64B8-4.025. Licensure Under Supervision

Unless otherwise approved by the Board or its designee, or addressed by Board Order, the following are provisions applicable to Orders rendered by the Board when an applicant is certified for licensure but said licensure is restricted or conditioned in such a manner as to require a period of practice under supervision of another licensee approved by the Board.

(1) The applicant’s license shall not be issued until a supervisor is approved by the Board or its designee. However, unless provided otherwise in the Board’s Order, the person who is certified for licensure must have a supervisor approved within 12 months of the date the Board certifies the applicant for licensure. If the person certified for licensure does not obtain an approved supervisor within that 12 month period, the certification for licensure expires and the person must reapply for licensure.

(2) Required Supervision.

(a) Direct Supervision. If an applicant is required to work under the direct supervision of another physician, “direct supervision” shall require the physical presence of the supervising physician in the building so that the supervising physician is immediately available when needed.

(b) Indirect Supervision. If an applicant is required to work under the indirect supervision of another physician, “indirect supervision” shall mean the responsible supervision of the licensee by a supervising physician, approved by the Board, which supervision shall not require the physical presence of the supervising physician when procedures are performed, but shall require the supervisor to be reasonably available, so as to be physically present to provide consultation or direction in a timely fashion as required for appropriate care of the patient. The supervisor shall practice within a reasonable geographic proximity to the applicant, which shall be within 20 miles.

(c) Immediate Supervision. If an applicant is required to work under the immediate supervision of another physician, Respondent shall not perform designated procedures unless under the immediate supervision of a board-certified physician fully licensed under Chapter 458, F.S., who has been approved by the Probationer’s Committee. The physician providing immediate supervision shall be physically located in the same room with the applicant where the designated procedure is performed.

(d) If the terms of the Order include indirect or direct supervision of the applicant’s practice, the applicant shall not practice medicine without an approved supervisor. If the terms of the Order include immediate supervision, the applicant shall not perform designated procedures unless under the immediate supervision of an approved supervisor.

(e) The applicant shall furnish to the proposed supervisor a copy of the Board’s order requiring supervision and any other relevant orders.

(f) The applicant shall submit to the Board his or her proposed practice plan and designation of an area of practice. The applicant also shall submit to the Board the name, curriculum vitae, and a letter from the proposed supervisor stating that he or she:

1. Is willing to serve as a supervisor,

2. Has received a copy of the Board’s order requiring supervision,

3. Is aware of his or her duties and responsibilities as a supervisor,

4. Discloses any conflicts of interests,

5. Specifies distance to the applicant’s practice location; and,

6. Agrees to appear before the Board if required to do so.

(g) The supervisor must be licensed under Chapter 458, F.S., in good standing, in active status, without restriction or limitation on his or her license, must be qualified by training and experience, and must not have any conflicts of interest that would prohibit him or her from impartially performing his or her duties as a monitor. The supervisor shall be board-certified in the applicant’s specialty area. Specific grounds for rejecting a proposed supervisor by the Board or its designee shall include but are not limited to the following:

1. The proposed supervisor has previously been subject to disciplinary action against his or her medical license in this or any other jurisdiction,

2. The proposed supervisor is currently under investigation, or is the subject of a pending disciplinary action,

3. The proposed supervisor is not actively engaged in the same or similar specialty area,

4. If under indirect supervision, the proposed supervisor is not practicing within a distance of no more than 20 miles from the applicant’s practice location. If under direct supervision, the proposed supervisor is not practicing on the premises.

(h) Failure to complete the supervision in the required time period may result in an additional required appearance before the Credentials Committee and may result in extending the time to complete the required supervision.

(3) Approval. The Board confers authority on the Chair of the Credentials Committee to temporarily approve an applicant’s supervisor, practice plans, and designation of an area of practice. To obtain this temporary approval, applicant shall submit to the Board the information required in paragraph (2)(e). Absent said approval, applicant shall not practice medicine or perform designated procedures until a supervising physician is approved. Temporary approval shall only remain in effect until the next meeting of the Board. Final approval is to be made by the Board.

(4) Change in Supervisor. In the event that applicant’s supervisor is unable or unwilling to fulfill his or her responsibilities as a supervisor, the applicant shall advise the Board of this fact within 24 hours of becoming aware of the situation. Applicant shall submit to the Board the name of a temporary supervisor for consideration. Applicant shall not practice medicine or perform designated procedures pending approval of this temporary supervisor by the Chair of the Credentials Committee. Temporary approval shall only remain in effect until the next meeting of the Board. Final approval is to be made by the Board.

(5) Reports. Prior to termination of the supervisory period, supervision reports, in affidavit format, shall be submitted by the applicant and the supervisor and shall contain the information set forth below:

(a) A report submitted by the applicant shall contain a brief statement of why the applicant is being supervised; the applicant’s practice location; description of current practice (type and composition); compliance with supervisory terms; description of relationship with supervising physician; and advising of any problems.

(b) A report submitted by the supervising physician shall contain a brief statement of why the applicant is being supervised; description of applicant’s practice; applicant’s compliance with terms of supervision; applicant’s relationship with supervisor; and details of any problems which may have arisen with applicant.

(6) Tolling Provisions. After the period of supervision begins, in the event that the applicant leaves the State of Florida for a period of 30 days or more or otherwise does not or may not engage in the active practice of medicine in the State of Florida, then the time period and provisions regarding supervision and required reports shall be tolled and shall remain in a tolled status until applicant returns to the active practice of medicine in the State of Florida. Applicant shall notify the Board 10 days prior to his or her return to practice in the State of Florida.

(7) Supervisors must serve as volunteers without compensation, but in instances where an applicant is unable to find a volunteer supervisor, the applicant, with the approval of the Board, may contract with a third party entity that provides supervisors for a fee.

(8) This rule shall be reviewed, and if necessary, repealed, modified, or renewed through the rulemaking process five years from the effective date.

Rulemaking Authority 458.309 FS. Law Implemented 458.311, 458.313, 458.3145, 458.315, 458.317 FS. History–New 9-21-93, Formerly 61F6-22.025, 59R-4.025, Amended 3-12-08, 7-1-13, 9-26-16, 5-7-18, 3-31-24.