year certified.
Sign and Pay
Once you are satisfied with all of the information you have provided, all there is left to do is sign the attestation stating that you agree with the terms and that all the information you provided is accurate.
Lastly, you pay the $867 licensure application fee, plus $28 in surcharges (more on that below).
This sample application can give you a more detailed look into what kind of questions will be on your Texas Medical License application.
This first stage, called Pre-Licensure/Screening, is only to ensure that you have submitted all the necessary documents. It does not guarantee that all the documents meet the requirements. Documents aren’t reviewed for content until you’re marked Screen Complete.
Help the process along by checking LIST often to see what you still need to submit.
Once you have all the documents submitted, your application will be forwarded to the Licensing stage.
See also: What It Takes to Be a Traveling Physician
Are You Eligible for a Texas Medical License?
Before you apply, you will want to ensure you’re even eligible to receive a physician license and provide patient care as a Texas physician.
No one wants to shell out $895 at submission just to be denied on something that could’ve been rectified.
To be eligible for licensure through the TMB, you will have to qualify in three different aspects: education, exams, and demonstrating competence.
Education
If you graduated from an accredited U.S. or Canadian medical school, you’ve met the education requirement.
If you went to medical school outside the U.S. or Canada, you’ll need to show one of three things: your school is on TMB’s substantial equivalence list, you hold specialty board certification through ABMS or AOA BOS, or you’ve had your education evaluated by the Foreign Credentials Service of America (FCSA) and found equivalent to a U.S. medical degree.
The substantial equivalence list is simply a list of schools whose graduates TMB has already licensed and whose education meets the Board’s standard. If your school isn’t on it, you can still apply. Your licensing analyst will tell you if an FCSA evaluation is needed. You request it with TMB’s Form N and pay for it yourself.
You’ll also need postgraduate training. U.S. and Canadian graduates need one continuous year of graduate medical training in the U.S. or Canada in an ACGME or AOA accredited program, or a Board-approved fellowship.
International graduates need two years. That can be two years of continuous, progressive accredited training, two years in a teaching faculty position under a Texas Faculty Temporary License, or a combination. Five years of practice under an unrestricted U.S. license with no disciplinary action in any state can substitute for the two years of training.
Exam
To be eligible to receive your license from the Texas Medical Board, you must meet specific exam qualifications.
You must have passed each step of your licensing exam (USMLE or COMLEX) in three or fewer attempts. There are exceptions to this limit, including for physicians who have been licensed and in good standing in another state for five years.
You must also have passed all licensing exam steps within a time frame of seven years. TMB extends this to 10 years if you’re specialty board certified by ABMS or AOA BOS, or if you’ve practiced under a Texas Faculty Temporary License for one year.
You must also pass the Texas Medical Jurisprudence (JP) Exam with a score of 75 or higher. The JP Exam can only be taken by those who have an active, pending application.
This test is to ensure that you are aware of the state rules and laws.
To study for and take the JP Exam, you need to create a My TMB account. Once your application is active, log in to access the exam and the optional study guide.
There is no limit to the number of times you can take the JP Exam, and the fee is already included in your application fee. You can retake it through My TMB as many times as needed until you pass.
The exam covers the Texas Occupations Code and Board Rules in the Texas Administrative Code. The study guide in My TMB walks through the material, and access lasts until you pass or your application expires.
If you’d rather have more structure, third-party prep courses exist. They charge a fee, but some physicians find the extra support worth it.
Demonstrate Competence to the Medical Board of Texas
Proving your competence is pretty simple for most applicants. TMB wants to see that you’ve actively practiced medicine within the three years preceding your application date.
That can mean diagnosing and treating patients, participating in postgraduate training, or serving on the active teaching faculty of a medical school.
If you don’t meet that requirement, the Executive Director may set conditions you’ll need to satisfy before a license can be issued.
Texas Medical Board Licensure Stage
After finishing pre-screening, your application will be assigned to a licensing analyst who will review all your submitted documentation.
This individual will post requests for additional items in the Lacking Reasons section of your LIST account.
