In Ohio, regulation of physicians is found in ORC Ann. 4731.01 through 4731.40. ORC Ann. 4731.08 states that except as provided in ORC Ann. 4731.29 and ORC Ann. 4731.29.4, and until November 15, 1998, in section ORC Ann. 4731.295, each person who desires to practice medicine and surgery or osteopathic medicine and surgery in Ohio shall file with the secretary of the state medical board a written application for admission to the examination conducted by the board under ORC Ann. 4731.13. The applicant shall furnish evidence satisfactory to the board that the applicant is more than eighteen years of age and of good moral character. The applicant should not have any criminal background and the board will conduct a criminal records check[i].
If the entrance examiner appointed to determine the sufficiency of preliminary education of an applicant finds the preliminary education of the applicant sufficient, the entrance examiner shall issue a certificate of preliminary examination upon the payment to the treasurer of the board of a fee of thirty-five dollars[ii].
Pursuant to ORC Ann. 4731.091, the applicant shall fulfill the medical education and graduate medical education requirements. Graduate medical education means education received through any of the following:
- An internship or residency program conducted in the United States and accredited by either the accreditation council for graduate medical education of the American medical association or the American osteopathic association;
- A clinical fellowship program conducted in the United States at an institution with a residency program accredited by either the accreditation council for graduate medical education of the American medical association or the American osteopathic association that is in a clinical field the same as or related to the clinical field of the fellowship program;
- An internship program conducted in Canada and accredited by the committee on accreditation of preregistration physician training programs of the federation of provincial medical licensing authorities of Canada;
- A residency program conducted in Canada and accredited by either the royal college of physicians and surgeons of Canada or the college of family physicians of Canada[iii].
The applicant shall meet the medical education and graduate medical education requirements specified in any one of the following:
- Hold a diploma from an accredited medical school or osteopathic medical school and have successfully completed not less than nine months of graduate medical education or its equivalent as determined by the board;
- Hold certification from the educational commission for foreign medical graduates and have successfully completed not less than nine months of graduate medical education through the first-year level of graduate medical education or its equivalent as determined by the board;
- Be a qualified graduate of a fifth pathway training program as recognized by the board and have successfully completed, subsequent to completing fifth pathway training, not less than nine months of graduate medical education or its equivalent as determined by the board. Fifth pathway training means supervised clinical training obtained in the United States as a substitute for the internship or social service requirements of a foreign medical school[iv].
In addition to the medical education and graduate medical education requirements, the applicant shall also meet any of the additional requirements mentioned below.
Thus, if an applicant holding certification from the educational commission for foreign medical graduates received the core clinical instruction segment of the applicant’s medical education at an institution in the United States, the board may require that to be eligible for admission to its examination, the applicant must have received the instruction at either of the following:
- An institution that, at the time of the instruction, was a formal part of or had formal affiliation with a medical school accredited by the liaison committee on medical education or an osteopathic medical school accredited by the American osteopathic association.
- An institution with, at the time of the instruction, a graduate medical education program accredited by either the accreditation council for graduate medical education of the American medical association or the American osteopathic association that is in a field the same as or related to the core clinical instruction.
Evidence of the educational qualifications and an affidavit regarding the name, age, residence, and schools of study and relevant discipline have to be submitted along with the application[v]. If the applicant has practiced medicine and surgery or osteopathic medicine and surgery in another state or country, the affidavit shall state the period during which and the place where he has practiced. The state medical board shall admit to the examination it conducts under ORC Ann. 4731.13 an applicant who meets the age, moral character, and educational requirements and pays the examination fee. The board shall not admit an applicant to its examination unless the applicant submits evidence satisfactory to the board that he has successfully completed all other parts of the standard examination or the equivalent of any of those parts. The board shall specify the other parts of the standard examination that must be successfully completed and shall determine what constitutes the equivalent of any of those parts[vi].
The board shall issue its certificate to each individual who was admitted to the board’s examination by meeting the educational requirements if the individual passes the examination, pays a certificate issuance fee of three hundred dollars, and submits evidence satisfactory to the board that the individual has successfully completed not less than twelve months of graduate medical education or its equivalent as determined by the board. Except as provided in ORC Ann. 4731.14.2, the board shall issue its certificate to each individual who was admitted to the board’s examination by meeting the educational requirements specified in ORC Ann. 4731.09.1(B)(2) if the individual passes the examination, pays a certificate issuance fee of three hundred dollars, submits evidence satisfactory to the board that the individual has successfully completed not less than twenty-four months of graduate medical education through the second-year level of graduate medical education or its equivalent as determined by the board, and, if the individual passed the examination prior to completing twenty-four months of graduate medical education or its equivalent, the individual continues to meet the moral character requirements for admission to the board’s examination[vii].
