HB2038

The DOCTOR Act creates a provisional-license route for qualifying foreign-licensed physicians and a separate, supervised limited license for physician graduates. Neither is permission for anyone with a medical degree to practice independently without further qualifications. This explanation describes the enacted statute, not whether an individual qualifies under current Medical Board rules. Final law.

Foreign-licensed physicians: Applicants need a qualifying medical degree, a foreign license in good standing without pending disciplinary action, and the residency or substantially similar postgraduate training required by their country of licensure. They must pass the Texas medical-law examination and the first two steps of the United States Medical Licensing Examination, meet English and federal work-authorization requirements, have a Texas physician job offer in a facility or group practice, and satisfy additional board rules. Final law, Article 2; examination provisions.

The initial provisional license lasts two years. Practice is restricted to a facility/group with a qualifying accredited residency program or an affiliated setting. Renewal requires the first two exam steps and a valid Educational Commission for Foreign Medical Graduates certificate. A renewed license instead permits practice only in a qualifying rural, medically underserved or health-professional-shortage area with a current physician shortage. A full license requires the statutory examination requirements and clearance of the specified disciplinary and criminal-history/investigation restrictions. The final law does not retain the proposed four-years-in-seven provisional-practice prerequisite. Final law, Section 155.1015.

A restriction covers citizens of countries identified in the latest U.S. intelligence annual threat assessment or the specified international arms regulations. It does not apply if the applicant is a U.S. citizen or has been issued a visa to work legally in the United States. Other licensing conditions still apply; this is not an unconditional nationality ban or a grant of immigration status. Final law, Section 155.1015(b).

Physician graduates: The separate limited license requires Texas residency, citizenship/permanent residency or other federal work authorization, English proficiency, qualifying medical education, the first two USMLE components or an accepted equivalent, no enrollment in a board-approved postgraduate residency, and board-rule requirements. Generally the qualifying degree must be within two years of the initial application; the separate alternative for a foreign-licensed physician in good standing does not contain that two-year limit. The statute says not enrolled, not necessarily someone who applied for and failed to match into residency. Final law, Section 155.203.

Graduates may practice only in a county with fewer than 100,000 residents, under a supervising practice agreement, and only in the sponsoring physician’s certified specialty. The sponsor needs a full, unrestricted license, no current disciplinary action, and qualifying specialty certification and practice. Another supervisor requires written authorization and must meet the same-group/facility and specialty conditions. The board sets supervision limits. The sponsor retains legal responsibility for patient care. Patients must receive the statutory disclosure about graduate status and lack of formal specialized postgraduate/residency training; identification must display graduate status even though use of “doctor,” “Dr.” or “doc.” is allowed. Profiles must identify the supervision arrangement. Renewal requires verified supervised practice and continuing education; disciplinary authority remains. Final law, Sections 155.205–155.212.

Graduate licensing fees cannot exceed the corresponding physician-assistant fees. The act treats graduates as general practitioners for the stated federal-regulation purposes, but should not be read as a guarantee of federal enrollment or payment. It also allows an insured to select a graduate for services already scheduled in the policy and within the graduate’s license scope, for policies delivered, issued or renewed from January 1, 2026. It does not itself promise every service is covered or every provider is in network. The board’s implementation-rule deadline was January 1, 2026. Final law, Articles 3–5.