2005 Texas Education Code CHAPTER 58. COMPENSATION OF RESIDENT PHYSICIANS

EDUCATION CODE

CHAPTER 58. COMPENSATION OF RESIDENT PHYSICIANS


	§ 58.001. LEGISLATIVE FINDING AND INTENT.  (a) The 
legislature finds that it will improve the quality of the delivery 
of medical care to the citizens of this state and, therefore, that 
it will be in the public interest of this state for the resident 
physicians being educated, trained, developed, and prepared for a 
career in medicine by the schools of medicine in The University of 
Texas System, the Texas Tech University Health Sciences Center, the 
Texas A & M University Medical Program, and the University of North 
Texas Health Science Center at Fort Worth to be compensated by those 
schools while the resident physicians are undergoing education, 
training, development, and preparation.  The legislature further 
finds that the delivery of quality medical care to the citizens of 
this state has been and will continue to be enhanced by the 
expansion of family practice residency programs as provided by 
Sections 61.501 through 61.505 of this code and intends that 
nothing in this chapter be interpreted or implemented in a manner 
that will deter the development or expansion of family practice 
residency programs or will deter the legislative goal of having at 
least 25 percent of the first-year residency positions devoted to 
family medicine.
	(b)  Beginning September 1, 1981, and subject to the 
provisions of Section 58.003 of this code, each resident physician 
being educated, trained, developed, and prepared for a career in 
medicine by an accredited school of medicine in the schools listed 
in Subsection (a) of this section shall be compensated by that 
school while the person is undergoing education, training, 
development, and preparation at or under the direction and 
supervision of the school.

Added by Acts 1981, 67th Leg., p. 3245, ch. 855, § 1, eff. Aug. 
31, 1981.  Amended by Acts 1993, 73rd Leg., ch. 408, § 6, eff. 
Aug. 30, 1993.


	§ 58.002. DEFINITIONS.  (a) In this chapter:                                
		(1)  "Resident physician" means a person who is 
appointed a resident physician by one of the schools of medicine 
listed in Section 58.001 of this code and who:
			(A)  has received a Doctor of Medicine or a Doctor 
of Osteopathic Medicine degree from the Baylor College of Medicine 
or from one of the schools listed in Section 58.001 of this code;  or
			(B)  is a citizen of Texas and has received a 
Doctor of Medicine or a Doctor of Osteopathic Medicine degree from 
some other school of medicine that is accredited by the Liaison 
Committee on Medical Education or by the Bureau of Professional 
Education of the American Osteopathic Association.
		(2)  "Primary teaching hospital" means a hospital at 
which one of the schools listed in Section 58.001 of this code 
educates and trains both resident physicians and undergraduate 
medical students.
		(3)  "Compensation" includes stipends;  payments, if 
any, for services rendered;  and fringe benefits when applied to 
payments to or for the benefit of resident physicians.
	(b)  A person may not be considered a resident physician for 
a period of time longer than is ordinarily and customarily required 
for a resident physician to complete a graduate medical specialty 
program approved by the Accrediting Council on Graduate Medical 
Education or the American Osteopathic Association for the specialty 
in which the resident physician seeks certification as a diplomate 
and to obtain the certification from the appropriate board or 
agency approved by the American Board of Medical Specialties or the 
American Osteopathic Association.
	(c)  Notwithstanding the provisions of Subsection (b) of 
this section, a person may not be considered a resident physician 
under this Act for a period of time longer than four years.
	(d)  The total number of the first-year resident physicians 
compensated under this chapter and Sections 61.097 through 61.099 
of this code may not exceed the combined total number of persons in 
the previous year's graduating classes of the schools listed in 
Section 58.001 of this code and the Baylor College of Medicine.  
Each school shall give priority consideration to applicants who 
demonstrate a willingness to practice in medically underserved 
areas of Texas.
	(e)  It is the intent of this chapter that at least 50 percent 
of resident physicians shall be in the areas of family medicine, 
general internal medicine, general pediatrics, geriatrics, 
obstetrics/gynecology, and emergency medicine, with 25 percent of 
those residents in family practice.

