653—9.3(147,148) Eligibility for licensure.
	9.3(1) Requirements. To be eligible for permanent or administrative medicine licensure, an applicant shall meet all of the following requirements:
	a. 	Fulfill the application requirements specified in rule 653—9.4(147,148).
	b. 	Hold a medical degree from an educational institution approved by the board at the time the applicant graduated and was awarded the degree.
	(1)	Educational institutions approved by the board shall be fully accredited by an accrediting agency recognized by the board as schools of instruction in medicine and surgery or osteopathic medicine and surgery and empowered to grant academic degrees in medicine.
	(2)	The accrediting bodies currently recognized by the board are:
	1.	LCME for the educational institutions granting degrees in medicine and surgery; and
	2.	AOA for educational institutions granting degrees in osteopathic medicine and surgery.
	(3)	If the applicant holds a medical degree from an educational institution not approved by the board at the time the applicant graduated and was awarded the degree, the applicant shall meet one of the following requirements:
	1.	Hold a valid certificate issued by ECFMG;
	2.	Pass the MCCEE;
	3.	Have successfully completed a fifth pathway program established in accordance with AMA criteria;
	4.	Have successfully passed either a basic science examination administered by a United States or Canadian medical licensing authority or SPEX; and have successfully completed three years of resident training in a program approved by the board; and have submitted evidence of five years of active practice without restriction as a licensee of any United States or Canadian jurisdiction; or
	5.	Have successfully passed either a basic science examination administered by a United States or Canadian medical licensing authority or SPEX; and hold board certification by a specialty board approved by ABMS or AOA; and submit evidence of five years of active practice without restriction as a licensee of any United States or Canadian jurisdiction.
	c. 	Have successfully completed one year of resident training in a hospital-affiliated program approved by the board at the time the applicant was enrolled in the program. An applicant who is a graduate of an international medical school shall have successfully completed 24 months of such training.
	(1)	For those required to have 12 months of training, the program shall have been 12 months of progressive training in not more than two specialties and in not more than two programs approved for resident training by the board. For those required to have 24 months of training, the program shall have been 24 continuous months of progressive training in not more than two specialties and in not more than two programs approved for resident training by the board.
	(2)	Resident training approved by the board shall be accredited by an accrediting agency recognized by the board for the purpose of accrediting resident training programs.
	(3)	The board approves resident training programs accredited by:
	1.	ACGME;
	2.	AOA;
	3.	RCPSC; and
	4.	CFPC.
	(4)	The board may accept resident training that is not accredited as specified in subparagraph 9.3(1)“c”(3) on a case-by-case basis. In making this determination, the board may consider any relevant factors, including but not limited to the following:
	1.	The length of time the program has been in existence;
	2.	The location of the program;
	3.	The institution or organization that administers the program;
	4.	The reason that the program is not accredited; and
	5.	Whether the program is accredited or recognized by any agency other than those listed in subparagraph 9.3(1)“c”(3).
	(5)	The board shall accept each 12 months of practice as a special licensee as equivalent to one year of resident training in a hospital-affiliated program approved by the board.
	(6)	The board may accept a current, active ABMS or AOA board certification obtained through an alternate pathway as equivalent to resident training in a hospital-affiliated program approved by the board. The alternate pathway must be a minimum of 24 months completed at an institution with a program approved by the board as specified in subparagraph 9.3(1)“c”(3).
	d. 	Pass one of the licensure examinations or combinations as prescribed in rule 653—9.7(147,148).
	9.3(2) Exceptions to the eligibility requirements.
	a. 	A military service applicant or a veteran may apply for credit for verified military education, training, or service toward any experience or educational requirement for permanent licensure under this subrule or may be eligible for permanent licensure through reciprocity as specified in 653—Chapter 18.
	b. 	A physician who holds a valid Letter of Qualification asserting eligibility for licensure through the IMLC is eligible for a permanent Iowa medical license.
	9.3(3) Use of criminal convictions in eligibility determinations and initial licensing decisions.
	a. 	Definitions.
“Complete criminal record” includes the complaint and judgment of conviction for each offense of which the applicant has been convicted, regardless of whether the offense is classified as a felony or a misdemeanor, and regardless of the jurisdiction in which the offense occurred.
“Conviction” means a finding, plea, or verdict of guilt made or returned in a criminal proceeding, even if the adjudication of guilt is deferred, withheld, or not entered. “Conviction” includes Alford pleas and pleas of nolo contendere.
