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The following state medical and osteopathic boards use the Uniform Application for Physician State Licensure. More boards are implementing the Uniform Application into their licensure processes so check back often.  

UA Participating Boards for MD and DO

Alaska State Medical Board Forms & Instructions 
Alabama Board of Medical Examiners * Forms & Instructions 
Guam Board of Medical Examiners Forms & Instructions
Idaho State Board of Medicine * Forms & Instructions
Medical Licensing Board of Indiana Forms & Instructions
Iowa Board of Medicine * Forms & Instructions
Kansas State Board of Healing Arts Forms & Instructions
Maine Board of Licensure in Medicine * Forms & Instructions
Maine Board of Osteopathic Licensure * Forms & Instructions
Maryland Board of Physicians * Forms & Instructions
Montana Board of Medical Examiners Forms & Instructions
New Hampshire Board of Medicine * Forms & Instructions
New Mexico Medical Board Forms & Instructions
Commonwealth of the Northern Mariana Islands Forms & Instructions
State Medical Board of Ohio Forms & Instructions
Oklahoma Board of Medical Licensure and Supervision Forms & Instructions
Oklahoma State Board of Osteopathic Examiners   Paper Only
Rhode Island Board of Medical Licensure and Discipline *   Forms & Instructions
Texas Medical Board Forms & Instructions
Vermont Board of Medical Practice Paper Only
Virgin Islands Board of Medical Examiners * Forms & Instructions
Washington Medical Commission Forms & Instructions
Washington Board of Osteopathic Medicine and Surgery Forms & Instructions
West Virginia Board of Medicine Forms & Instructions
West Virginia Board of Osteopathic Medicine Forms & Instructions
Wisconsin Medical Examining Board Forms & Instructions
Wyoming Board of Medicine * Forms & Instructions

 

*Requires the UA Application

UA for PAs:

Maine Board of Licensure in Medicine Forms & Instructions 
Maine Board of Osteopathic Licensure Forms & Instructions
Maryland Board of Physicians Paper Only
Montana Board of Medical Examiners Forms & Instructions
Oklahoma Board of Medical Licensure and Supervision                           Forms & Instructions
Virgin Islands Board of Medical Examiners * Forms & Instructions
Washington Medical Commission Forms & Instructions

    

Key Insights from the FSMB The Big Picture Informing the Future of Healthcare

A Record Year for New Licenses

 

Who Makes Up the Workforce? Global Education, Local Impact

Rapid Growth in DOs

 

Aging Workforce Gender Shift in Medicine

Demand Is Outpacing Supply

 

   
Alaska State Medical Board Forms & Instructions
   
   
   
   
   
   
   
   
   
   
   

The PLAS collaborates with the following national assessment programs to assist them in conducting comprehensive, tailored assessments of physicians' medical knowledge, clinical judgment and patient management skills. The tools provided by PLAS complement these programs' other performance-based methods of assessment, such as medical record reviews, peer (preceptor) assessment and feedback, patient evaluations and case-based evaluations of physician care.

Information about obtaining an assessment through these collaborators can be obtained directly from the programs through the contact information provided below. Physicians can obtain an assessment via self-referral or third-party referral (e.g., state medical board, physician practice, hospital, other healthcare entity).

  • The Center for Personalized Education for Professionals (CPEP)
  • Drexel Medicine® Physician Refresher/Re-Entry Course
  • LifeGuard
  • Physician Assessment and Clinical Education Program (PACE) at UCSD
  • Texas A&M University
  • University of Florida

Please feel free to contact FSMB if you have any questions: 817-868-4041, Monday - Friday 9:00 a.m. - 6:00 p.m. (Eastern Time), or via e-mail at plas@fsmb.org.

NOTE: Programs are listed in alphabetical order by state.


California
Physician Assessment and Clinical Education Program (PACE)

UCSD School of Medicine
1899 McKee Street, Suite 100
San Diego, CA 92110
(619) 543-6770 Office

Contact: Kaden Segren
E-mail: ksegren@ucsd.edu
Website: http://www.paceprogram.ucsd.edu

Program:


Length: 3-5 days

 

Cost: $16,000 - $19,000


Final Report: Four (4) weeks following completion of all program components

Assessment Components:

  • PLAS exams including CCS/
    TSR
  • 360 assessment
  • Oral clinical exam
  • Medical record/chart review
  • Practice profile
  • History & Physical Skills exam
  • Health exam & Cognitive
    function screening
  • Exit interview
  • Clinical Observation with UC
    San Diego Faculty (matched by specialty)
  • Clinical Skills Simulation(s) - various specialties
  • Final grade and
    recommendations specific to
    each individual participant.

