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Took the Texas Jurisprudence Exam a few days ago for Texas licensure.
We did not have an 'in house' crib sheet at my program for this exam, and I couldn't find much on the forums, so I decided to put this together to help those of you who need a bit of guidance with study strategy and resources.
The exam is 60 questions, for which you have 100 minutes. All multiple choice with many including "all of the above" or "none of the above" as a final option. You will schedule the exam with Pearsonvue online. Bathroom breaks are allowed, but the clock does not stop, so pee quickly.
With the following guidelines, I was fortunate to overachieve, finishing the test in about 30 minutes and scoring a 98%. If anyone has any corrections or additions, please feel free to PM me or comment directly in the thread; I will update as appropriate.
Overall thoughts:
The exam is, at its essence, a collection of exceptions, deadlines, and crime classifications. Much of it is not well organized by any of the resources out there (the TJP tried in one of their updates, but still came up short). As such, I have included a summary of exceptions, deadlines and crime classifications that I made myself later in this post. The TJP website repeatedly makes the point that knowing specific classification of misdemeanors is not important, but they test it in their own material, and the classification is definitely on the exam.
Study guides:
Different reviews have different strengths and weaknesses. None is complete in and of itself. Reviewing them, I found several discrepancies between the texts, which I have also summarized later in this post. The Zerris prep is available on Quizlet, as are some other high yield notecard sets. In brief:
- UTMB Galveston Texas Jurisprudence Study Guide (3/5) $$ - The text was written by JD/PhDs and is the most comprehensive resource that I used in prep. This is an outline format study guide which goes through all of Texas law to an insane level of detail. The major strength of the text are the questions at the book finale.
While the book is about 400 pages, the last 70 are multiple choice questions with the answer key referencing the part of the book text that explains the correct answer. These are incredibly high yield, and resemble about 50% of test content -- many of them were taken by the TJP website for their own questions. The only way I was able to go through this text without falling asleep too much was by doing the multiple choice first, then retrograde reading the appropriate sections. Afterwards, I quickly skimmed the text antegrade. The major negative, which is significant, is that the text is mind numbingly boring, with huge sections of text cut-and-paste repeated, and with little shorthand.
-Texasjurisprudenceprep.com (3/5) $$$ - This is a decent resource written and prepared by two Texan ER docs. The course is somewhat costly, and essentially consists of a flash powerpoint presentation with the course creators speaking over the slide followed by 6 short quizzes. Their humor is a bit annoying (ie. hearing the joke the first time is cute, but can be trying when hearing it again and again with each review), but they convey their points succinctly.
Regarding the course content, it is decent. The highest yield portions are 1) the last slide of the entire presentation which is an overall review and 2) the quizzes, many of which are copied from the UTMB Galveston study guide almost word for word. The authors stress Quizzes 5 and 6, but all are helpful, and can be done fairly quickly a few times. They apparently have done their best to duplicate questions on the exam, and they do a decent job of it, with about 30-60% overlap. With a minimum passing score of 75%, this website can take you much of the way there.
-Texas Jurisprudence Study Guide by Zerris and Smith (2/5) $ - This is a bulletpoint question and answer book written by three Texan neurosurgeons, one of whom is also trained as a JD. There are two great things about this study guide and a few bad things. First, it is available on Kindle. As such, you can quickly go through it on your phone running around the hospital or while in line running errands till the answers are memorized. Second, the final chapter is a summary of several of the dates and misdemeanors that need to be remembered, and is the most useful part of the entire text. I have included most of the information from that section later in this post. The negatives of this book are that is has quite a few discrepancies, is out of date, and does not provide much context. Whereas the Galveston study guide is overly detailed, this text is too sparse. The book is available for free online via Quizlet (just google Texas Jurisprudence Prep study cards).
Shorthand:
- MHIP = Mental Health InPatient
- Galveston = UTMB Galveston Texas Jurisprudence Self Study Guide, 13th edition 2010 (http://imh.utmb.edu/resources/jurisprudence-study-guide)
- Zerris = Texas Jurisprudence Study Guide by Zerris and Smith (available on Amazon)
- TJP = Online review course texasjurisprudenceprep.com
- TJP updates = The TJP website has updated its information a few times and made charts of important deadlines and penalties. These can be found for free (at the time of this post) by googling the pdfs.
