Medicine

Regulations of the Commissioner

Part 60 Medicine, Physician Assistant, Specialist Assistant and Acupuncture

§60.1 Professional study of medicine.

1. To meet the preprofessional and the professional education requirement for licensure in this State, the applicant shall present evidence of:
   1. the completion of two years of preprofessional education acceptable to the department;
   2. the completion of a curriculum of not less than 32 months in length in a medical program registered by the department, accredited by an accrediting organization acceptable to the department, or recognized by the appropriate civil authorities of the country in which the school is located as an acceptable educational program for physicians or the completion of a medical program registered by the department or accredited by an accrediting organization acceptable to the department in which the student received advanced standing for prior academic work;
   3. having received, from a school offering a program which meets the requirements of paragraph (2) of this subdivision, the degree doctor of medicine or doctor of osteopathic medicine or the equivalent as determined by the department; and
   4. having obtained a passing score on a satisfactory proficiency examination, if the program of medical education is completed in a medical school not registered by the department or determined by the department to be equivalent to a registered program; provided, however, that a satisfactory diplomate certificate earned by examination may be accepted for the required proficiency examination.
2. Courses failed in a school of medicine, for which credit has been granted toward meeting the requirements of a medical degree by another school of medicine, may not be counted toward meeting the requirements of this Part.
3. A clinical clerkship may be part of a program of study subject to the provisions of section 60.2 of this Part.

§60.2 Clinical clerkships.

1. Clinical clerkship as used in this Part shall mean a supervised educational experience which is part of the clinical component of a program of undergraduate medical education, which takes place in a general hospital or in an equivalent health organization acceptable to the department and which is performed in accordance with all requirements of the jurisdiction in which such facility is located.
2. Students enrolled in medical programs registered by the department or determined by the department to be equivalent to such programs, or students whose clerkships shall not exceed an aggregate of 12 weeks in two academic years may serve in clinical clerkships.
3. Except as provided in subdivision (b) of this section, students enrolled in medical programs not registered by the department may serve in clinical clerkships in teaching hospitals in this State provided that:
   1. the student was engaged in a clinical clerkship in this State prior to May 1, 1981;
   2. the student was enrolled in the medical school on or before September 25, 1980 and has provided evidence of having obtained a satisfactory score on the medical sciences knowledge profile examination taken prior to July 1, 1985, a passing score on Part I of the Foreign Medical Graduate Examination in the Medical Sciences (FMGEMS), or an acceptable score on a satisfactory equivalent examination;
   3. the student was enrolled in the medical school after September 25, 1980 and has provided evidence of having obtained a satisfactory score on the medical sciences knowledge profile examination taken prior to July 1, 1985, a passing score on Part I of the Foreign Medical Graduate Examination in the Medical Sciences (FMGEMS), or an acceptable score on a satisfactory equivalent examination, provided that the program in the medical school attended has been determined by the department, after a site visit conducted at the expense of the applicant by persons designated by the department and experienced in medical program evaluation, to meet substantially the requirements of section 60.1(a)(1) of this Part and of Parts 50 and 52 of this Title except any provision thereof that states or implies that a particular form of governing body is required, and provided further that formal agreements satisfactory to the department have been executed between the medical school and the hospital(s) in which students from the school are to be engaged in clinical clerkships, which specify responsibility for planning, managing and supervising clerkships in each subject area, and further that the department shall be notified by the medical school of any changes in such agreements, including termination or the initiation of new agreements; or
   4. the student was enrolled in the medical school after September 25, 1980 but before May 1, 1981 and has provided evidence of having obtained a satisfactory score on the medical sciences knowledge profile examination taken prior to July 1, 1985, a passing score on Part I of the Foreign Medical Graduate Examination in the Medical Sciences (FMGEMS), or an acceptable score on a satisfactory equivalent examination and the medical school in which he is enrolled has submitted a formal application for approval pursuant to paragraph (3) of this subdivision.
   5. The satisfactory score specified in paragraphs (2), (3) and (4) of this subdivision shall be a score comparable to the performance on Part I of the National Board of Medical Examiners examination of students who attend medical schools registered by the department or accredited by an accrediting organization acceptable to the department.
4. A clinical clerkship may be performed only in a clinical subject or subjects in which the teaching hospital has a residency program accredited by the Accreditation Council on Graduate Medical Education, or an equivalent accrediting agency acceptable to the department, or which is part of such a program through affiliation(s) approved by the Accreditation Council on Graduate Medical Education, or an equivalent agency acceptable to the department. The requirements of this subdivision shall not apply to students who were engaged in clinical clerkships in this State prior to May 1, 1981. To engage in a clerkship which, in the aggregate of all clerkship experience during two academic years, will not exceed 12 weeks, the student shall present a letter of eligibility if issued by the department.
5. No teaching hospital shall be under obligation by virtue of these regulations to accept medical students in clinical clerkships, and any medical school or teaching hospital may impose standards for admission to clinical clerkships which exceed the standard set forth in this section.

