Additional Requirements for Graduates of Approved Medical Schools (United States or Canada):
	Must have successfully completed 12 months hospital internship, residency or fellowship program which was approved by the Accreditation Council for Graduate Medical Education, the Association of American Medical Colleges, the Royal College of Physicians and Surgeons of Canada or any similar body in the United States or Canada whose function is that of approving training programs. Must have successfully passed a complete written examination administered by any state, territory or district of the United States, or province of Canada, or be certified by the National Board of Medical Examiners as having pass all three parts of the National Board Examination or all three Steps of the United States Medical Licensing Examination or be certified by the Licensing Medical Council of Canada, or passed the Federation Licensing Examination. NOTE: If applicant's written examination was the FLEX exam taken prior to January 1, 1985, must have been taken in one sitting and must have achieved a FLEX weighted average of at least 75. If FLEX was taken after December 1, 1984, both Component I and Component II must hare been passed within a 5 year period and must have received al least a 75 in each Component. If applicant is an initial licensee and the written examination was the USMLE exam, all three Steps must have been taken within a 7 year period after first sitting for step one and must have received at least a 75 in each Step.
	The following combinations of Examinations (hybrids) are acceptable: Parts One and Two of the NBME AND either Step Three of the USMLE or Component II of FLEX with a scaled score of 75; or FLEX Component I AND Step Three of the USMLE with a scaled score of 75; or Each of the following: NBME Part One or Step One of the USMLE with a scaled score of 75 NBME Part Two or Step Two of the USMLE with a scaled score of 75 NBME Part Three or Step Three of the USMLE or Component II of FLEX with a scaled score of 75 An applicant seeking licensure by endorsement based on successful passage of a written examination which precedes by more than ten years the application for licensure by endorsement in this state shall take and successfully complete a special purpose licensing examination to determine the applicants ability to safely engage in the practice of medicine. An applicant who fails the special purpose licensing examination three times shall prove that he has successfully completed an additional twelve months of postgraduate training in an approved hospital internship, residency or clinical fellowship program before retaking the special purpose licensing examination. Must file a complete application for licensure by either Endorsement or Endorsement and SPEX or by written examination. Must pay all fees. Must contact the Federation of State Medical Boards at 400 Fuller Wiser Road, Suite 300, Euless, Texas 76039-3855, to request that all FLEX and USMLE scores be sent to this office. (Scores must be received in this office before any application will be forwarded to the applicant.)
Additional Requirements for Graduates of Unapproved Allopathic Medical Schools:
	In addition to the above requirements, the following must be met: Be able to read, write, speak, understand and be understood in the English language. Hold a standard certificate issued by the Educational Council for Foreign Medical Graduates, complete a Fifth Pathway program, or complete thirty-six months as a full-lime Assistant Professor or higher position in an approved school of medicine. Successfully complete an additional, approved twenty-four month hospital internship, residency or clinical fellowship program, for a total of thirty-six months, unless the applicant successfully completed a Fifth Pathway program, or has served as a full-time Assistant Professor or higher position at an approved school of medicine. NOTE: The licensure requirements are set by statute and cannot be waived by the Board.
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