--
Discrepancies:
1. CME
- Zerris - 6 CMEs from volunteering, 12 CME 1 category, 24 total
- Galveston - 50% from volunteering - 50% of category 2 credit is the correct answer
2. NP/PA supervision
- Zerris - 3 PAs
- Internet and TJP update - 7 PAs - 7 is the updated answer
3. Secondary practice sites
- Zerris - 60 miles
- Galveston - 75 miles - 75 is the updated answer
4. How many days can NPs and PA prescribe
- Zerris - 90 days / 30 days
- Galveston - 30 days
- TJP update - 90 days - 90 is the updated answer
5. How many abortions per year for facility to be licensed
- Zerris - 50/year
- Galveston - 100/year (p. 346)
--
Time:
Immediate
-Verbal report abuse (professionals/nonprofessionals; professionals have 48 hours for written report)
-Report to State Dept re: anthrax, botulism, cholera, smallpox, diphtheria, rabies, polio, plague, typhus, yellow fever - "outbreak" diagnoses (1 day for tb/pertussis)
-Gunshot and overdose reports
-Notify DFPS about abandoned infant
1 hour
-Time to evaluate restrained patient as to need for restraints
4 hours
-Time to spend looking for next of kin with organ donation
-Time within which to notify MD of MHIP discharge request and after which MD must examine w/i 24hrs
24 hours
-Department of Protective Regulatory Services investigates report of suspected child/elder abuse
-Notice to pt re: impending abortion
-Time to evaluate non restrained patient for involuntary POC/court ordered (12/48 for initial assessment/eval of need if just MD and involuntary) mental health admission; have till 72 hours for probable cause, no longer than 90 days total
-Inform re: pertussis and tb
-<24 h death of nursing home resident after xfer to hospital has to be reported
-Inform mental health pt of rights (72 h for written bill of rights)
48 hours
-Notice to parents of minor re: impending abortion
-After emergency detention, time for probable cause hearing (MD far less power than courts)
-Report child abuse
-Length of time pt has to discuss psychoactive rx w/md
3 days
-Pharmacist can prescribe emergency prescription for this long if provider cannot be reached
-Time frame for probable cause hearing after point of custody for drug/MHIP; set date of judicial hearing within 14 days from date of court ordered detention (as opposed to 12/48 hours and 14 for emergency detention)
4 days
-Time from a sexual assault that victim can still have a useful rape exam (ie. residua)
5 days
-Nursing home abuse confirmation in writing (oral report immediately)
-Birth report
-Days within which MD eval has to be done for inpatient mental health protective custody hearing; follow up probable cause needs to be w/i next 3 days
7 days
-Days of Schedule 2-5 rx with which you can discharge a patient from hospital
-Time for MD to mail emergency rx to pharmacy when it's called in (i.e. same length of time for which rx can be filled)
-Inform re: communicable diseases like gonorrhea, syphilis and salmonella
-Inform DPS of changes to info (strict; 30 days in TJP update)
10 days - Death and taxes
-Death report (by funeral director; by MD it is 5 days)
-Itemized bill if patient requests (15 days for medical records) - per website; vs 30 on Zerris
-Time for pt to pay for requested medical records
-MD has to visit underserved clinic q10 days
-Time TMB has to update profile in response to complaint about inaccuracy
15 days
-Report anesthesia office complication (admission to hospital in 24h or death in 72h)
-MD to provide requested medical records (calendar days for hospital; business days for MD)
-Blood bank to pay for blood
-Time board has to report on website information given to them about physician incompetence from hospital/professional society
-MD to review board reported info on first release (then it is 30 days within each yearly release)
-Time from petition for indefinite stay petition that hearing must be held
-MD to respond to board requests for medical records or question responses about renewal application
-After involuntary admission by protective order custody/court order, time from detention for final judicial hearing in drug abuse/MHIP (14)
-Days before xfer of embryo/sperm that gestational agreement has to be signed (14)
TMB hospital <--> board communication
-Time hospital committee has to report disciplinary medical actions to TMB (for restrictions greater than 30 days) [hospital:TMB]
-Time board has to give data to hospital requesting it [TMB:hospital]
30 days
-Terminate physician patient relationship / sexual abuse of patient / Time to notify Dept of Health of 3rd trimester abortion / Send itemized bill to patient after request / initial hearing screening (f/u till 2 yrs; book says during birth admission)
-Time to have hearing regarding psychoactive rx by MD
-Time after 3rd trimester abx for written explanation
