In order to be eligible for a license to practice as a physician under North Carolina law, an applicant must prove that s/he has passed each part of an examination described in N.C. Gen. Stat. § 90-10.1 and is of good moral character.  In addition, the applicant must be a graduate of a medical college approved by the Liaison Commission on Medical Education, the Committee for the Accreditation of Canadian Medical Schools, or an osteopathic college approved by the American Osteopathic Association and has successfully completed one year of training in a medical education program approved by the Board after graduation from medical school[i].  A graduate of a similarly approved medical college who is a dentist licensed to practice dentistry under Article 2 of Chapter 90 of the General Statutes, and has been certified by the American Board of Oral and Maxillofacial Surgery after having completed a residency in an Oral and Maxillofacial Surgery Residency program approved by the Board before completion of medical school is also eligible to apply for a license under this section[ii].

A foreign applicant shall submit proof as to the successful completion of three years of training in a medical education program approved by the Board after graduation from medical school and possession of a valid standard certificate of Educational Commission for Foreign Medical Graduates (ECFMG)[iii].  Further, the applicant must be of good moral character and be able to communicate in English.  However, the board has discretion to waive the ECFMG certification if the applicant has passed the ECFMG examination and successfully completed an approved Fifth Pathway Program.  The applicant is required to provide the original ECFMG Certification Status Report from the ECFMG or must have been a licensed physician in another state on the basis of written examination before the establishment of ECFMG in 1958[iv].  The board may require any additional information from the applicant as it deems appropriate.

For the purpose of licensure, the Board may administer or accept a State Board licensing examination, the National Board of Medical Examiners (NBME) examination or its successor, the United States Medical Licensing Examination (USMLE) or its successor or the Federation Licensing Examination (FLEX) or its successor[v].

A criminal record check of the applicant is a mandatory requirement and the Department of Justice may provide a criminal record check to the Board.  For this purpose, the Board shall provide the Department of Justice a request, along with the fingerprints of the applicant, and a form signed by the applicant consenting to such verification[vi].

Pursuant to N.C. Gen. Stat. § 90-12.01, the Board may issue a limited license known as a “resident’s training license” to a physician not otherwise licensed by the board who is participating in a graduate medical education training program.  Such a license shall become inactive once the holder ceases to be a resident in a training program or obtains any other license to practice medicine.  However, the board shall retain jurisdiction over the holder of the inactive license[vii].

The board may also issue a “military limited volunteer license” to an applicant who has a license to practice medicine and surgery in another state and is authorized to treat personnel enlisted in a branch of the U.S. armed services or veterans[viii].  Such applicant shall produce a letter from the state of licensure indicating the applicant is in good standing.  The board may issue a “retired limited volunteer license” to a retired physician and has allowed his/her license to practice medicine and surgery to become inactive[ix].  The board shall issue a limited license within 30 days and the limited license holders shall comply with the continuing medical education requirements pursuant to rules adopted by the Board.

The holder of a limited license may practice medicine and surgery only at clinics that specialize in the treatment of indigent patients and may not receive compensation for services rendered at clinics specializing in the care of indigent patients.  Persons violating this provision shall be guilty of a Class 3 misdemeanor and, upon conviction, shall be fined not less than twenty-five dollars ($ 25.00) nor more than fifty dollars ($ 50.00) for each offense.  The board, in its discretion, may revoke the limited license after due notice is given to the holder[x].

The board may also issue a special purpose license to an applicant who holds a full and unrestricted license to practice in at least one other jurisdiction and does not have any current or pending disciplinary or other action against him/her by any medical licensing agency in any state or other jurisdiction[xi].  If such person acts beyond the limitations of a special purpose license, s/he shall be guilty of a Class 3 misdemeanor and, upon conviction, shall be fined not less than twenty-five dollars ($ 25.00) nor more than fifty dollars ($ 50.00) for each offense. The board, at its discretion, may revoke the special license after giving due notice[xii].

In the event of disasters and emergencies, the board may waive the requirements of this Article in order to permit the provision of emergency health services to the public[xiii].

The fee schedule for licensure is as follows:

• Each applicant for a license to practice medicine and surgery under either G.S. 90-9.1 or G.S. 90-9.2 shall pay to the North Carolina Medical Board an application fee of three hundred fifty dollars ($ 350.00).
• Each applicant for a limited license to practice in a medical education and training program under G.S. 90-12.01 shall pay to the Board a fee of one hundred dollars ($ 100.00).
• An applicant for a limited volunteer license under G.S. 90-12.1A shall not pay a fee.
• A fee of twenty-five dollars ($ 25.00) shall be paid for the issuance of a duplicate license[xiv]

The Board shall have the power to place on probation, impose limitations and conditions on, publicly reprimand, assess monetary redress, issue public letters of concern, mandate free medical services, require satisfactory completion of treatment programs or remedial or educational training, fine, deny, annul, suspend, or revoke a license, or other authority to practice medicine in North Carolina, issued by the board to any person who has been found by the board to have committed any of the following acts or conduct, or for any of the following reasons[xv]:

• Immoral or dishonorable conduct.
• Producing or attempting to produce an abortion contrary to law.
• Made false statements or representations to the board, or willfully concealing vital information from the board.
• Being unable to practice medicine with reasonable skill and safety to patients by reason of illness, drunkenness, and excessive use of alcohol, drugs, chemicals, or any other type of material or by reason of any physical or mental abnormality.
• Unprofessional conduct, including, but not limited to, departure from, or the failure to conform to, the standards of acceptable and prevailing medical practice, or the ethics of the medical profession, irrespective of injury to patient.
• Conviction in any court of a crime involving moral turpitude, or the violation of a law involving the practice of medicine, or a conviction of a felony; provided that a felony conviction shall be treated as provided in subsection (c) of this section.
• Obtaining practice, money or anything of value by false representations or advertising the profession.
• Adjudication of mental incompetency, which shall automatically suspend a license unless the Board orders otherwise.
• Not actively practiced medicine or practiced as a physician assistant, or having not maintained continued competency, as determined by the Board, for the two-year period immediately preceding the filing of an application for an initial license from the board or a request, petition, motion, or application to reactivate an inactive, suspended, or revoked license previously issued by the Board.
• Promotion of the sale of drugs, devices, appliances or goods for a patient, or providing services to a patient, in such a manner as to exploit the patient.
• Having a license to practice medicine or the authority to practice medicine revoked, suspended, restricted, or acted against or having a license to practice medicine denied by the licensing authority of any jurisdiction.
• The failure to respond, within a reasonable period of time and in a reasonable manner as determined by the board, to inquiries from the Board concerning any matter affecting the license to practice medicine.
• The failure to complete an amount not to exceed 150 hours of continuing medical education during any three consecutive calendar years pursuant to rules adopted by the board.

A physician practicing without a license shall be guilty of a Class 1 misdemeanor, except that if the person so practicing without a license is an out-of-state practitioner who has not been licensed and registered to practice medicine or surgery in this State, the person shall be guilty of a Class I felony[xvi]. A felony conviction shall result in the automatic revocation of a license issued by the board, unless the board orders otherwise or receives a request for a hearing from the person within 60 days of receiving notice from the board, after the conviction.

At the time of first communication from the board to a licensee regarding a complaint or investigation, the board shall provide notice in writing to the licensee that informs the licensee: (i) of the existence of any complaint or other information forming the basis for the initiation of an investigation; (ii) that the licensee may retain counsel; (iii) how the Board will communicate with the licensee regarding the investigation or disciplinary proceeding;(iv) that the licensee has a duty to respond to inquiries from the board concerning any matter affecting the license, and all information supplied to the board and its staff will be considered by the board in making a determination with regard to the matter under investigation; (v) that the board will complete its investigation within six months or provide an explanation as to why it must be extended; and (vi) that if the board makes a decision to initiate public disciplinary proceedings, the licensee may request in writing an informal nonpublic precharge conference[xvii].

The Board shall normally complete any investigation initiated pursuant to this section no later than six months from the date of first communication[xviii].  If a person who has requested a hearing does not appear, and no continuance has been granted, the board may hear the evidence of such witnesses as may have appeared, and the board may proceed to consider the matter and dispose of it on the basis of the evidence before it[xix].  For good cause, the board may reopen any case for further hearing.

Subject to the North Carolina Rules of Civil Procedure and Rules of Evidence, the individual under investigation may call witnesses, including medical practitioners licensed in the U.S. with training and experience in the same field of practice and familiar with the standard of care among members of the same health care profession in North Carolina.  Witnesses shall not be restricted to experts certified by the American Board of Medical Specialties.  However, a board member shall not testify as an expert witness.  Statements contained in medical or scientific literature shall be competent evidence and documentary evidence may be received in the form of a copy or excerpt or may be incorporated by reference, if the materials so incorporated are available for examination by the parties[xx].  The board’s decision regarding licensure is subject to judicial review within 20 days after service of notice of the Board’s final decision[xxi].  The court shall schedule and hear the case within six months of the filing of the appeal[xxii].

[i] N.C. Gen. Stat. § 90-9.1.

[ii] Id.

[iii] N.C. Gen. Stat. § 90-9.2.

[iv] Id.

[v] N.C. Gen. Stat. § 90-10.1.

[vi] N.C. Gen. Stat. § 90-11.

[vii] N.C. Gen. Stat. § 90-12.01.

[viii] N.C. Gen. Stat. § 90-12.1A.

[ix] Id.

[x] Id.

[xi] N.C. Gen. Stat. § 90-12.2A.

[xii] Id.

[xiii] N.C. Gen. Stat. § 90-12.5.

[xiv] N.C. Gen. Stat. § 90-13.1.

[xv] N.C. Gen. Stat. § 90-14.

[xvi] N.C. Gen. Stat. § 90-18.

[xvii] Id.

[xviii] Id.

[xix] N.C. Gen. Stat. § 90-14.7.

[xx] N.C. Gen. Stat. § 90-14.6.

[xxi] N.C. Gen. Stat. § 90-14.1.

[xxii] N.C. Gen. Stat. § 90-14.8.