Added by Acts 1981, 67th Leg., p. 3245, ch. 855, § 1, eff. Aug. 
31, 1981.  Amended by Acts 1989, 71st Leg., ch. 991, § 1, eff. 
Aug. 28, 1989;  Acts 1995, 74th Leg., ch. 965, § 12, eff. June 16, 
1995.


	§ 58.003. AUTHORIZATION FOR LEGISLATIVE APPROPRIATIONS OF 
FUNDS;  CONDITIONS REGARDING THOSE FUNDS.  (a) Beginning September 
1, 1981, each accredited school listed in Section 58.001 of this 
code is entitled to receive funds appropriated by the legislature 
in an amount not to exceed $15,000 in any fiscal year for each 
resident physician appointed by the school as a resident physician 
for that year.  Money appropriated under this chapter may not be 
transferred from the resident physicians program.
	(b)  If a resident physician under this chapter does not 
perform in that appointed capacity during an entire fiscal year, 
the compensation paid to the person by the school shall be reduced 
proportionately to cover only the part of the fiscal year during 
which the performance is actually rendered.
	(c)  If any resident physician under this chapter is 
compensated by an agency or institution of the federal government 
or by any other agency or institution other than a primary teaching 
hospital for the person's performance as a resident physician, the 
compensation that would otherwise be paid to the person by the 
school shall be reduced by the amount of the compensation actually 
received by the person from the agency or institution.  If a school 
under this chapter receives from an agency or institution of the 
federal government or from any other agency or institution other 
than a primary teaching hospital compensation for the performance 
of resident physicians' duties by any of the school's resident 
physicians to or for the benefit of the agency or institution, to 
the extent of the compensation actually received by the school, the 
school is prohibited from spending funds appropriated under this 
chapter that would otherwise be available to pay the same resident 
physicians for the performance of the same resident physician 
duties.
	(d)  If a school covered by this chapter receives from the 
Coordinating Board, Texas College and University System, a sum 
granted for the education, training, development, and preparation 
of the school's family practice resident physicians, to the extent 
of the sum actually received by the school, the school is prohibited 
from spending funds appropriated under this chapter that would 
otherwise be available to pay the same family practice resident 
physicians for the same education, training, development, and 
preparation.
	(e)  To the extent that The University of Texas Medical 
Branch at Galveston receives legislative appropriations under this 
chapter for the education and training of resident physicians, that 
school may not receive legislative appropriations in any other 
state appropriation act for the education and training of the same 
resident physicians in the same fiscal year.

Added by Acts 1981, 67th Leg., p. 3245, ch. 855, § 1, eff. Aug. 
31, 1981.


	§ 58.004. CONTINGENT ARRANGEMENT IN THE EVENT OF 
INSUFFICIENT FUNDS.  Notwithstanding any other provisions of this 
chapter, if at any time a school under this chapter determines that 
it does not have sufficient available funds from legislative 
appropriations and other sources to support adequately the full 
number of resident physicians that the school deems to be required 
in order to provide the delivery of the best possible medical care 
to the citizens of this state, the school may assign and place for 
education and training in any hospital or hospitals with which the 
school has a resident physician affiliation agreement any of its 
resident physicians that cannot be supported adequately from the 
funds available for that purpose.  During the period for which a 
resident physician is assigned and placed in a hospital or 
hospitals under the terms of this section, the resident physician 
shall directly or indirectly receive all or the primary portion of 
his or her compensation from the hospital or hospitals just as has 
been ordinarily and customarily done before the adoption of this 
chapter.  The exact method and manner of compensating the resident 
physician shall be set forth in the resident physician affiliation 
agreement entered into between the school and the hospital or 
hospitals.

Added by Acts 1981, 67th Leg., p. 3245, ch. 855, § 1, eff. Aug. 
31, 1981.