-Provide bill for nursing home inpt (same amt as time to discharge)
TMB communication license/lawsuits/files/appeals/penalties
-Days prior to expiration of license that TMB notifies you; also how long you can practice without renewing and still have a license
-Report lawsuits moral turpitude, drug abuse, to TMB
-Time to appeal board disciplinary action; pay administrative penalty, MD gets file from board
-How long in advance the board tells MD of pending hearing
-Time board has to report to NPDB/MD/medicare suspension/restriction of physician or malpractice claim (board more time than hospital committee to board; report to hospital of MD next work day)
-TDH needs to update online list of post partum depression counselors
-Time frame ahead that 2 physicians need to agree before final hearing for chemical dependency eval or court ordered MHIP (only one of MDs has to be w/i 30 days for MHIP)
-PD to tell that someone did not show up for residency (vs 7)
-Police run a "monthly check" on physicians (Zerris)
-After allowing Schedule 2 phone rx in emergency, send written report to DPS (7 days for rx to pharmacy)
45 days - law and corporate payout
-Time to provide medical records to suing attorney
-Time for HMO to pay after receipt of bill from MD (either regular bill or workers comp)
60 days
-Age until which ER can take possession of abandoned infant
-Notice for sexual assault charges (longer to write the report)
-Advanced notice (letter of intent) of lawsuit sent to MD - give time for settlement
-Min time for indefinite commitment hearing for mental health inpatient stay
75 things
-75 days - notice letter extends statute date limitation for lawsuit
-75 miles - distance a secondary practice can be from primary practice site
90 days
-Length of time for which PA/NPs can write rx
-Physician in training has to submit permit 90 days before beginning training
->this late for child support, suspend license
-30-90 days is temporary mental health involuntary admission; 90-365 is extended stay; need to have re-hearing at 60 days for extended/indefinite
-Pt requested amendments to their record are accepted or denied
-Frequency that DPS checks on physicians
-How often MD updated on complaints filed with TMB
95 days
-Time after workers comp injury that MD needs to submit bill to insurance; insurance then has 45 days to respond; if denied, MD has another 45 days to appeal
120 days
-Expert findings for liability must be filed w/i 120 days of a malpractice claim
-Results of NBME examinations to examinees
6 months
-Board reports disciplinary actions on MDs
270 days
-Time that non licensed MD can have provisional license while awaiting licensure, but only if good standing license in another state and sponsored by native TX MD
11 months
-Time to bill patient for services
1 year
-DPS license renewal (stricter than DEA; where rx sends Schedule II records)
-After license expiration that it is cancelled and requires reapplication
-Update of core credentials on board website (30 days after publication can submit correction; 15 days within first posting)
-Pharmacy license to prescribe renewal
-Abortion clinics and private hospitals submit yearly reports to TSDHS
-Private psychiatry hospital report
2 years
-DPS keeps drug records (increased to 3 years per TJP update)
-Keep copies of ads
-Medical license renewal
-Min pt age for which PA/NPs can write rx
-Follow up period for hearing screenings that is covered
-Hospital queries NPDB q2yrs
3 years
-DEA license
-HMOs provide health risk assessment to subscribers
-Length of time to keep DPS records (extended from 1 or 2 years - discrepancy between TJP handouts)
4 years
-Time insurance adjuster has time to bring lawsuit for fraud
5 years
-Records of xferred patients
-Time limit to self report intemperate use of drugs/etoh to board and still be considered self admission
-Board has to remove complaints from website after 5 years if no action taken on MD license as a result of complaint
6 years
-immunizations paid for by insurance
-<6 yo death leads to inquest with JP or ME
-Time to keep record of PHI disclosures
12 years
-Minimum age MR child can donate kidney (with consent of ward)
14 years
-Less than this age, abuse is classified 'child abuse' and a criminal offense
-If pt pregnant <14 yo, suspect abuse
16 years
-Can self admit as MHIP
17 years
-Donate blood (not compensated till 18)
18 years
-Min age organ donation
65 years
-Over this age, need 2 physician approval for ECT
100 years
-Time after which medical records declassified for historical purposes
--
Fetal age:
-16 weeks - until which can do outpatient abortion
-20 weeks - after which must report fetal death (or 350 grams)
--
Committees:
- TMB - 9 3 7
- District review committees - 3 1 3 - 4 total in Texas
- Medical competence 3 / 3 (only physicians)