§60.3 Experience.

1. For issuance of a license to practice medicine, all applicants who make application for licensure after July 1, 1985 shall have completed at least one year of postgraduate hospital training acceptable to the department, except as otherwise provided in subdivision (b) of this section.
2. For issuance of a license to practice medicine, graduates of medical education programs neither registered by the department nor accredited by an accrediting organization acceptable to the department, except those applicants seeking licensure pursuant to section 6528 of the Education Law, shall meet the following requirements:
   1. those individuals who complete medical education and make application for licensure to the department prior to July 1, 1981, shall have completed two years of postgraduate hospital training satisfactory to the department, provided that graduates of schools designated by the department shall be exempted from the second year of required hospital training; and
   2. those individuals who make application for licensure on or after July 1, 1981, shall have completed at least three years of postgraduate training approved by the Accreditation Council on Graduate Medical Education or the American Osteopathic Association or their predecessors or successors.
3. A year of postgraduate training shall mean a period of not less than the equivalent of 11 calendar months of full-time experience after passing an acceptable proficiency examination. A graduate entering the licensing examination pursuant to this section may sit for the examination following completion of undergraduate medical education but prior entry into the required postgraduate training.
4. Fellowships in the United States or Canada which are clinical in nature or postgraduate hospital training obtained in a country in which such training is regulated by an organization designated as responsible for quality assurance that has been approved by the Board of Regents, may be accepted by the Committee on the Professions toward meeting the postgraduate training requirement. Fellowships determined to be other than clinical or postgraduate hospital training obtained outside the United States or Canada may be accepted on a pro rata basis at the discretion of the Committee on the Professions, based on the content of the experience as compared to the experience obtained in the postgraduate training prescribed in subdivision (b)(2) of this section.
5. A diplomate certificate satisfactory to the department and earned by examination may be accepted for one year of the required postgraduate hospital training.

§60.4 Licensing examinations.

1. An applicant who is a graduate of a medical school may fulfill the examination requirements for licensure by submitting evidence of having achieved grades acceptable to the State Board for Medicine on:
   1. all parts of the three-part Federation Licensing Examination (FLEX); or
   2. both Component I and Component II of the two-component Federation Licensing Examination (FLEX); or
   3. all parts of the examination of the National Board of Medical Examiners, Inc.; or
   4. all parts of the examination of the National Board of Osteopathic Medical Examiners, Inc. given after January 1, 1972; or
   5. examinations of other states given prior to January 1, 1972, which are satisfactory to the State Board for Medicine; or
   6. all steps of the United States Medical Licensing Examination; or
   7. Part I of the examination of the National Board of Medical Examiners or Step 1 of the United States Medical Licensing Examination, and Part II of the examination of the National Board of Medical Examiners or Step 2 of the United States Medical Licensing Examination, and Part III of the examination of the National Board of Medical Examiners or Step 3 of the United States Medical Licensing Examination; or
   8. Component I of the Federation Licensing Examination (FLEX) and Step 3 of the United States Medical Licensing Examination; or
   9. Component II of the Federation Licensing Examination (FLEX); and
      1. Parts I and II of the examination of the National Board of Medical Examiners; or
      2. Steps 1 and 2 of the United States Medical Licensing Examination; or
      3. Part I of the examination of the National Board of Medical Examiners and Step 2 of the United States Medical Licensing Examination; or
      4. Step 1 of the United States Medical Licensing Examination and Part II of the examination of the National Board of Medical Examiners.
2. A graduate of a registered or accredited college of osteopathic medicine who has obtained grades on Parts I and II of the examination of the National Board of Osteopathic Medical Examiners, Inc. which meet New York State standards for licensure but who, after completing nonosteopathic postgraduate training, is refused admission to Part III of that examination by the National Board of Osteopathic Medical Examiners, Inc., may satisfy the licensing examination requirement in this State by obtaining grades satisfactory to the State Board for Medicine on the clinical competence portion of a Federation Licensing Examination or on Step 3 of the United States Medical Licensing Examination.
3. Passing score.
   1. The passing score in any group of basic science, clinical science or clinical competence subjects of the three-part Federation Licensing Examination shall be 75.0, provided that in the computation of final average score, additional weight may be assigned to the clinical subjects. A final weighted average score of 75.0 shall be required for passing. In the event the candidate does not achieve a final weighted average score of 75.0, a reexamination shall be required.
   2. The passing score on FLEX Component I and Component II shall be 75.0 in each component.
4. A completed application for initial admission to the licensing examination and all supporting documents shall be filed with the department not less than 90 days prior to the date of the examination. An application for admission to subsequent examinations shall be filed with the department not less than 60 days prior to the date of the examination.

