653—10.4 (147,148) Special licensure.
	 10.4(1) General provisions.
	  a.   	 The board may grant a special license to a physician who is an academic staff member of a college of medicine or osteopathic medicine if that physician does not meet the qualifications for permanent licensure, but is held in high esteem for unique contributions the individual has made to medicine and will make by practicing in Iowa. The license is not designed for physicians in regular faculty positions that could be filled by a physician qualified for permanent licensure in Iowa or for the purpose of training the physician who receives the license, i.e., participating in a fellowship of any kind. The board will consider granting and renewing a special license on a case-by-case basis.
	  b.   	 A special license may be issued for a period of not more than one year and may be renewed annually prior to expiration. The number of renewals granted by the board is not limited. The renewal of any special license granted for the first time after July 1, 2001, shall be limited to those physicians who continue to meet the requirements of paragraph “a” of this subrule and subrule 10.4(5). Academic institutions are encouraged to assist special licensees in qualifying for permanent licensure if the physician is to remain in Iowa long term.
	  c.   	 A special license shall specifically limit the licensee to practice at the medical college and at any health care facility affiliated with the medical college.
	  d.   	 A special license shall automatically be placed on inactive status when the licensee discontinues service on the academic medical staff for which the special license was granted.
	  e.   	 The board may cancel a special license if the licensee has practiced outside the scope of this license or for any of the grounds for which licensure may be revoked or suspended as specified in Iowa Code sections 147.55, 148.6, and 272C.10 and 653—Chapter 23. When cancellation of such a license is proposed, the board shall promptly notify the licensee by sending a statement of charges and notice of hearing by certified mail to the last-known address of the licensee. This contested case proceeding shall be governed by the provisions of 653—Chapter 25.
	  f.   	 A special physician licensee shall notify the board of any change in home address or the address of the place of practice within one month of making an address change.
	  g.   	 A special physician licensee shall notify the board of any change in name within one month of making the name change. Notification requires a notarized copy of a marriage license or a notarized copy of court documents.
	  h.   	 A special physician licensee file shall be closed and labeled “deceased” when the board receives a copy of the physician’s death certificate.
	  i.   	 The board shall accept each 12 months of practice as a special licensee as equivalent to one year of postgraduate training in a hospital-affiliated program approved by the board for the purposes of permanent licensure.
	 10.4(2) Special license eligibility. To be eligible for a special license, an applicant shall meet all of the following requirements:
	  a.   	 Fulfill the application requirements specified in subrule 10.4(3);
	  b.   	 Be at least 21 years of age;
	  c.   	 Be a physician in a medical specialty;
	  d.   	 Present evidence of holding a medical degree from an educational institution that is located in a jurisdiction outside the United States or Canada and that is listed in the Directory of Medical Schools published by the International Medical Education Directory;
	  e.   	 Have completed at least two years of postgraduate education in any jurisdiction;
	  f.   	 Have practiced for five years after postgraduate education;
	  g.   	 Demonstrate English proficiency as set forth in subparagraph 10.4(3)“a”(4); and
	  h.   	 Be licensed in a jurisdiction outside the United States or Canada and present evidence that any licenses held in any jurisdiction are unrestricted.
	 10.4(3) Special license application.
	  a.   	 Requirements. To apply for a special license an applicant shall:
	 (1) 	 Pay a nonrefundable special license fee of $300 plus the fee identified in 653—subrule 8.4(7) for the evaluation of the fingerprint packet and the DCI and FBI criminal history background checks;
	 (2) 	 Complete and submit forms provided by the board, including required credentials, documents, a completed fingerprint packet, and a sworn statement by the applicant attesting to the truth of all information provided by the applicant;
	 (3) 	 Provide verification of successful completion of a medical degree;
	 (4) 	 Demonstrate proficiency in English by providing a valid ECFMG certificate or verification of a passing score on the TSE, the Test of Spoken English, or TOEFL, the Test of English as a Foreign Language, examinations administered by the Educational Testing Service. A passing score on TSE is a minimum of 50. A passing score on TOEFL is a minimum overall score of 550 on the paper-based TOEFL that was administered on a Friday or Saturday (formerly special or international administration), a minimum overall score of 213 on the computer-administered TOEFL, or a minimum overall score of 79 on the Internet-based examination;
	 (5) 	 Present a letter from the dean of the medical college in which the applicant will be practicing that indicates all of the following:
	  1. 	 The applicant has been invited to serve on the academic staff of the medical school and in what capacity;
	  2. 	 The applicant’s qualifications and the unique contributions the applicant has made to the practice of medicine;
	  3. 	 The unique contributions the applicant is expected to make by practicing in Iowa and how these contributions will serve the public interest of Iowans; and
	 (6) 	 Present at least two letters of recommendation from universities, other educational institutions, or research facilities that indicate the applicant’s noteworthy professional attainment.