- Medical disclosure panel 6 / 3 (MDs and JDs)
- Rural medical education board 3 / 3 (rural MDs / citizens)
--
Felonies and misdemeanors:
Felonies: Kevorkian (encourage pt suicide & successful), malicious child abuse reporting (not reporting is class B), kickback repeat offender, manufacture/sale dangerous drug (possession=class A); practicing without license (3rd), falsifying birth/death certif (3rd), xfer child for $ (3rd), malicious reporting of child abuse, promoting suicide if successful, solicitationx2 (3rd), manufacture/sale of dangerous rx; practicing medicine in violation of MPA (3rd); sexual abuse nursing home pt (2nd); accepting money that affects care of patient; surgery while drunk (state jail felony); MR sexual assault (2nd degree); 2nd time cosmetics violation
Class A Gossiping, unauthorized drug tx program, unlawful possession of dangerous drug, gossiping, cosmetics (2nd time, felony); moving dead body, solicitation/payment for referral, possession of dangerous rx; elder abuse/malicious reporting (except outside nursing home=B, give the benefit of the doubt for kid ratting on parents/grandparents). Secretly tests for HIV before procedure. violation of Texas FD and cosmetic act (ie. manufacture/sale/advertisement/distribution/dispensing; alteration drug labels). Violation of medical practice act. Tampering w medical record (heavy bc almost impossible); tampering with TMB documents. Alteration of advanced directive. Operating drug tx program sans license. Dissect/disturb corpse. Ignore court order to stop spreading disease. Running drug rehab program sans license. MPA violation (other than practicing sans license); EMTALA B/A depending on if injury or intentional A/felony (intentional or injury each upgrade it a class); unlawful disclosure of physician investigation by board; mental health abuse treated like elder abuse not child abuse (class A not B); failure to report MR abuse
Class B Unapproved medical claim; not reporting communicable disease (w/i 7 days). Fake DEA registration or use of suspended DEA registration; child abuse failure/malicious (per TJP website; Zerris says malicious felony 2nd), illegal autopsy (invalid order); concealing infectious disease exposure or quarantine device/control measures (refusal of entry is class A)
Class C KDS knowingly do not notify of inquest for death; doesn't file death certificate properly and encourages suicide but fails; prescribes morphine using DEA; consensual sex with his elderly patient; poor birth report filing (mistaken, not falsified)
Unauthorized release of medical records is "misdemeanor". PHI fines below.
--
Fines:
-EMTALA = 50k
-Anti-kickback = Civil $50k/Criminal $25k + 5 years jail
* Violation Kickback = 10k per violation
* Up to 250k/physician or 500k/hospital
-Civil False claim $10k / Criminal False Claim $25k 5y / Fraud Statement $250k 5 yrs / Rico $25k 20 years in prison
-Violation of MPA class act $5k
-Abortion on minor without calling $10k
-HIPAA - negligent violations $100/violation up to $25k
-PHI 50k/1 year for violating
-$100k/5 yrs if committed under false pretenses
-$250k/10 yrs if for profit
-Fraud $50 - 500 - 1.5k - 20k - 100k - 200k - Class A misdemeanor to 1st degree felony; if multiple crimes, get upgraded a degree from the most serious of them
--
Misc:
-48 CME can be carried forward, 24 CME applied retrograde
-Diseases that need immediate report to TSDHS: Anthrax/SARS, yellow fever/plague/rabies, pertussis/measles/smallpox, polio, hepatitis, diphtheria
-Microbiology immediate report to TSDHS: VRSA, VRE, Neisseria, HIV
-Toe tagging: AIDS, anthrax, avian flu, brucellosis, cholera, CJD, hanta, hepatitis, plague, Q fever, rabies, relapsing fever, RMSF, SARS, smallpox, tb, tularemia, viral hemorrhagic fever (ie. dengue)
-Dangerous drugs not in sched 1-5: procaine
-Schedule I: LSD, heroin, quaaludes
-Schedule II: Codeine, demerol, cocaine, amphetamines, barbiturates
-Schedule III: Anabolic steroids, tylenol #3
-Schedule IV: Valium chlordiazeoxide clonazepam (klonopin)
-Schedule V: antitussive anti-diarrheal
-Child vaccines MMR DTP + Hep A and strep
-Organ donation allowed for xplant, hospital research, forensic program at college
The exam is essentially rote memorization, equivalent to about 1-2 days of medical school. Start with TJP online and this text on your phone. If you want to be completely safe, purchase the Galveston review, but do the questions in back first then retrograde read the text based on the page numbers in the answer key. Do all of that, and you should be golden. Good luck!
PS. I am selling my UTMB Galveston study guide. The text is in used condition, but has appropriate highlighting based on the TJP website. Questions in back are untouched (aside from errata amendments from Galveston that I updated in the answer key).