§60.5 License by endorsement.

1. Endorsement of foreign licenses. A medical license or registration certificate granted in a foreign country in which licensure or registration is regulated by an organization designated as responsible for quality assurance of licensees and acceptable to the Board of Regents, may be accepted by the department for licensure in New York State if the applicant:
   1. is eligible for admission to the medical licensing examination;
   2. has acceptable grades on a clinical competency examination acceptable to the department or has a diplomate certificate which was obtained on the basis of satisfying the experience and examination requirements established by a recognized organization responsible for specialty certification;
   3. is in possession of the appropriate medical license or certificate from that country;
   4. presents evidence satisfactory to the department of completion of the postgraduate training required by section 60.3 of this Part; and
   5. has not less than five years of satisfactory professional experience or practice following licensure or registration.
2. Endorsement of licenses of other states or Canadian provinces.
   1. A medical license issued by another state or political subdivision of the United States or by a Canadian province may be endorsed by the department for practice in New York if the applicant:
      1. is eligible for admission to the New York State medical licensing examination;
      2. has completed not less than two years of satisfactory professional experience; and
      3. either:
         1. has achieved grades satisfactory to the State Board for Medicine on a medical licensing examination which meets New York standards for licensure as provided in section 60.4 of this Part; or
         2. has achieved grades satisfactory to the State Board for Medicine on a state medical licensing examination given prior to January 1, 1972 which is equivalent in all parts, except for the clinical competency component, to the examination leading to licensure set forth in section 60.4 of this Part, provided that the applicant has obtained a diplomate certificate which was obtained on the basis of satisfying the experience and examination requirements established by a recognized organization responsible for specialty certification in a field of medicine, such as the American Board of Internal Medicine or an equivalent organization; or
         3. has achieved grades satisfactory to the State Board for Medicine on the licensing examination of The Medical Council of Canada.
   2. The department may license an applicant who:
      1. has been licensed to practice medicine in another jurisdiction of the United States or its territories as a result of an examination the scope and content of which are found by the State Board for Medicine to be equivalent to the licensing examination in New York State;
      2. has achieved a grade on such examination which is acceptable for licensure in such state or territory and which is not more than one percentage point below the weighted average required for licensure in New York;
      3. submits satisfactory evidence of at least seven years of experience, following licensure; and
      4. meets all other requirements for licensure in New York State.

§ 60.6 Limited permits.

For renewal of a limited permit in medicine the department may accept satisfactory evidence of personal or family illness or extenuating circumstances preventing the candidate from taking the licensing examination, or satisfactory performance on a significant part of the New York State licensing examination in medicine, provided that such permit shall not be renewed for more than 24 months.

§60.7 Definitions relating to limited permits and persons exempt from licensure.

1. The words hospital, as used in subdivision (2) of section 6525, and public hospital, as used in subdivision (1) of section 6526 of the Education Law, shall be construed to include a general hospital as defined by Public Health Law, section 2801(10), a psychiatric center operated by the State Office of Mental Health, a developmental center operated by the State Office of Mental Retardation and Developmental Disabilities, an alcohol treatment center operated by the State Office of Alcoholism and Substance Abuse Services, a nursing home, a facility licensed pursuant to article 31 of the Mental Hygiene Law for the care and treatment of persons with mental illness and approved by the State Office of Mental Health, or an incorporated nonprofit home or institution for the care of the chronically ill approved by the State Department of Health.
2. The word resident as used in subdivision (1) of section 6526 of the Education Law shall be construed to include interns, employed in a public hospital, who are graduates of medical schools located outside the United States and Canada and who hold the standard certificate of the Educational Council for Foreign Medical Graduates.