The most common requests from a licensing analyst are for documentation and explanation of malpractice claims, as well as anything you answered “yes” to in the Professionalism questions.
These requests help investigate any discrepancies in your background.
Related: How to Get Your Medical License
Texas Medical Board Licensure Time Frame
The process of applying to the Texas Medical Board is time-consuming, and once you’ve sent it in, the wait can feel excruciating. It’s important to practice patience and to be ready for a little leg work.
This is the breakdown of the timetable you will be looking at from the time you begin your application to the issuance of your license:
The Pre-Screen
The length of the pre-screening process is dependent on your own efficiency in gathering all the required documentation and how long each organization takes to deliver the requested documents.
Therefore, you should expect about a month to contact all the organizations, fill out all the forms, and receive any materials through the mail.
Criminal Background Checks
Checking your criminal background is a process that usually takes six to eight weeks, depending on how busy the system is at the time of your application.
You also have to get your fingerprinting done through IdentoGO at an approved location.
Licensure Issuance
TMB is legislatively required to process physician applications within an average of 51 days. This number was taken from the tmb.texas.gov website and should be updated as it changes. The clock starts once your file leaves screening and lands with a licensing analyst, so the total from first submission is longer than that.
Applications that answer “yes” to any Professionalism questions, or that don’t follow the document instructions, take longer.
The TMB issues licenses roughly twice a month, almost always on a Friday. Your file has to be complete about a week before a licensing date to make that batch. This schedule is listed here. Expand the “Licensing Dates” section.
If you’re already licensed in another state and need to start faster, Texas participates in the Interstate Medical Licensure Compact. You’ll still owe the JP Exam and lawful presence documentation, and you must register the license within 90 days of issuance.
See also: The 3 Biggest Financial Mistakes New Doctors Make
Cost of Texas Medical Board License
As already noted, applying to become a doctor to the citizens of Texas is expensive. Not only do you have a large sum due just to apply, but there are many other fees to know about before starting the application process.
There is an application fee of $867, which includes the Jurisprudence Exam.
The following surcharges are billed with the application: $21 for the National Practitioner Data Bank plus $7 for the Texas Physician Health Program. This means you will have a total due at application submission of $895.
Those surcharges are non-refundable. The application fee itself may be refunded in limited circumstances. Military service members, spouses, and veterans can have the application fee waived, though the surcharges still apply.
Once your application is active, create your My TMB account to access the Texas Medical Jurisprudence (JP) Exam. The JP exam is taken online from My TMB. You have unlimited attempts at no additional charge and need a passing score of 75.
You’ll also complete a fingerprint background check through IdentoGO. The $39.50 fee is paid directly to the vendor. Note a possible $39.95 additional vendor fee if you use an approved out-of-state live scan site.
Other outside fees can add up too: FSMB charges for FCVS packets and exam transcripts, and international graduates who need an FCSA evaluation pay for that separately.
After TMB issues your license number, you must activate it within 90 days by paying your first registration. TMB assigns your initial term. If you’re assigned 12 months, the total is $281.48; if 24 months, it’s $467.48.
Note: There is a $75 late fee if you neglect to register your license within 90 days of the license issue date. This fee increases to $150 after 120 days.
Your license renews every two years at $491.48. Even-number licenses expire in even-number years and odd-number licenses expire in odd-number years.
Adding it up, the application, surcharges, fingerprinting, and a 12-month initial registration come to $1,215.98 before any FSMB or FCSA costs.
In Conclusion
You have done your homework, turned in all your documentation, and paid all the necessary fees.
Therefore, most of the work to earn your Texas medical license is finished on your end. Next, all you do is wait.
As long as you’re honest on your application and meet the requirements, you will become a licensed physician in the state of Texas.
With your license in hand, you can practice as an MD or DO anywhere in the state, whether that’s primary care, a hospital-based specialty, or your own private practice. In other words, you can be the physician you’ve worked so hard to become.
If you encounter any hiccups or need legal counsel along the way, Physicians Thrive advisors are always here to help.
Not sure if Texas is the state for you? Check out our article on the Best States to Practice Medicine!
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