We did not have an 'in house' crib sheet at my program for this exam, and I couldn't find much on the forums, so I decided to put this together to help those of you who need a bit of guidance with study strategy and resources.
The exam is 60 questions, for which you have 100 minutes. All multiple choice with many including "all of the above" or "none of the above" as a final option. You will schedule the exam with Pearsonvue online. Bathroom breaks are allowed, but the clock does not stop, so pee quickly.
With the following guidelines, I was fortunate to overachieve, finishing the test in about 30 minutes and scoring a 98%. If anyone has any corrections or additions, please feel free to PM me or comment directly in the thread; I will update as appropriate.
Overall thoughts:
The exam is, at its essence, a collection of exceptions, deadlines, and crime classifications. Much of it is not well organized by any of the resources out there (the TJP tried in one of their updates, but still came up short). As such, I have included a summary of exceptions, deadlines and crime classifications that I made myself later in this post. The TJP website repeatedly makes the point that knowing specific classification of misdemeanors is not important, but they test it in their own material, and the classification is definitely on the exam.
Study guides:
Different reviews have different strengths and weaknesses. None is complete in and of itself. Reviewing them, I found several discrepancies between the texts, which I have also summarized later in this post. The Zerris prep is available on Quizlet, as are some other high yield notecard sets. In brief:
- UTMB Galveston Texas Jurisprudence Study Guide (3/5) $$ - The text was written by JD/PhDs and is the most comprehensive resource that I used in prep. This is an outline format study guide which goes through all of Texas law to an insane level of detail. The major strength of the text are the questions at the book finale.
While the book is about 400 pages, the last 70 are multiple choice questions with the answer key referencing the part of the book text that explains the correct answer. These are incredibly high yield, and resemble about 50% of test content -- many of them were taken by the TJP website for their own questions. The only way I was able to go through this text without falling asleep too much was by doing the multiple choice first, then retrograde reading the appropriate sections. Afterwards, I quickly skimmed the text antegrade. The major negative, which is significant, is that the text is mind numbingly boring, with huge sections of text cut-and-paste repeated, and with little shorthand.
-Texasjurisprudenceprep.com (3/5) $$$ - This is a decent resource written and prepared by two Texan ER docs. The course is somewhat costly, and essentially consists of a flash powerpoint presentation with the course creators speaking over the slide followed by 6 short quizzes. Their humor is a bit annoying (ie. hearing the joke the first time is cute, but can be trying when hearing it again and again with each review), but they convey their points succinctly.
Regarding the course content, it is decent. The highest yield portions are 1) the last slide of the entire presentation which is an overall review and 2) the quizzes, many of which are copied from the UTMB Galveston study guide almost word for word. The authors stress Quizzes 5 and 6, but all are helpful, and can be done fairly quickly a few times. They apparently have done their best to duplicate questions on the exam, and they do a decent job of it, with about 30-60% overlap. With a minimum passing score of 75%, this website can take you much of the way there.
-Texas Jurisprudence Study Guide by Zerris and Smith (2/5) $ - This is a bulletpoint question and answer book written by three Texan neurosurgeons, one of whom is also trained as a JD. There are two great things about this study guide and a few bad things. First, it is available on Kindle. As such, you can quickly go through it on your phone running around the hospital or while in line running errands till the answers are memorized. Second, the final chapter is a summary of several of the dates and misdemeanors that need to be remembered, and is the most useful part of the entire text. I have included most of the information from that section later in this post. The negatives of this book are that is has quite a few discrepancies, is out of date, and does not provide much context. Whereas the Galveston study guide is overly detailed, this text is too sparse. The book is available for free online via Quizlet (just google Texas Jurisprudence Prep study cards).
Shorthand:
- MHIP = Mental Health InPatient
- Galveston = UTMB Galveston Texas Jurisprudence Self Study Guide, 13th edition 2010 (http://imh.utmb.edu/resources/jurisprudence-study-guide)
- Zerris = Texas Jurisprudence Study Guide by Zerris and Smith (available on Amazon)
- TJP = Online review course texasjurisprudenceprep.com
- TJP updates = The TJP website has updated its information a few times and made charts of important deadlines and penalties. These can be found for free (at the time of this post) by googling the pdfs.