§60.8 Registration of physician assistants or specialist assistants.

1. General requirements. An applicant for registration as a physician assistant or specialist assistant shall submit the required application form to the department and shall have met the requirements of section 6541 of the Education Law.
2. Professional study.
   1. An applicant who has completed a program for the training of physician assistants or specialist assistants, which has been approved by the department, shall be eligible for registration.
   2. An applicant who has completed a program for the training of physician assistants or specialist assistants outside New York State shall be eligible for registration if the applicant meets the requirements of section 6541 of the Education Law and the program is determined by the department to be substantially equivalent to programs registered in New York State.
   3. Equivalent education and training. In lieu of all or part of a registered program for the training of physician assistants or specialist assistants, the commissioner may accept evidence of an extensive health oriented education and of appropriate experience and training. The commissioner may require such an applicant to pass an examination acceptable to the department as set forth in subdivision (c) of this section and to make up any deficiencies in education or experience prior to registration.
3. An applicant for registration as a physician assistant shall provide evidence of having obtained a passing score on an examination acceptable to the department. The examination requirement shall apply to all applicants for initial registration whose applications are received on or after January 1, 1991 and shall also apply to any applicant whose acceptable educational program was completed after January 1, 1991 regardless of the applicant's date of application. The department shall accept passing grades on an examination that adequately assesses entry level skills for the profession of physician assistant and does not unreasonably restrict access to the profession.
4. Permits limited as to eligibility, practice and duration, shall be issued by the department to eligible applicants as follows:
   1. A person who fulfills all requirements for registration as a physician assistant except that relating to the examination shall be eligible for a limited permit.
   2. A permittee shall be authorized to practice as a physician assistant only under the direct supervision of a licensed physician.
   3. A limited permit shall expire one year from the date of issuance or upon notice to the permittee by the department that the application for registration has been denied. A limited permit shall be extended upon application for one additional year in accordance with the requirements of section 6548(3) of the Education Law. If the permittee is awaiting the results of a licensing examination at the time such limited permit expires, such permit shall continue to be valid until ten days after notification to the permittee of the result of such examination.
5. Registration designations. Registration as a specialist assistant shall be for a particular field of practice as defined by the Commissioner of Health pursuant to section 3701 of the Public Health Law.

§ 60.9 Acupuncture.

1. To practice acupuncture as a physician, dentist or specialist assistant-acupuncture in New York State, a person shall possess one of the following credentials:
   1. a license to practice medicine or dentistry and a certificate to practice acupuncture issued pursuant to paragraph (b)(1) of this section; or
   2. a registration as a specialist assistant-acupuncture, pursuant to Education Law, section 6541 and the requirements of paragraph (b)(2) of this section.
2. Qualifications for practice.
   1. For a certificate to practice acupuncture, the applicant shall:
      1. possess a license to practice medicine or dentistry;
      2. have completed at least 200 hours of instruction in programs in acupuncture registered by the department, or in programs determined by the department to be the equivalent of registered programs, and at least 100 hours of supervised experience acceptable to the department. Instruction shall consist of:
         1. at least 100 hours of instruction and clinical demonstrations in general and basic aspects of acupuncture;
         2. at least 100 hours of sequential specialized instruction in specific uses and techniques of acupuncture. Topics of instruction shall include indications and contraindications for acupuncture administration, techniques for locating acupuncture points, needling and stimulating techniques, and trainee participation in administration of acupuncture in clinical demonstrations; and
         3. at least 100 hours of supervised experience acceptable to the department and under the supervision of a currently registered physician or dentist certified in acupuncture; and
      3. pay the fees specified in section 59.9(e) of this Title.
   2. For registration as a specialist assistant-acupuncture, the applicant shall:
      1. satisfy the education and training requirements set forth in subparagraph (1)(ii) of this subdivision;
      2. have graduated from a school of medicine or a school of traditional oriental medicine, herb medicine or acupuncture acceptable to the department;
      3. have at least five years of experience in the use of acupuncture;
      4. pay the fees specified in section 6541 of the Education Law.
   3. Examination requirement. The department, in its discretion, may require the passing of an examination in acupuncture as an additional qualification of any applicant for certification or registration who is unable to submit satisfactory evidence of the education and training requirements set forth in subparagraph (1)(ii) of this subdivision, but who meets all other requirements for an authorization to practice acupuncture.