	§ 58.005. APPOINTMENT OF RESIDENT PHYSICIANS UNDER 
CERTAIN CONDITIONS.  Notwithstanding any other provisions of this 
chapter, if at any time a school under this chapter determines that 
it cannot provide one of its primary teaching hospitals with 
resident physicians who qualify under Subdivision (1) of Subsection 
(a) of Section 58.002 of this code in sufficient quantity or kind to 
meet the standard that the school deems necessary in order to 
provide the delivery of the best possible medical care to the 
citizens of this state, until the school is able to provide the 
hospital with a sufficient quantity and kind of resident physicians 
who do qualify, the school may appoint, to be educated and trained 
in the hospital, resident physicians who are not citizens of Texas 
but otherwise qualify under Subdivision (1) of Subsection (a) of 
Section 58.002 and may compensate those resident physicians as if 
they did qualify under the provisions of that section.

Added by Acts 1981, 67th Leg., p. 3245, ch. 855, § 1, eff. Aug. 
31, 1981.


	§ 58.006. STATEWIDE PRECEPTORSHIP PROGRAMS.  (a) The 
Texas Higher Education Coordinating Board may contract with one or 
more organizations to operate the statewide preceptorship program 
in general internal medicine and the statewide preceptorship 
program in general pediatrics for medical students enrolled in 
Texas medical schools.
	(b)  An organization eligible to receive funds under this 
subsection must:   
		(1)  qualify for exemption from federal income tax 
under Section 501, Internal Revenue Code of 1986 (26 U.S.C. Section 
501);  or
		(2)  be operated by a state accredited medical school 
as defined in Section 61.501(1).
	(c)  Students eligible to participate in the preceptorship 
programs under this section must indicate an interest in a primary 
care career.

Added by Acts 1995, 74th Leg., ch. 518, § 1, eff. June 12, 1995.           


	§ 58.007. ADVISORY COMMITTEE.  (a)  Nothing in this 
section or Section 58.006 or 58.008 shall diminish or abolish the 
activities of the Family Practice Residency Advisory Committee 
established under Section 61.505.  It is not the intent of this 
section to combine or assimilate advisory programs but only to add 
to and enhance the training of primary care physicians in Texas.
	(b)(1)  The Primary Care Residency Advisory Committee is 
created and shall consist of 12 members as follows:
			(A)  seven members shall be licensed physicians, 
one appointed by each of the following:
				(i)  the Texas Medical Association;                                         
				(ii)  the Texas Osteopathic Medical 
Association;                          
				(iii)  the Texas Academy of Family 
Physicians;                            
				(iv)  the Texas Society of the American 
College of Osteopathic Family Physicians;
				(v)  the Texas Society of Internal Medicine;                                
				(vi)  the Texas Pediatric Society;  and                                     
				(vii)  the Texas Association of 
Obstetricians and Gynecologists;          
			(B)  one member shall be appointed by the Office 
of Rural Community Affairs;
			(C)  one member shall be appointed by the Bureau 
of Community Oriented Primary Care at the Texas Department of 
Health;  and
			(D)  three members shall be members of the public, 
one appointed by each of the following:
				(i)  the governor;                                                          
				(ii)  the lieutenant governor;  and                                         
				(iii)  the speaker of the house of 
representatives.                       
		(2)  No individual who has a direct financial interest 
in primary care residency training programs shall be appointed to 
serve as a member of the advisory committee.
	(c)  The terms of the office of each member shall be for three 
years, except for the initial term, which shall be designated in a 
manner approved by the Texas Higher Education Coordinating Board in 
such a way that one-third of the members shall serve for one year, 
one-third for two years, and one-third for three years, and 
thereafter each member shall serve for a term of three years.  Each 
member shall serve until the member's replacement has been 
appointed to the committee.
	(d)  The members of the committee shall not be compensated 
for their service.
	(e)  The committee shall meet at least annually and so often 
as requested by the Texas Higher Education Coordinating Board or 
called into meeting by the committee chair.
	(f)  The committee chair shall be elected by the members of 
the committee for a term of one year.
	(g)  The committee shall review for the Texas Higher 
Education Coordinating Board applications for approval and funding 
of primary care residency training program expansion as described 
in Section 58.008 and related support programs, make 
recommendations to the board relating to the standards and criteria 
for approval of residency training and related support programs, 
and perform such other duties as may be directed by the board.
	(h)  The committee shall review for the Texas Higher 
Education Coordinating Board applications for approval and funding 
of faculty enhancement for generalist physicians at Texas medical 
schools as described in Section 58.009, make recommendations to the 
board relating to the standards and criteria for approval of 
faculty enhancement awards, monitor compliance with the 
contractual conditions associated with faculty enhancement awards, 
and evaluate the success of the faculty enhancement program in 
reaching the goal of increasing the number of generalist physician 
faculty at Texas medical schools.

