# Untitled Texas Attorney General Opinion > Texas Attorney General Reports · July 2, 1986 URL: https://www.frixlaw.com/law-library/cases/4130955 ## Case - **Court:** Texas Attorney General Reports - **Decided:** July 2, 1986 - **Precedential status:** Published - **Opinion:** Opinion - **Judges:** Jim Mattox - **Cited by:** 0 later opinions in the Frix Law Library ## Citator (automated) - No negative treatment found by the automated citator. That is not the same as a confirmation that the case is good law; read the citing cases. - Full citator and citing cases: https://www.frixlaw.com/law-library/cases/4130955 ## Opinion text The Attorney General of Texas .luly 9, 1986 JIM MAl-TOX Attorney General Supreme Court Building Honorable Brad WrigY~t Opinion No. JM-512 P. 0. BOX 12548 Austin, TX. 78711.2548 Chairman 5121475.2501 Cormnittee on Public Realth Re: Licensing of out-of-state Telex 9101874.1367 Texas House of Repr~asentatlves physicians Telecopier 512/4750266 P. 0. Box 2910 Austin, Texas 787’59 714 Jackson, Suite 700 Dallas, TX. 75202-4508 Dear Representative Wright: 214/742-8944 You have requested an Attorney General’s Opinion concerning the authority of the Te:cas Board of Medical Examiners. You state that the 4824 Alberta Ave.. Suite 160 El Paso, TX. 79905-2793 board has refused to grant a reciprocal license to a doctor licensed 915/533-3484 in Arkansas because! that doctor took the Federation Licensing Exam (FLEX) before he graduated from medical school. Applicants for licensing by examination-- in Texas are not eligible to take the Texas ‘001 Texas, suite 700 Licensing Examination, which includes the FLEX, until after graduation -Mon. TX. 77002-3111 from medical school. In Arkansas, both graduation from medical schcol .2234886 and a passing sco’re on the FLEX are prerequisites to licensing. Arkansas differs fruxn Texas in that in Texas a person may not take the 808 Broadway, Suite 312 FLEX until after grzuluation. Therefore, you ask: Lubbock, TX. 79401-3479 806/747-5238 Does the fact that the state in which a medical doctor attended school allowed the doctor to take 4304 N. Tenth. Suite B the FLEX exam prior to graduation statutorily McAllen. TX. 78501-1685 prevent Texas from granting rticiprocity to that 512/682-4547 doctor? 200 MaIn Plaza, Suite 400 The Medical P,:actice Act grants the board authority to grant San Antonio, TX. 78205.2797 licenses to physlciims licensed in other states: 5121225-4191 Sec. 2.03 (a) The board . . . at its sole An Equal Opportunity/ discretion and upon payment by an applicant of a Affirmative Action Employer fee prescr,fbed by the board under this Act, may grant a l.icense to practice medicine to any reputable, physician who is a graduate of a reputable medical college and who: (1) %I# a licensee . . . of another state or Canadian province having requirements for physician registration and practice substantially equivalenl: to those established by the laws of P this statc!. . . . p. 2352 Honorable Brad Wright - Page 2 (JM-512) V.T.C.S. art. 4495b. $3.03(a). In other words, section 3.03(a) allows the board to license by reciprocity a physician who meets the following requirements: (1) the applicant is a “reputable physician”; (2) the applicant is a grilduate of a “reputable medical school”; and (3) the applicant is licensed in a state or Canadian province that has requirement,s for regislzation and practice “substantially equiva- lent” to those in Texas. The act defines “reputable physician” as “one who would be eligible for examination by the board.” V.T.C.S. art. 449:b, §3.03(d). To be eligible for examination in Texas an applicant must show that he: (1) is at lez.st 21 years of age; (2) is of gocd professional character; (3) has compkted 60 semester hours of college courses other thr.n in medical school, which courses would be acceptab1.e. at the time of completion, to The University of’ Texas for credit on a bachelor of arts degree or a bachelor of science degree; (4) is a gradua.te of a medical school OS college that was approvqzl by the board at the time the degree was confe&ed* --* and (5) has s”cl:essf”lly completed a one year program of graduate medical training approved by the board. In cld.dition to other license require- merits, the board may require by rule and regulation that graduates cf medical schools located outside the United States and Canada comply with other requirements that the board considers appropriate, ikluding but not limited to additional graduate medical training in the United States, except those who qualify for Hcensure in Section 5.04 of this Act. However, thse applicant shall be eligible for examination prio:: to complying with Subdivision (5) of Subsection (a) of this section but shall not be eligible for the issuance of an unrestricted license until the requirements of this subsection have been satisf,Led. (Emphasis added). Art. 4495b. 53.04(a). Ycu tell us that the applicant in question meets all these requiremenrs and that he is a graduate of a “reputable medical school.” The board has submitt,zd a brief explaining that its determination in the case you describe, j.s based. (at least in part) on the statutory requirement that an applkant for licensing by reciprocity be licensed -. in a state or Canadian prov:lnce that has requirements for registration and practice “substantially equivalent” to those in Texas. Art. 4495b. p. 2353 Honorable Brad Wright - Page 3 (JM-512) 83.03(a). The board has submitted a brief arguing that the timing of the FLEX is important for quality control. Logic and experience however, tell us that a test score would not be deceptively h&& because the person taking the test had less training than others taking the test. Therefore, we.think it would be unreasonable as a matter of law for the boar,d to conclude, based on the timing of the FLEX alone, that the test sc:ore requirements of a state that accepted FLEX scores achieved before graduation were,not "substantially equiva- lent" to Texas' test score requirements.' See Allstate Insurance Company v. State Board of Insurance, 401 S.W.2d131, 132 (Tex. Civ. APP. - Austin 1966, writ r;f'd n.r.e.) (administrative rules must be reasonable). The board's brief dor:s, however, point to a potential problem with reciprocal licensing of physicians licensed in Arkansas. . The board tells us that Arkacsas does not require a year of graduate medical training as a prerequisite to licensing of physicians. If that is in fact so, an Arkansas physician may be licensed in a state that does not have "requllrements for registration and practices substantially equivalent" to those in Texas. Apart from the question of the sequence of the FLEX and graduation, however, the question of. whether or not the Arkansas requirements for registration and practice are "substantially equivalent" to those in Texas is not before us. SUMMARY P The Medical P:ractice Act does not prevent the licensing by reciprocity of a physician solely because the physician took the Federal Licensing Examination before graduation from medical school. J /NJ& Very truly yours A;, JIM MATTOX Attorney General of Texas JACK HIGHTOWER First Assistant Attorney General MARY KELLER Executive Assistant Attorney General RICK GILPIN Chairman, Opinion Committee Prepared by Sarah Woelk Assistant Attorney General 1. We assume that the version of the FLEX is one that is accept- able to Texas. -See 22 T.A.C. 0163.3. p. 2354 --- Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/4130955. Public record. Not legal advice.