(a) Licensing Examinations Accepted by the Board for Licensure. The following examinations are acceptable for licensure:      
        (1) United States Medical Licensing Examination (USMLE), or its successor, with a score of 75 or better, or a passing grade if applicable, on each step;       
        (2) COMLEX-USA, or its successor, with a score of 75 or better, or a passing grade if applicable, on each step;       
        (3) Federation Licensing Examination (FLEX), on or after July 1, 1985, passage of both components with a score of 75 or better on each component;       
        (4) Federation Licensing Examination (FLEX), before July 1, 1985, with a FLEX weighted average of 75 or better in one sitting;       
        (5) National Board of Medical Examiners Examination (NBME) or its successor;       
        (6) National Board of Osteopathic Medical Examiners Examination (NBOME) or its successor;       
        (7) Medical Council of Canada Examination (LMCC) or its successor;       
        (8) State board licensing examination, passed before January 1, 1977, (with the exception of Virgin Islands, Guam, Tennessee Osteopathic Board or Puerto Rico then the exams must be passed before July 1, 1963); or       
        (9) One of the following examination combinations with a score of 75 or better on each part, level, component, or step;                  (A) FLEX I plus USMLE 3;                   (B) USMLE 1 and USMLE 2 (including passage of the clinical skills component if applicable), plus FLEX II;                   (C) NBME I or USMLE 1, plus NBME II or USMLE 2 (including passage of the clinical skills component if applicable), plus NBME III or USMLE 3;                   (D) NBME I or USMLE 1, plus NBME II or USMLE 2 (including passage of the clinical skills component if applicable), plus FLEX II;                   (E) The NBOME Part I or COMLEX Level I and NBOME Part II or COMLEX Level II and NBOME Part III or COMLEX Level III.         
      (b) Examination Attempt Limit.      
        (1) An applicant must pass each part of an examination listed in subsection (a) of this section within three attempts. An applicant who attempts more than one type of examination must pass each part of at least one examination and shall not be allowed to combine parts of different types of examination.       
        (2) Notwithstanding paragraph (1) of this subsection, an applicant who, on September 1, 2005, held a Texas physician-in-training permit issued under §155.105 of the Act or had an application for that permit pending before the board must pass each part of the examination within three attempts, except that, if the applicant has passed all but one part of the examination within three attempts, the applicant may take the remaining part of the examination one additional time. However, an applicant is considered to have satisfied the requirements of this subsection if the applicant:                  (A) passed all but one part of the examination approved by the board within three attempts and passed the remaining part of the examination within six attempts;                   (B) is specialty board certified by a specialty board that:                      (i) is a member of the American Board of Medical Specialties; or                       (ii) is approved by the American Osteopathic Association; and                       (iii) has completed in this state an additional two years of postgraduate medical training approved by the board.           
        (3) The limitation on examination attempts by an applicant under paragraph (1) of this subsection does not apply to an applicant who meets the following criteria:                  (A) holds a license to practice medicine in another state(s);                   (B) is in good standing in the other state(s);                   (C) has been licensed in another state(s) for at least five years;                   (D) such license has not been restricted, cancelled, suspended, revoked, or subject to other discipline in the other state(s);                   (E) has never held a medical license that has been restricted for cause, canceled for cause, suspended for cause, revoked or subject to another form of discipline in a state or territory of the United States, a province of Canada, or a uniformed service of the United States; and                   (F) has passed all but one part of the examination approved by the board within three attempts and:                      (i) passed the remaining part of the examination within one additional attempt; or                       (ii) passed the remaining part of the examination within six attempts if the applicant:                          (I) is specialty board certified by a specialty board that:                              (-a-) is a member of the American Board of Medical Specialties; or                               (-b-) is approved by the American Osteopathic Association; and                             (II) has completed in this state an additional two years of postgraduate medical training approved by the board.             
        (4) Attempts at a comparable part of a different type of examination shall be counted against the three attempt limit.       
      (c) Limit on Time to Complete Examination.      