An affirmative vote of not less than six members of the board is required for the issuance of a certificate authorizing practice of medicine or surgery or osteopathic medicine. The board may conduct a standard medical licensing examination established for purposes of determining the competence of individuals to practice medicine and surgery or osteopathic medicine and surgery in the United States[viii]. Demonstration of proficiency in spoken English may be required for foreign graduates[ix].
The board, by an affirmative vote of not fewer than six of its members, may revoke or may refuse to grant a certificate to a person found by the board to have committed fraud during the examination or securing any certificate to practice or certificate of registration issued by the board. The board may also limit, revoke, or suspend an individual’s certificate to practice, refuse to register an individual, refuse to reinstate a certificate, or reprimand or place on probation the holder of a certificate for one or more of the following reasons:
- Permitting one’s name or one’s certificate to practice to be used by a person, group, or corporation when the individual concerned is not actually directing the treatment given;
- Failure to maintain minimal standards applicable to the selection or administration of drugs, or failure to employ acceptable scientific methods in the selection of drugs or other modalities for treatment of disease;
- Selling, giving away, personally furnishing, prescribing, or administering drugs for other than legal and legitimate therapeutic purposes or a plea of guilty to, a judicial finding of guilt of, or a judicial finding of eligibility for intervention in lieu of conviction of, a violation of any federal or state law regulating the possession, distribution, or use of any drug;
- Willfully betraying a professional confidence.
- Making a false, fraudulent, deceptive, or misleading statement in the solicitation of or advertising for patients.
- A departure from, or the failure to conform to, minimal standards of care of similar practitioners under the same or similar circumstances, whether or not actual injury to a patient is established;
- Representing, with the purpose of obtaining compensation or other advantage as personal gain or for any other person, that an incurable disease or injury, or other incurable condition, can be permanently cured;
- Commission of felony or misdemeanor involving moral turpitude;
- Failure to pay license renewal fees;
- Engaging in the division of fees for referral of patients, or the receiving of a thing of value in return for a specific referral of a patient to utilize a particular service or business;
- Inability to practice according to acceptable and prevailing standards of care by reason of mental illness or physical illness, including, but not limited to, physical deterioration that adversely affects cognitive, motor, or perceptive skills.
- Violating or attempting to violate, directly or indirectly, or assisting in or abetting the violation of, or conspiring to violate, any provisions of this chapter or any rule promulgated by the board.
- Termination or suspension from participation in the medicare or medicaid programs by the department of health and human services or other responsible agency for any act;
- Drug or alcohol abuse;
- Impairment of ability to practice according to acceptable and prevailing standards of care because of habitual or excessive use or abuse of drugs, alcohol, or other substances that impair ability to practice.
- Failure to use universal blood and body fluid precautions;
- Failure to provide notice to, and receive acknowledgment of the notice from, a patient prior to providing nonemergency professional services, or failure to maintain that notice in the patient’s file;
- Failure to supervise anesthesiologist, acupuncturist or radiologist;
- Failure to cooperate in an investigation conducted by the board[x].
Unauthorized practice of medicine, surgery, or podiatry may also include:
- Using the words or letters, “Dr.,” “Doctor,” “M.D.,” “physician,” “D.O.,” “D.P.M.,” or any other title in connection with the person’s name in any way that represents the person as engaged in the practice of medicine and surgery, osteopathic medicine and surgery, or podiatric medicine and surgery, in any of its branches;
- Illegal advertising;
- Prescribing, advising , recommending, administering, or dispensing for compensation of any kind, direct or indirect, a drug or medicine, appliance, mold or cast, application, operation, or treatment, of whatever nature, for the cure or relief of a wound, fracture or bodily injury, infirmity, or disease.
- The treatment of human ills through prayer alone by a practitioner of the Christian Science church, in accordance with the tenets and creed of such church, shall not be regarded as the practice of medicine, provided that sanitary and public health laws shall be complied with, no practices shall be used that may be dangerous or detrimental to life or health, and no person shall be denied the benefits of accepted medical and surgical practices[xi].
The board can enjoin any person from engaging either directly or by complicity in the unlawful practice of medicine by seeking an injunction[xii].
[i] ORC Ann. 4731.081.
[ii] ORC Ann. 4731.09.
[v] ORC Ann. 4731.11.
[vi] ORC Ann. 4731.14.
[viii] ORC Ann. 4731.13.
[ix] ORC Ann. 4731.142.
[x] ORC Ann. 4731.22.
[xi] ORC Ann. 4731.34.
[xii] ORC Ann. 4731.341.