--
Discrepancies:
1. CME
- Zerris - 6 CMEs from volunteering, 12 CME 1 category, 24 total
- Galveston - 50% from volunteering - 50% of category 2 credit is the correct answer
2. NP/PA supervision
- Zerris - 3 PAs
- Internet and TJP update - 7 PAs - 7 is the updated answer
3. Secondary practice sites
- Zerris - 60 miles
- Galveston - 75 miles - 75 is the updated answer
4. How many days can NPs and PA prescribe
- Zerris - 90 days / 30 days
- Galveston - 30 days
- TJP update - 90 days - 90 is the updated answer
5. How many abortions per year for facility to be licensed
- Zerris - 50/year
- Galveston - 100/year (p. 346)
--
Time:
Immediate
-Verbal report abuse (professionals/nonprofessionals; professionals have 48 hours for written report)
-Report to State Dept re: anthrax, botulism, cholera, smallpox, diphtheria, rabies, polio, plague, typhus, yellow fever - "outbreak" diagnoses (1 day for tb/pertussis)
-Gunshot and overdose reports
-Notify DFPS about abandoned infant
1 hour
-Time to evaluate restrained patient as to need for restraints
4 hours
-Time to spend looking for next of kin with organ donation
-Time within which to notify MD of MHIP discharge request and after which MD must examine w/i 24hrs
24 hours
-Department of Protective Regulatory Services investigates report of suspected child/elder abuse
-Notice to pt re: impending abortion
-Time to evaluate non restrained patient for involuntary POC/court ordered (12/48 for initial assessment/eval of need if just MD and involuntary) mental health admission; have till 72 hours for probable cause, no longer than 90 days total
-Inform re: pertussis and tb
-<24 h death of nursing home resident after xfer to hospital has to be reported
-Inform mental health pt of rights (72 h for written bill of rights)
48 hours
-Notice to parents of minor re: impending abortion
-After emergency detention, time for probable cause hearing (MD far less power than courts)
-Report child abuse
-Length of time pt has to discuss psychoactive rx w/md
3 days
-Pharmacist can prescribe emergency prescription for this long if provider cannot be reached
-Time frame for probable cause hearing after point of custody for drug/MHIP; set date of judicial hearing within 14 days from date of court ordered detention (as opposed to 12/48 hours and 14 for emergency detention)
4 days
-Time from a sexual assault that victim can still have a useful rape exam (ie. residua)
5 days
-Nursing home abuse confirmation in writing (oral report immediately)
-Birth report
-Days within which MD eval has to be done for inpatient mental health protective custody hearing; follow up probable cause needs to be w/i next 3 days
7 days
-Days of Schedule 2-5 rx with which you can discharge a patient from hospital
-Time for MD to mail emergency rx to pharmacy when it's called in (i.e. same length of time for which rx can be filled)
-Inform re: communicable diseases like gonorrhea, syphilis and salmonella
-Inform DPS of changes to info (strict; 30 days in TJP update)
10 days - Death and taxes
-Death report (by funeral director; by MD it is 5 days)
-Itemized bill if patient requests (15 days for medical records) - per website; vs 30 on Zerris
-Time for pt to pay for requested medical records
-MD has to visit underserved clinic q10 days
-Time TMB has to update profile in response to complaint about inaccuracy
15 days
-Report anesthesia office complication (admission to hospital in 24h or death in 72h)
-MD to provide requested medical records (calendar days for hospital; business days for MD)
-Blood bank to pay for blood
-Time board has to report on website information given to them about physician incompetence from hospital/professional society
-MD to review board reported info on first release (then it is 30 days within each yearly release)
-Time from petition for indefinite stay petition that hearing must be held
-MD to respond to board requests for medical records or question responses about renewal application
-After involuntary admission by protective order custody/court order, time from detention for final judicial hearing in drug abuse/MHIP (14)
-Days before xfer of embryo/sperm that gestational agreement has to be signed (14)
TMB hospital <--> board communication
-Time hospital committee has to report disciplinary medical actions to TMB (for restrictions greater than 30 days) [hospital:TMB]
-Time board has to give data to hospital requesting it [TMB:hospital]
30 days
-Terminate physician patient relationship / sexual abuse of patient / Time to notify Dept of Health of 3rd trimester abortion / Send itemized bill to patient after request / initial hearing screening (f/u till 2 yrs; book says during birth admission)
-Time to have hearing regarding psychoactive rx by MD
-Time after 3rd trimester abx for written explanation
-Provide bill for nursing home inpt (same amt as time to discharge)
TMB communication license/lawsuits/files/appeals/penalties