        (1) An applicant must pass all parts of an examination listed in subsection (a)(1), (2), (4), (5), (6), or (7) of this section within seven years; or       
        (2) If the applicant is a graduate of a program designed to lead to both a doctor of philosophy degree and a doctor of medicine degree or doctor of osteopathy degree, the applicant may qualify by passing each part of an examination listed in subsection (a)(1), (2), (4), (5), or (6) of this section not later than the second anniversary of the date the applicant completed the required graduate medical training.       
      (d) The time frame to pass each part of the examination described by subsection (c)(1) of this section is extended to 10 years and the anniversary date to pass each part of the examination described by subsection (c)(2) of this section is extended to the 10th anniversary if the applicant:      
        (1) is specialty board certified by a specialty board that:                  (A) is a member of the American Board of Medical Specialties; or                   (B) is a member of the Bureau of Osteopathic Specialists; or         
        (2) has been issued a faculty temporary license, as prescribed by board rule, and has practiced under such a license for a minimum of 12 months and, at the conclusion of the 12-month period, has been recommended to the board by the chief administrative officer and the president of the institution in which the applicant practiced under the faculty temporary license.       
      (e) Texas Medical Jurisprudence Examination (JP Exam).      
        (1) In this chapter, when applicants are required to pass the JP exam, applicants must pass the JP exam with a score of 75 or better.       
        (2) An examinee shall not be permitted to bring medical books, compendia, notes, medical journals, calculators or other help into the examination room, nor be allowed to communicate by word or sign with another examinee while the examination is in progress without permission of the presiding examiner, nor be allowed to leave the examination room except when so permitted by the presiding examiner.       
        (3) Irregularities during an examination such as giving or obtaining unauthorized information or aid as evidenced by observation or subsequent statistical analysis of answer sheets, shall be sufficient cause to terminate an applicant's participation in an examination, invalidate the applicant's examination results, or take other appropriate action.       
        (4) A person who has passed the JP Exam shall not be required to retake the Exam for another or similar license, except as a specific requirement of the board.       
        (5) The Board shall provide reasonable examination accommodations to applicants diagnosed with dyslexia. Satisfactory proof of an applicant's dyslexia is:                  (A) proof of accommodations made by any entity which administers a national licensing examination accepted for licensure in this section;                   (B) proof of accommodations made by a specialty board recognized by the ABMS or BOS; or                   (C) documentation from a medical professional acceptable to the board regarding the applicant's condition and need for accommodations.         
      (f) The time frame described by subsections (c) and (d) of this section does not apply to an applicant who meets the following criteria:      
        (1) holds a license to practice medicine in another state(s);       
        (2) is in good standing in the other state(s);       
        (3) has been licensed in another state(s) for at least five years;       
        (4) such license has not been restricted, cancelled, suspended, revoked, or subject to other discipline in the other state(s);       
        (5) will practice exclusively in a medically underserved area or a health manpower shortage area, as those terms are defined in Chapter 157 of the Texas Occupations Code; and       
        (6) has never held a medical license that has been restricted for cause, canceled for cause, suspended for cause, revoked or subject to another form of discipline in a state or territory of the United States, a province of Canada, or a uniformed service of the United States.       
     Source Note:        The provisions of this §163.6 adopted to be effective November 10, 1999, 24 TexReg 9835; amended to be effective November 30, 2003, 28 TexReg 10480; amended to be effective May 2, 2004, 29 TexReg 3961; amended to be effective November 7, 2004, 29 TexReg 10104; amended to be effective January 25, 2006, 31 TexReg 382; amended to be effective June 28, 2006, 31 TexReg 5098; amended to be effective January 4, 2007, 31 TexReg 10797; amended to be effective July 3, 2007, 32 TexReg 3991; amended to be effective August 10, 2008, 33 TexReg 6133; amended to be effective November 29, 2009, 34 TexReg 8530; amended to be effective September 19, 2010, 35 TexReg 8349; amended to be effective December 4,2011, 36 TexReg 8026; amended to be effective May 6, 2013, 38 TexReg 2759; amended to    be effective January 20, 2014, 39 TexReg 273; amended to be effective September 28, 2014, 39 TexReg 7580; amended to be effective July 9, 2015, 40 TexReg 4353; amended to be effective November 26, 2017, 42 TexReg 6510