(a) Pursuant to the authority of §155.006, Texas Occupations Code, the board may issue a limited license to an applicant licensed or educated in another state, territory, Canadian province or country conceded eminence and authority in the applicant's specialty.
(b) "Conceded eminence and authority in the applicant's specialty," as used in this section, shall mean that the physician has achieved a high level of academic or professional recognition, domestically or internationally, for excellence in research, teaching, or the practice of medicine within the applicant's specialty.
(c) In determining whether an applicant has recognized conceded eminence and authority in the applicant's specialty, the Board shall consider whether:
  (1) the applicant has been the recipient of professional honors and awards, and professional recognition in the international or domestic medical community, for achievements, contributions, or advancements in the field of medicine, or medical research as evidenced by objective factors, including, but not limited to:
    (A) publications in recognized scientific, medical, or medical research journals, including American peer review journals;
    (B) being the recipient or nominee for international or national awards for distinguished contributions to the advancement of medicine or medical research;
    (C) acknowledgement of expertise from recognized American authorities in the applicant's field of medical specialty; and
    (D) other professional accomplishments as determined meritorious in the discretion of the Board;
  (2) the recommending institution is unable to recruit, after good faith effort, a physician with the same sub-specialty who is: either already licensed in Texas or is eligible for an unrestricted license in Texas; and
  (3) other full licensure options are available to the applicant.
(d) An applicant must complete an application and present satisfactory proof to the board that the applicant:
  (1) is a graduate of:
    (A) a medical school which is recognized or accredited by the Liaison Committee on Medical Education (LCME) of the Association of American Medical Colleges, Royal College of Physicians in Canada or the American Osteopathic Association (AOA); or
    (B) a foreign medical school and
      (i) holds a valid medical license or registration certificate issued by a state or territory in the United States or a valid foreign medical license or registration certificate issued by another country or Canadian province on the basis of a foreign examination, and has practiced medicine for at least 10 years, 5 years of which occurred immediately preceding the date applications is made to the Board; or
      (ii) held a valid foreign medical license or certificate at the time of coming to the United States and has since continuously worked under a Faculty Temporary License; and
  (2) is recommended to the board by the dean, president, or chief academic officer of:
    (A) a school of medicine in this state accredited by the LCME or AOA;
    (B) The University of Texas Health Science Center at Tyler;
    (C) The University of Texas M.D. Anderson Cancer Center; or
    (D) a program of graduate medical education, accredited by the Accreditation Council for Graduate Medical Education, that exceeds the requirements for eligibility for first board certification in the discipline; and
  (3) is expected to receive an appointment at the institution or program making the recommendation under paragraph (2) of this subsection; and
  (4) has demonstrated conceded eminence and authority in a medical specialty identified in the application.
(e) Examination Requirements. An applicant must submit evidence that the applicant:
  (1) has passed the Texas Medical Jurisprudence Examination; and
  (2) has passed an examination that is:
    (A) accepted by the board for licensure as defined in §163.6(a) of this title, (relating to Examinations Accepted for Licensure) and has not exceeded the number of failed attempts allowed for a licensing exam as provided by §163.6(b) of this title; or
    (B) accepted for physician licensure in another state, territory, Canadian province, or country; or
    (C) accepted for specialty board certification by:
      (i) the American Board of Medical Specialties; or
      (ii) the American Osteopathic Association.
(f) Additional requirements and documentation for Conceded Eminence License. An applicant:
  (1) must submit 3 letters of recommendation from Texas-licensed physicians who practice in the same specialty area as the applicant and who shall attest to the candidate's conceded eminence qualifications, character, and ethical behavior;
  (2) must submit 5 letters from renowned specialists in the applicant's discipline who attest to the applicant's eminence and qualifications;
  (3) has successfully completed at least one year of approved subspecialty training accredited by the Accreditation Council for Graduate Medical Education (ACGME) or the American Osteopathic Association (or has completed a substantially equivalent program that has since received ACGME accreditation);
  (4) has not been convicted of, or placed on deferred adjudication, community supervision, or deferred disposition for a felony, a misdemeanor connected with the practice of medicine, or a misdemeanor involving moral turpitude;
  (5) has not been the subject of disciplinary action related to the practice of medicine by any other state; the uniformed services of the United States; the applicant's peers in a local, regional, state, or national professional medical association or staff of a hospital; or a territory, Canadian province, or other country in which the applicant holds or has held a medical license or registration certificate;
  (6) is of good professional character, as defined by §163.1(a)(8) of this title (relating to Definitions); and
  (7) has read and will abide by board rules and the Medical Practice Act.
(g) Supervision. The Board may require an applicant to submit:
  (1) the name of a Texas-licensed physician, in good standing, who will supervise the medical services provided by the applicant for the first 6 months of practice; and
  (2) a detailed description of the medical services, duties, and responsibilities that the applicant will perform.
(h) Applicants with complete applications may qualify for a Temporary License prior to being considered by the board for licensure, as required by §172.11 of this title (relating to Temporary Licensure--Regular).
(i) The holder of a conceded eminence license shall be limited to the practice of only a specialty of medicine for which the license holder has conceded eminence and authority, as identified in the application. The license holder may only practice medicine within the setting of the institution or program that recommended the license holder under subsection (d)(3) of this section, including a setting that is part of the institution or program by contractual arrangement.
(j) If the holder of a conceded eminence license terminates the relationship with the institution or program that recommended the license holder under subsection (d)(3) of this section, the conceded eminence license shall be considered automatically canceled. To practice medicine in Texas, the license holder must:
  (1) file a new application with the recommendation of a new institution or program, as required by subsection (d)(3) of this section; or
  (2) file an application for another Texas medical license or permit.
(k) The holder of a conceded eminence license shall be required to pay the same fees and meet all other procedural requirements for issuance and renewal of the license as a person holding a full Texas medical license.
(l) The holder of a conceded eminence license shall be subject to disciplinary action under the Medical Practice Act and board rules.

Source Note: The provisions of this §172.13 adopted to be effective June 29, 2006, 31 TexReg 5104; amended to be effective August 10, 2008, 33 TexReg 6135; amended to be effective January 20, 2014, 39 TexReg 279; amended to be effective July 12, 2020, 45 TexReg 4523