-Days prior to expiration of license that TMB notifies you; also how long you can practice without renewing and still have a license
-Report lawsuits moral turpitude, drug abuse, to TMB
-Time to appeal board disciplinary action; pay administrative penalty, MD gets file from board
-How long in advance the board tells MD of pending hearing
-Time board has to report to NPDB/MD/medicare suspension/restriction of physician or malpractice claim (board more time than hospital committee to board; report to hospital of MD next work day)
-TDH needs to update online list of post partum depression counselors
-Time frame ahead that 2 physicians need to agree before final hearing for chemical dependency eval or court ordered MHIP (only one of MDs has to be w/i 30 days for MHIP)
-PD to tell that someone did not show up for residency (vs 7)
-Police run a "monthly check" on physicians (Zerris)
-After allowing Schedule 2 phone rx in emergency, send written report to DPS (7 days for rx to pharmacy)
45 days - law and corporate payout
-Time to provide medical records to suing attorney
-Time for HMO to pay after receipt of bill from MD (either regular bill or workers comp)
60 days
-Age until which ER can take possession of abandoned infant
-Notice for sexual assault charges (longer to write the report)
-Advanced notice (letter of intent) of lawsuit sent to MD - give time for settlement
-Min time for indefinite commitment hearing for mental health inpatient stay
75 things
-75 days - notice letter extends statute date limitation for lawsuit
-75 miles - distance a secondary practice can be from primary practice site
90 days
-Length of time for which PA/NPs can write rx
-Physician in training has to submit permit 90 days before beginning training
->this late for child support, suspend license
-30-90 days is temporary mental health involuntary admission; 90-365 is extended stay; need to have re-hearing at 60 days for extended/indefinite
-Pt requested amendments to their record are accepted or denied
-Frequency that DPS checks on physicians
-How often MD updated on complaints filed with TMB
95 days
-Time after workers comp injury that MD needs to submit bill to insurance; insurance then has 45 days to respond; if denied, MD has another 45 days to appeal
120 days
-Expert findings for liability must be filed w/i 120 days of a malpractice claim
-Results of NBME examinations to examinees
6 months
-Board reports disciplinary actions on MDs
270 days
-Time that non licensed MD can have provisional license while awaiting licensure, but only if good standing license in another state and sponsored by native TX MD
11 months
-Time to bill patient for services
1 year
-DPS license renewal (stricter than DEA; where rx sends Schedule II records)
-After license expiration that it is cancelled and requires reapplication
-Update of core credentials on board website (30 days after publication can submit correction; 15 days within first posting)
-Pharmacy license to prescribe renewal
-Abortion clinics and private hospitals submit yearly reports to TSDHS
-Private psychiatry hospital report
2 years
-DPS keeps drug records (increased to 3 years per TJP update)
-Keep copies of ads
-Medical license renewal
-Min pt age for which PA/NPs can write rx
-Follow up period for hearing screenings that is covered
-Hospital queries NPDB q2yrs
3 years
-DEA license
-HMOs provide health risk assessment to subscribers
-Length of time to keep DPS records (extended from 1 or 2 years - discrepancy between TJP handouts)
4 years
-Time insurance adjuster has time to bring lawsuit for fraud
5 years
-Records of xferred patients
-Time limit to self report intemperate use of drugs/etoh to board and still be considered self admission
-Board has to remove complaints from website after 5 years if no action taken on MD license as a result of complaint
6 years
-immunizations paid for by insurance
-<6 yo death leads to inquest with JP or ME
-Time to keep record of PHI disclosures
12 years
-Minimum age MR child can donate kidney (with consent of ward)
14 years
-Less than this age, abuse is classified 'child abuse' and a criminal offense
-If pt pregnant <14 yo, suspect abuse
16 years
-Can self admit as MHIP
17 years
-Donate blood (not compensated till 18)
18 years
-Min age organ donation
65 years
-Over this age, need 2 physician approval for ECT
100 years
-Time after which medical records declassified for historical purposes
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Fetal age:
-16 weeks - until which can do outpatient abortion
-20 weeks - after which must report fetal death (or 350 grams)
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Committees:
- TMB - 9 3 7
- District review committees - 3 1 3 - 4 total in Texas
- Medical competence 3 / 3 (only physicians)
- Medical disclosure panel 6 / 3 (MDs and JDs)
- Rural medical education board 3 / 3 (rural MDs / citizens)