Possible recommendations include:

  • Specific CME courses 
  • Proctoring of practice or cases
  • Ongoing, on-site, in-practice medical record and practice monitoring and insight (PEP Program)
  • Customized CME
  • Independent self-study

CME Courses:

  • Medical Record Keeping
  • Prescribing
  • Anger Management
  • Professional Boundaries
  • Communication Workshop
  • Customized CME Programs (developed for specific needs) 


Colorado
The Center for Personalized Education for Professionals (CPEP)
720 South Colorado Blvd., Suite 1100-N
Denver, Colorado 80246
(303) 577-3232 Office

Contact: Elizabeth Korinek, MPH
E-mail: info@cpepdoc.org
Website: www.cpepdoc.org

Program:


Length:
 1-2 days

 

Cost: $9,000 - $14,000

 

Final Report: approx. 8 weeks

 

Assessment Components:

  • PLAS exams
  • COMVEX exam
  • Matched specialty clinical interviews (more than 250 community and university-
    based board-certified
    physicians)
  • Review of patient charts (20-40 charts from practice)
  • Fetal Monitor Strip
    interpretation
  • ECG Interpretation
  • Simulated patient encounter
    and review of progress notes
  • Cognitive function screening
  • Review of health information
  • Fundamentals of Laparoscopic Surgery (FLS) Exam
    (appropriate to practice)
  • Fundamentals of Endoscopic Surgery (FES) Exam
    appropriate to practice)
  • “Difficult Airway Simulation” (appropriate to practice)
  • Emergency Medicine
    Simulation (appropriate to practice) 
  • Robotic Surgery Simulation (appropriate to practice)
  • General (Open) Surgery Simulation (appropriate to practice)
  • Trauma Simulation
    (appropriate to practice)
  • Obstetrics Simulation
    appropriate to practice)
  • Crisis Management Simulation (appropriate to practice) 

Follow-Up Education Options:

  • Offers customized education intervention including
    development of education plan, monitoring of progress and
    regular reports to referring organization. Education
    activities arranged in
    participant's home community.
  • Education remediation takes
    from 6-12 months, depending
    on needs.

Other Programs:

  • Reentry into Clinical Practice Program (RCP)
  • Fitness for Duty Assessments
  • Credentialing/Privileging
    Screen
  • Practice Monitoring

CME Courses:

  • Medical Record Keeping
    Seminar
  • PROBE/Ethics - Ethics and Boundaries Program
  • Prescribing Controlled Drugs: Critical Issues and Common Pitfalls©
  • Basics of Chronic Pain Management
  • Improving Inter-Professional Communication: Working Effectively in Medical Teams
  • Advanced Skills in Clinician -Patient Communication 


Florida
Florida Competency Advancement Program

P.O. Box 100277
Gainesville, FL 32610
(352) 273-9063 Office

E-mail: floridacares@medicine.ufl.edu
Website: floridacares.med.ufl.edu

Program:


Length:
 2-3 days

 

Cost: varies; dependent on assessment needs

 

Final Report: 8-10 weeks 

Assessment Components:

  • PLAS exams
  • Chart stimulated recall Exam
  • Standardized Patient
    Examination
  • Psychological Evaluation

 

Assessments are tailored based on circumstances and specialty.

Follow-Up Education Options:

Remediation:

  • PLAS exams
  • Chart stimulated recall Exam
  • Standardized Patient
    Examination
  • Psychological Evaluation


North Carolina

The Center for Personalized Education for Professionals (CPEP)
222 N. Person Street
Raleigh, NC 27601
(919) 238-6436 Office

Contact: Bill O'Neill, MBA
E-mail: info@cpepdoc.org
Website: www.cpepdoc.org

Program:


Length:
 1-2 days

 

Cost: $9,000 - $14,000

 

Final Report: approx. 8 weeks

 

Assessment Components:

  • PLAS exams
  • COMVEX exam 
  • Matched specialty clinical interviews (more than 250 community and university-
    based board-certified
    physicians)
  • Review of patient charts (20-40 charts from practice)
  • Fetal Monitor Strip
    interpretation
  • ECG Interpretation
  • Simulated patient encounter
    and review of progress notes
  • Cognitive function screening
  • Review of health information
  • Fundamentals of Laparoscopic Surgery (FLS) Exam
    (appropriate to practice)
  • Fundamentals of Endoscopic Surgery (FES) Exam
    (appropriate to practice)
  • “Difficult Airway Simulation” (appropriate to practice)
  • Emergency Medicine
    Simulation (appropriate to practice) 
  • Robotic Surgery Simulation (appropriate to practice)
  • General (Open) Surgery Simulation (appropriate to practice)
  • Trauma Simulation
    (appropriate to practice)
  • Obstetrics Simulation
    (appropriate to practice)
  • Crisis Management Simulation (appropriate to practice) 

Follow-Up Education Options:

  • Offers customized education intervention including
    development of education plan, monitoring of progress and
    regular reports to referring organization. Education
    activities arranged in
    participant's home community.
  • Education remediation takes
    from 6-12 months, depending
    on needs. 

