In Missouri, regulation of physicians and surgeons are provided for under 4 CSR 150-2.001- 4 CSR 150-2.165 of Missouri Code of State Regulations. 20 CSR 2150-2.010 of the code states the qualification of applicants necessary to obtain a license. To obtain a license, the applicant shall furnish satisfactory evidence as to their innocence of unprofessional or dishonorable conduct and good moral character, including postgraduate reference letters from the applicant’s training programs. The applicant shall furnish a certificate of graduation from an accredited high school showing satisfactory completion of pre-professional education consisting of a minimum 60 semester hours of college credit in acceptable subjects from a reputable college or university approved by the board. The applicant should also provide satisfactory evidence of having attended throughout at least four terms of 32 weeks of actual instructions in each term and of having received a diploma from some reputable medical or osteopathic college that enforces requirements of four 4 terms of 32 weeks for actual instruction in each term, including, in addition to class work and experience in operative and hospital work during the last two years of instruction as is required by the American Medical Association (AMA) and the American Osteopathic Association. All applicants shall file a photocopy of their professional degrees in the office of the executive director.
The applicant must furnish to the board a copy of their credentials in the original form with a translated copy of each attached. The executive director will notify applicants of the time and place examinations are to be held as soon as possible. Any applicant detected to be seeking or giving help during the hours of the examination will be dismissed and his/her paper cancelled under 20 CSR 2150-2.020.
The applicant is required to make application upon the form prepared by the board.
No application will be considered unless fully and completely made out on the specified form and properly attested. Applications shall be sent to the executive director of the State Board of Registration for the Healing Arts. The board shall charge an appropriate fee established by the board to each person applying to and appearing before it for examination for certificate of licensure to practice as a physician and surgeon. A copy of the professional degree shall be sent to the executive director of the State Board of Registration for the Healing Arts for verification. When an applicant has 1 or more years in a pre professional or professional institution other than the one from which s/he is a graduate, s/he must file with the application a statement under seal from those institutions showing time spent and credit received[i].
Whenever a licensed practitioner fails to renew his/her registration for any period in excess of 6 months after the expiration of his/her last registration, his/her application for renewal of registration shall he denied unless it is accompanied by all fees required by statute. The application shall be made under oath on a form furnished by the board. The application shall include the applicant’s full name and the office and residence addresses and the issuance date and number of the license. It shall state all final disciplinary actions taken against the applicant by any professional medical or osteopathic association or society, licensed hospital or medical staff of the hospital, state, territory, federal agency or country; and information concerning the applicant’s current physical and mental fitness to practice as a physician and surgeon[ii].
20 CSR 2150-2.060 of the code provides the issuance of temporary licenses. The applicant is required to make application upon a form prepared by the board. No application will be considered unless fully and completely made out on the specified form and properly attested. Completed applications shall be sent by the superintendent of the hospital where the applicant is to be in an approved training program to the executive director of the State Board of Registration for the Healing Arts. This requirement does not relieve the applicant of the responsibility for the filing of the application and no applicant shall begin practicing until the temporary license has been issued. The board shall charge each person applying to it for certificate of temporary licensure to practice as a physician and surgeon in Missouri an appropriate fee to be established by the board. An appropriate fee shall be charged annually in the event the temporary license is renewed. The executive director will sign the temporary license. A letter shall be sent to the chief executive officer and the director of the training program to inform them of the board’s decision to approve or deny issuance of the temporary license to the applicant. The board may terminate a temporary license at its own discretion.
4 CSR 150-2.155 of the code deals with limited licenses. The applicant shall apply for a limited license upon a form prepared by the board. No application will be considered by the board unless fully completed and properly attested by the board. If the applicant did not previously hold a permanent license to practice in the state of Missouri, then the applicant shall present evidence of meeting the board’s requirements for permanent licensure.
Duplicate licenses are dealt under 4 CSR 150-2.160. A duplicate license may be issued upon receipt of a notarized statement requesting the duplicate license and stating the reason the duplicate license is being requested. The notarized statement shall be accompanied by an appropriate fee to be established by the board. The fee shall be sent in the form of a cashier’s check or money order made payable to the Missouri Board of Healing Arts.
An individual who has graduated from a school of medicine which is located outside the United States may be eligible for licensure to practice the healing arts in this state by reciprocity if he/she has completed all of the prescribed curriculum at his/her school of medicine. The applicant must be a graduate of a medical school whose curriculum has been approved by the proper government agency of the country in which the school is located. If the applicant meets the academic and postgraduate training requirements for licensure to practice medicine in the country in which the applicant’s school of graduation is located, he is eligible for licensure by reciprocity[iii].
Pursuant to the statute, whenever the board has reason to believe that a physician or surgeon is unable to practice with reasonable skill and safety to patients by reasons of incompetency, illness, drunkenness, excessive use of drugs, narcotics, chemicals or as a result of any mental or physical condition, the board may hold a hearing to determine whether probable cause exists to establish competency in a specialty, examine a pattern and practice of professional conduct or to examine to determine mental or physical competency, or both. Notice of the probable cause hearing shall be served on the licensee within a reasonable amount of time before the hearing, but in no event later than 10 days before the hearing. The board shall issue an order based on the hearing leading to a finding of probable cause, the method of further determination of competency. The board may include the reasonable intervals at which the physician may be given an opportunity to demonstrate competency. Following a determination by the panel, the panel shall make a written report to the board either that the physician examined is able to practice with reasonable skill and safety to patients or that the physician examined is unable to practice with reasonable skill and safety to patients and specify the reasons or grounds for the opinion. Upon receipt of the written report from the panel, the board shall serve the physician with a copy of the report and notify the physician of the time, date and place of the meeting at which the board will formally accept and review the findings of the panel and determine a final order of discipline based on the evidence presented by the written report of the panel and any other evidence that pertains to the issue of the final order of discipline to be imposed[iv].
[iv] 4 CSR 150-2.015