Vermont statutes stipulate that an applicant has to attain the age of majority for applying for a license to practice medicine[i]. The applicant must be a graduate of a legally chartered college or university authorized to confer degrees in medicine and surgery, which is recognized by the board, and must be of good moral character. Before applying for the examination for licensure, the applicant shall furnish evidence of good moral character and proficiency in English language, from the chief of service and two other active physician staff members at the hospital where the person was last affiliated[ii]. However, the board may accept evidence from other sources in its discretion.
If a person successfully completes the examination and an interview before the board, s/he may then apply for licensure to practice medicine and surgery[iii].
In the case of foreign medical graduates, the board has discretion to refuse applications for want of approval of credentials by the educational council for foreign medical graduates.
If an applicant is seeking a temporary license, then such a person shall furnish satisfactory proof regarding age, character and educational credentials and that s/he has been appointed an intern, resident, fellow or medical officer in a licensed hospital or in a clinic which is affiliated with a licensed hospital, or in any hospital or institution maintained by the state, or in any clinic or outpatient clinic affiliated with or maintained by the state. The board, in such cases may grant a limited temporary license for a period of up to 54 weeks[iv].
A temporary license may be renewed or reissued, upon payment of the fee, for the period of the applicant’s postgraduate training, internship or fellowship program[v]. Such limited temporary license shall entitle the said applicant to practice medicine only in the hospital or other institution designated on his/her certificate of limited temporary license and in clinics or outpatient clinics operated by or affiliated with such designated hospital or institution and only if such applicant is under the direct supervision and control of a licensed physician[vi]. Such licensed physician shall be legally responsible and liable for all negligent or wrongful acts or omissions of the limited temporary licensee.
A limited temporary license shall be revoked upon the death or legal incompetency of the licensed physician or, upon ten days written notice, by withdrawal of his/her filing by such licensed physician[vii]. The limited temporary licensee shall at all times exercise the same standard of care and skill as a licensed physician of the same specialty. Termination of appointment as intern, resident, fellow or medical officer of such designated hospital or institution shall operate as a revocation of such limited temporary license[viii].
The board may also grant a license without examination. Such a facility is usually available to a reputable physician or surgeon who personally appears and presents a certified copy of a certificate of registration or a license issued to him/her in a jurisdiction with similar requirements. However, there should be a reciprocity agreement between the state of Vermont and such other jurisdiction[ix]. Similarly, the board may waive the examination requirement for a reputable physician or surgeon who is a resident of a foreign country and who has been appointed to the faculty of a medical college in Vermont accredited by the Liaison Committee on Medical Education (LCME). Such a temporary license shall expire automatically upon termination for any reason of the licensee’s faculty appointment[x].
In order to be eligible for admission to practice, the applicant must be a graduate of a medical college approved by the board or approved by an accrediting body satisfactory to the board and completed at least a one-year hospital program of postgraduate training approved by the board or approved by an accrediting body satisfactory to the board[xi]. The examination in writing shall have embraced 13 subjects of 90 questions, viz.: anatomy, physiology, chemistry, pathology, bacteriology, hygiene, practice of medicine, surgery, obstetrics, gynecology, materia medica, therapeutic and legal medicine. The applicant must achieve a grade of at least 75 percent in each subject.
The board may refuse to issue a license to criminal convicts or persons who sought license by false or fraudulent representations or who assume names other than their own, or for any other immoral, unprofessional or dishonorable conduct[xii]. The board may suspend or revoke a certificate in the event of a licensee becoming mentally incompetent. However, prior to such revocation, the person shall be given a hearing before the board.
The license is renewable biennially on payment of a renewal fee. A practitioner who fails to renew his/her license shall be deemed an illegal practitioner and shall forfeit the right to so practice or to hold himself/herself out as a person licensed to practice medicine and surgery in the state until reinstated by the board. However, a person who was licensed to practice medicine and surgery at the time of his induction, call on reserve commission or enlistment into the armed forces of the United States, shall be entitled to practice medicine and surgery during the time of his service with the armed forces of the United States and for 60 days after separation from such service[xiii]. A licensee who fails to renew his/her license may renew the license by paying a renewal fee and the late renewal penalty[xiv].