“Disqualifying offense” means a conviction directly related to the duties and responsibilities of the profession. A conviction is directly related to the duties and responsibilities of the profession if either (1) the actions taken in furtherance of an offense are actions customarily performed within the scope of practice of a licensed profession, or (2) the circumstances under which an offense was committed are circumstances customary to a licensed profession.
	b. 	License application. Unless an applicant for licensure petitions the board for an eligibility determination pursuant to paragraph 9.3(3)“c,” the applicant’s convictions will be reviewed when the board receives a completed license application.
	(1)	An applicant must disclose all convictions on a license application. Failure to disclose all convictions is grounds for license denial or disciplinary action following license issuance.
	(2)	An applicant with one or more convictions shall submit the complete criminal record for each conviction and a personal statement regarding whether each conviction directly relates to the practice of the profession in order for the license application to be considered complete.
	(3)	An applicant must submit as part of the license application all evidence of rehabilitation that the applicant wishes to be considered by the board.
	(4)	The board may deny a license if the applicant has a disqualifying offense unless the applicant demonstrates by clear and convincing evidence that the applicant is rehabilitated pursuant to Iowa Code section 272C.15.
	(5)	An applicant with one or more disqualifying offenses who has been found rehabilitated must still satisfy all other requirements for licensure.
	(6)	Any application fees paid will not be refunded if the license is denied.
	c. 	Eligibility determination.
	(1)	An individual who has not yet submitted a completed license application may petition the board for a determination of whether one or more of the individual’s convictions are disqualifying offenses that would render the individual ineligible for licensure. An individual with a conviction is not required to petition the board for an eligibility determination prior to applying for licensure.
	(2)	To petition the board for an eligibility determination of whether one or more of the petitioner’s convictions are disqualifying offenses, a petitioner shall submit all of the following:
	1.	A completed petition for eligibility determination form;
	2.	The complete criminal record for each of the petitioner’s convictions;
	3.	A personal statement regarding whether each conviction directly relates to the duties and responsibilities of the profession and why the board should find the petitioner rehabilitated;
	4.	All evidence of rehabilitation that the petitioner wishes to be considered by the board; and
	5.	Payment of a nonrefundable fee of $25.
	d. 	Appeal. A petitioner deemed ineligible or an applicant denied a license because of a disqualifying offense may appeal the decision in the manner and time frame set forth in the board’s written decision. A timely appeal will initiate a nondisciplinary contested case proceeding. The board’s rules governing contested case proceedings will apply unless otherwise specified in this rule. If the petitioner fails to timely appeal, the board’s written decision will become a final order.
	(1)	An administrative law judge will serve as the presiding officer of the nondisciplinary contested case proceeding, unless the board elects to serve as the presiding officer. When an administrative law judge serves as the presiding officer, the decision rendered shall be a proposed decision.
	(2)	The contested case hearing shall be closed to the public, and the board’s review of a proposed decision shall occur in closed session.
	(3)	The office of the attorney general shall represent the board’s initial ineligibility determination or license denial and shall have the burden of proof to establish that the petitioner or applicant’s convictions include at least one disqualifying offense. Upon satisfaction of this burden by a preponderance of the evidence by the office of the attorney general, the burden of proof shall shift to the petitioner or applicant to establish rehabilitation by clear and convincing evidence.
	(4)	A petitioner or applicant must appeal an ineligibility determination or license denial in order to exhaust administrative remedies. A petitioner or applicant may only seek judicial review of an ineligibility determination or license denial after the issuance of a final order following a contested case proceeding. Judicial review of the final order following a contested case proceeding shall be in accordance with Iowa Code chapter 17A.
	e. 	Future petitions or applications. If a final order determines a petitioner is ineligible, the petitioner may not submit a subsequent petition for eligibility determination or a license application prior to the date specified in the final order. If a final order denies a license application, the applicant may not submit a subsequent license application or a petition for eligibility determination prior to the date specified in the final order.
[ARC 8554B, IAB 3/10/10, effective 4/14/10; ARC 0215C, IAB 7/25/12, effective 8/29/12; ARC 2524C, IAB 5/11/16, effective 6/15/16; ARC 3587C, IAB 1/17/18, effective 2/21/18; ARC 5749C, IAB 7/14/21, effective 8/18/21; ARC 6682C, IAB 11/30/22, effective 1/4/23]