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Felonies and misdemeanors:
Felonies: Kevorkian (encourage pt suicide & successful), malicious child abuse reporting (not reporting is class B), kickback repeat offender, manufacture/sale dangerous drug (possession=class A); practicing without license (3rd), falsifying birth/death certif (3rd), xfer child for $ (3rd), malicious reporting of child abuse, promoting suicide if successful, solicitationx2 (3rd), manufacture/sale of dangerous rx; practicing medicine in violation of MPA (3rd); sexual abuse nursing home pt (2nd); accepting money that affects care of patient; surgery while drunk (state jail felony); MR sexual assault (2nd degree); 2nd time cosmetics violation
Class A Gossiping, unauthorized drug tx program, unlawful possession of dangerous drug, gossiping, cosmetics (2nd time, felony); moving dead body, solicitation/payment for referral, possession of dangerous rx; elder abuse/malicious reporting (except outside nursing home=B, give the benefit of the doubt for kid ratting on parents/grandparents). Secretly tests for HIV before procedure. violation of Texas FD and cosmetic act (ie. manufacture/sale/advertisement/distribution/dispensing; alteration drug labels). Violation of medical practice act. Tampering w medical record (heavy bc almost impossible); tampering with TMB documents. Alteration of advanced directive. Operating drug tx program sans license. Dissect/disturb corpse. Ignore court order to stop spreading disease. Running drug rehab program sans license. MPA violation (other than practicing sans license); EMTALA B/A depending on if injury or intentional A/felony (intentional or injury each upgrade it a class); unlawful disclosure of physician investigation by board; mental health abuse treated like elder abuse not child abuse (class A not B); failure to report MR abuse
Class B Unapproved medical claim; not reporting communicable disease (w/i 7 days). Fake DEA registration or use of suspended DEA registration; child abuse failure/malicious (per TJP website; Zerris says malicious felony 2nd), illegal autopsy (invalid order); concealing infectious disease exposure or quarantine device/control measures (refusal of entry is class A)
Class C KDS knowingly do not notify of inquest for death; doesn't file death certificate properly and encourages suicide but fails; prescribes morphine using DEA; consensual sex with his elderly patient; poor birth report filing (mistaken, not falsified)
Unauthorized release of medical records is "misdemeanor". PHI fines below.
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Fines:
-EMTALA = 50k
-Anti-kickback = Civil $50k/Criminal $25k + 5 years jail
* Violation Kickback = 10k per violation
* Up to 250k/physician or 500k/hospital
-Civil False claim $10k / Criminal False Claim $25k 5y / Fraud Statement $250k 5 yrs / Rico $25k 20 years in prison
-Violation of MPA class act $5k
-Abortion on minor without calling $10k
-HIPAA - negligent violations $100/violation up to $25k
-PHI 50k/1 year for violating
-$100k/5 yrs if committed under false pretenses
-$250k/10 yrs if for profit
-Fraud $50 - 500 - 1.5k - 20k - 100k - 200k - Class A misdemeanor to 1st degree felony; if multiple crimes, get upgraded a degree from the most serious of them
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Misc:
-48 CME can be carried forward, 24 CME applied retrograde
-Diseases that need immediate report to TSDHS: Anthrax/SARS, yellow fever/plague/rabies, pertussis/measles/smallpox, polio, hepatitis, diphtheria
-Microbiology immediate report to TSDHS: VRSA, VRE, Neisseria, HIV
-Toe tagging: AIDS, anthrax, avian flu, brucellosis, cholera, CJD, hanta, hepatitis, plague, Q fever, rabies, relapsing fever, RMSF, SARS, smallpox, tb, tularemia, viral hemorrhagic fever (ie. dengue)
-Dangerous drugs not in sched 1-5: procaine
-Schedule I: LSD, heroin, quaaludes
-Schedule II: Codeine, demerol, cocaine, amphetamines, barbiturates
-Schedule III: Anabolic steroids, tylenol #3
-Schedule IV: Valium chlordiazeoxide clonazepam (klonopin)
-Schedule V: antitussive anti-diarrheal
-Child vaccines MMR DTP + Hep A and strep
-Organ donation allowed for xplant, hospital research, forensic program at college
The exam is essentially rote memorization, equivalent to about 1-2 days of medical school. Start with TJP online and this text on your phone. If you want to be completely safe, purchase the Galveston review, but do the questions in back first then retrograde read the text based on the page numbers in the answer key. Do all of that, and you should be golden. Good luck!
PS. I am selling my UTMB Galveston study guide. The text is in used condition, but has appropriate highlighting based on the TJP website. Questions in back are untouched (aside from errata amendments from Galveston that I updated in the answer key).
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