The board has power to investigate all complaints and charges of unprofessional conduct against any holder of a license or certificate, or any medical practitioner and to hold hearings to determine whether such charges are substantiated or unsubstantiated. The board also has power to issue subpoenas and administer oaths in connection with any investigations, hearings, or disciplinary proceedings[xv]. The board can also require a licensee or applicant to submit to a mental or physical examination, and an evaluation of medical knowledge and skill by individuals or entities designated by the board if the board has a reasonable basis to believe a licensee or applicant may be incompetent or unable to practice medicine with reasonable skill and safety[xvi]. The results of an examination or evaluation shall not be used for any purpose, including impeachment or cross-examination against the licensee or applicant in any criminal or civil case, except a prosecution for perjury or giving a false statement[xvii].
The board has discretion to deny license on the basis of any of the following conduct.
- Fraudulent or deceptive procuring or use of a license;
- Advertising of medical business with an intention to deceive the public;
- Abandonment of a patient;
- Drug abuse;
- Forging and filing false reports or records and willful omission to file or record, or willfully impeding or obstructing a filing or recording, or inducing another person to omit to file or record medical reports required by law;
- Division of fees or agreeing to split or divide the fees received for professional services for any person for bringing to or referring a patient;
- Illegal referrals to clinical laboratories;
- Willful misrepresentation in treatments;
- Practicing medicine with a physician who is not legally practicing within the state, or aiding or abetting such physician in the practice of medicine;
- Gross overcharging for professional services on repeated occasions, including filing of false statements for collection of fees for which services are not rendered;
- Offering or undertaking to cure or treat disease by a secret method, procedure, treatment or medicine;
- Professional incompetency resulting from physical or mental impairment;
- Failure to comply with provisions of federal or state statutes or rules governing the practice of medicine or surgery;
- Delegation of professional responsibilities to a person whom the licensed professional knows, or has reason to know, is not qualified by training, experience, education or licensing credentials to perform them;
- Conviction of a crime related to the practice of the profession or conviction of a felony, whether or not related to the practice of the profession[xviii];
The board may also find that failure to practice competently by reason of any cause on a single occasion or on multiple occasions constitutes unprofessional conduct. Failure to practice competently includes performance of unsafe or unacceptable patient care or failure to conform to the essential standards of acceptable and prevailing practice[xix]. The state has to show by a preponderance of the evidence that the person has engaged in unprofessional conduct.
The board may issue a notice of hearing to the erring licensee specifying the time and place of hearing[xx]
If the board finds the licensee guilty of unprofessional conduct, the board may reprimand the person and may condition, limit, suspend or revoke the license or practice or take such other action relating to discipline or practice as the board determines is proper[xxi]. On the other hand, if the licensee is found not guilty, the board shall forthwith order a dismissal of the charges and the exoneration of such person. An order issued under this section shall be in full force and effect until further order of the board or a court of competent jurisdiction.
If a person is convicted of a crime by a court, the board may immediately suspend that person’s license until the time for appeal has elapsed and no appeal has been taken, or until the judgment of conviction has been affirmed on appeal or has otherwise become final, and until further order of the board. The licensee will have a right to request a hearing, within 90 days and have the burden of showing why the suspension should not remain in effect pending appeal. The sole issue to be determined at such a hearing shall be the nature of the disciplinary action to be taken by the board[xxii].
A licensee who is aggrieved by a final order of the board may, within 30 days of the order, appeal that order to the Vermont Supreme Court on the basis of the record created before the board[xxiii].
[i] 26 V.S.A. § 1391.
[ix] 26 V.S.A. § 1395.
[xi] 26 V.S.A. § 1396
[xii] 26 V.S.A. § 1398.
[xiv] 26 V.S.A. § 1400.
[xv] 26 V.S.A. § 1353.
[xviii] 26 V.S.A. § 1354
[xx] 26 V.S.A. § 1357.
[xxi] 26 V.S.A. § 1361.
[xxii] 26 V.S.A. § 1365.
[xxiii] 26 V.S.A. § 1367.