	  b.   	 Application. The application shall request the following information:
	 (1) 	 Name, date and place of birth, home address, and mailing address;
	 (2) 	 A photograph of the applicant suitable for positive identification;
	 (3) 	 A statement listing every jurisdiction in which the applicant is or has been authorized to practice, including license numbers and dates of issuance;
	 (4) 	 A chronology accounting for all time periods from the date the applicant entered medical school to the date of the application;
	 (5) 	 A photocopy of the applicant’s medical degree issued by an educational institution and a sworn statement from an official of the educational institution certifying the date the applicant received the medical degree and acknowledging what, if any, derogatory comments exist in the institution’s record about the applicant. A complete translation of any diploma not written in English shall be submitted;
	 (6) 	 A statement disclosing and explaining any warnings issued, investigations conducted, or disciplinary actions taken, whether by voluntary agreement or formal action, by a medical or professional regulatory authority, an educational institution, training or research program, or health facility in any jurisdiction;
	 (7) 	 A statement of the applicant’s physical and mental health, including full disclosure and a written explanation of any dysfunction or impairment which may affect the ability of the applicant to engage in practice and provide patients with safe and healthful care;
	 (8) 	 A statement disclosing and explaining the applicant’s involvement in civil litigation related to practice in any jurisdiction. Copies of the legal documents may be requested if needed during the review process;
	 (9) 	 A statement disclosing and explaining any charge of a misdemeanor or felony involving the applicant filed in any jurisdiction, whether or not any appeal or other proceeding is pending to have the conviction or plea set aside; and
	 (10) 	 A completed fingerprint packet to facilitate a national criminal history background check. The fee for the evaluation of the fingerprint packet and the DCI and FBI criminal history background checks will be assessed to the applicant.
	 10.4(4) Special license application review process. The process below shall be utilized to review each application for a special license.
	  a.   	 An application shall be considered open from the date the application form is received in the board office with the nonrefundable special licensure fee.
	  b.   	 After reviewing each application, staff shall notify the applicant or the applicant’s academic institution about how to resolve any problems identified by the reviewer. The applicant shall provide additional information when requested by staff or the board.
	  c.   	 If the final review indicates no questions or concerns regarding the applicant’s qualifications for licensure, staff may administratively grant a special license.
	  d.   	 If the final review indicates questions or concerns that cannot be remedied by continued communication with the applicant, the executive director, director of licensure and administration, and director of legal affairs shall determine if the questions or concerns indicate any uncertainty about the applicant’s current qualifications for licensure.
	 (1) 	 If there is no current concern, staff shall administratively grant a special license.
	 (2) 	 If any concern exists, the application shall be referred to the committee.
	  e.   	 Staff shall refer to the committee for review matters which include, but are not limited to, falsification of information on the application, criminal record, substance abuse, questionable competency, physical or mental illness, or educational disciplinary history.
	  f.   	 If the committee is able to eliminate questions or concerns without dissension from staff or a committee member, the committee may direct staff to grant administratively a special license.
	  g.   	 If the committee is not able to eliminate questions or concerns without dissension from staff or a committee member, the committee shall recommend that the board:
	 (1) 	 Request that the applicant appear for an interview;
	 (2) 	 Grant a special license for practice at the medical college designated in the application;
	 (3) 	 Grant a license under certain terms and conditions or with certain restrictions;
	 (4) 	 Request that the applicant withdraw the licensure application; or
	 (5) 	 Deny a license.
	  h.   	 The board shall consider applications and recommendations from the committee and shall:
	 (1) 	 Request that the applicant appear for an interview;
	 (2) 	 Grant a special license for practice at the medical college designated in the application;
	 (3) 	 Grant a license under certain terms and conditions or with certain restrictions;
	 (4) 	 Request that the applicant withdraw the licensure application; or
	 (5) 	 Deny a license. The board may deny a license for any grounds on which the board may discipline a license. The procedure for appealing a license denial is set forth in 653—9.15(147,148).
	 10.4(5) Special license application cycle. If the applicant does not submit all materials within 90 days of the board’s initial request for further information, the application shall be considered inactive. The board office shall notify the applicant of this change in status. An applicant must reapply and submit a new nonrefundable application fee and a new application, documents and credentials.
	 10.4(6) Renewal of a special license.
	  a.   	 If the special physician licensee has not qualified for and received a permanent license, the board shall send a courtesy renewal notice by regular mail to the licensee’s last-known address at least 60 days prior to the expiration date of the special physician license. The licensee is responsible for renewing the license prior to its expiration. Failure of the licensee to receive the notice does not relieve the licensee of responsibility for renewing that license.
	  b.   	 A special physician licensee shall apply for a one-year renewal by submitting the following:
	 (1) 	 A completed renewal application;
	 (2) 	 The renewal fee of $200; and
	 (3) 	 Evidence of continuing education and training on chronic pain management, end-of-life care, and identifying and reporting abuse.
	  1. 	 The requirement for continuing education is 20 hours of category 1 credit as specified in 653—Chapter 11.
	  2. 	 The requirement for training on chronic pain management, end-of-life care, and identifying and reporting abuse is specified in 653—Chapter 11.
The dean of the medical college shall submit a letter that addresses the individual’s unique contribution to the practice of medicine in Iowa, how the anticipated contribution will serve the public interest of Iowans, and the need for renewal of this license. For a licensee who received the initial special license prior to July 1, 2001, the only statement needed from the dean is verification of the academic appointment the licensee continues to hold.
	  c.   	 Failure of the licensee to renew a license within one month of the expiration date shall cause the license to become inactive. A licensee whose license is inactive is prohibited from practice until a new special license is granted according to subrules 10.4(3) and 10.4(4).
[ARC 0216C, IAB 7/25/12, effective 8/29/12]