Other Programs:

  • Reentry into Clinical Practice Program (RCP)
  • Fitness for Duty Assessments
  • Credentialing/Privileging
    Screen
  • Practice Monitoring

CME Courses:

  • Medical Record Keeping
    Seminar
  • PROBE/Ethics - Ethics and Boundaries Program
  • Prescribing Controlled Drugs: Critical Issues and Common Pitfalls©
  • Basics of Chronic Pain Management
  • Improving Inter-Professional Communication: Working Effectively in Medical Teams
  • Advanced Skills in Clinician -Patient Communication 


Pennsylvania
Drexel Medicine® Physician Refresher/Re-Entry Course

Office of Continuing Medical Education
2900 W. Queen Lane
Building K., Suite 118
Philadelphia, PA 19129
(215) 991-8876 Office

Contact: Cynthia Johnson
E-mail: cynthia.johnson@drexelmed.edu
Website: https://drexel.edu/medicine/academics/continuing-education/physician-refresher-re-entry-program/

Program:


Length:
 Preceptorship is offered in 6 week blocks. The recommended duration varies – i.e., 6 weeks, 12 weeks,
18 weeks, ...

 

Cost: Tuition for 6-week block is $7,500. Assessment is an additional $2,000-6,000

 

Final Report: 4-6 weeks

Assessment Components:

  • PLAS exams including CCS/
    TSR
  • 360-dgree assessment which includes self- and peer assessment
  • Standardized Patients (4-6 or more): interviewing, physical exam, medical reasoning,
    patient communication and documentation
  • Medical documentation
    including oral presentation and medical reasoning
  • Simulated patients
    )intermittently depending on specialty
  • Virtual Online Patients
  • Online essay & MCQs on communication skills, medical knowledge, and clinical
    reasoning
  • Presentation skills

Follow-Up Education Options:

  • Assessments are followed by a structured educational Preceptorship in a university setting with other learners (students, residents, fellows) individualized for the
    physician’s needs.
    Assessments continue
    throughout the duration of the Preceptorship including a final assessment at the end of the program.


Pennsylvania
LifeGuard

777 East Park Drive
Harrisburg, Pennsylvania 17111
(717) 909-2590 Office

Contact: Marcia A. Lammando, RN, BSN, MHSAQ 
E-mail: info@lifeguardprogram.com
Website: https://www.lifeguardprogram.com/services-7

Program:


Length:
 Assessment components can typically be completed over a period of  1-3 days once scheduled. Typical length of full program is 3-6 months, depending on additional preceptorships that may be required.

Cost:  $8,500-$10,000 for full program (can be higher or lower depending on components required.)

Final Report: Four (4) weeks following completion of all program components.

Assessment Components:

  • PLAS exams including CCS/
    TSR
  • Neurocognitive assessment
  • Independent medical exam
  • Functional capacity exam
  • Standardized patients
  • Simulation laboratory
  • Preceptorship
  • Proctorship
  • Inter-rater reliability study
  • Medical records documentation review
  • Peer review
  • Coding audits
  • Professionalism assessment
  • Communication skills learning

Follow-Up Education Options:

  • Customized remediation recommendations are offered
  • Retesting of PLAS
    examinations, if necessary and available

CME Courses

  • Opioid Prescribing Practices
  • Coding/Billing Medical Records Documentation
  • Professional Boundaries


Texas
Knowledge Skills Training Assessment and Research (KSTAR)

The Rural and Community Health Institute
Crystal Park Plaza
2700 Earl Rudder Freeway South, Suite 3000
College Station, Texas 77845
(979) 436-0407 Office
(979) 436-0079 Fax

Contact: Tracy Adams, BBA Program Manager
E-mail: Tladams@tamu.edu
Website: https://www.architexas.org/  

Program:

Assessments are done at the Texas A&M Health Science Center Simulations Center on Hwy 47 in Bryan, TX.

Length: 2 days

Cost: $12,600

Final Report: 4 weeks 

Assessment Components:

  • PLAS exams
  • Clinical Interview
  • Standardized patients
  • Cognitive function screening
  • Pharmacology Testing
  • Ethics & Professionalism
    Testing
  • Additional tests per specialty
    may be included

Follow-Up Education Options:

  • Individualized Educational
    Plans
  • 90-day Mini-Residency Reentry Program at UTMB in Galveston, and Driscoll
    Children’s Hospital in Corpus Christi, Texas

 

This is the bullet list:

  • First bullet
  • Second bullet
  • Thirds Bullet

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