Added by Acts 1995, 74th Leg., ch. 518, § 1, eff. June 12, 1995.  
Amended by Acts 1997, 75th Leg., ch. 940, § 1, eff. June 18, 
1997;  Acts 2001, 77th Leg., ch. 1424, § 7, eff. Sept. 1, 2001.


	§ 58.008. PRIMARY CARE RESIDENCY PROGRAM EXPANSION.  (a) 
Only residency positions in family practice, general internal 
medicine, general pediatrics, and obstetrics and gynecology shall 
be eligible for these funds.
	(b)  The committee shall recommend to the Texas Higher 
Education Coordinating Board an allocation of new primary care 
residency positions that are to receive state support.  The 
committee shall take into consideration in recommending an 
allocation among the four primary care specialties designated for 
expansion the following factors:
		(1)  the current primary care specialties mix of Texas 
physicians in direct practice;
		(2)  projections for the primary care specialties mix 
of Texas physicians in direct practice;
		(3)  the current state-supported primary care 
positions;                    
		(4)  geographic shortages for primary care physicians;                        
		(5)  federally designated and state designated 
medically underserved areas; 
		(6)  the demographics of the Texas population;  and                           
		(7)  the infrastructure of existing residency 
programs.                     
	(c)  Once funds are awarded to support a resident position of 
a particular residency program, the board shall continue to award 
funds to support that residency position for all three or four 
postgraduate years of the residency training curriculum until the 
resident physician appointed to that position has completed or left 
the program.  The position would then be eligible for reallocation 
by the Primary Care Residency Advisory Committee.

Added by Acts 1995, 74th Leg., ch. 518, § 1, eff. June 12, 1995.           


	§ 58.009. FACULTY ENHANCEMENT FUND FOR GENERALIST 
PHYSICIANS.  (a) Only accredited medical schools identified in 
Section 61.501(1) shall be eligible to receive funds under this 
section.
	(b)  Only full-time, clinical faculty positions in family 
practice, general internal medicine, and general pediatrics whose 
faculty rank is no greater than assistant professor shall be 
eligible for funds under this section.
	(c)  The committee shall recommend to the Texas Higher 
Education Coordinating Board an allocation of generalist faculty 
positions that are to receive state support through the Faculty 
Enhancement Fund for Generalist Physicians.  The committee shall 
take into consideration in recommending an allocation the following 
factors:
		(1)  the faculty-student ratio in the generalist 
specialty at the applicant school;
		(2)  the length of time a budgeted generalist faculty 
position has gone unfilled;
		(3)  whether the position is a new generalist faculty 
position;  and        
		(4)  other factors as determined by the committee.                            
	(d)  Once funds are awarded to support a generalist faculty 
position at a particular medical school, the board shall continue 
to award funds to support that generalist faculty position for a 
period not to exceed one additional academic year.  After that time, 
the medical school shall provide an amount equal to the annualized 
faculty enhancement award in its operating budget to maintain the 
level of compensation for the position after the grant period has 
ended.
	(e)  The board may spend not more than 10 percent of the 
amounts appropriated for this program in fiscal year 1998, and not 
more than five percent of the amounts appropriated for this program 
in succeeding years, for administering the faculty enhancement 
program for generalist physicians.
	(f)  The board may solicit, receive, and spend grants, gifts, 
and donations from public and private sources to comply with this 
section.

Added by Acts 1997, 75th Leg., ch. 940, § 2, eff. June 18, 1997.           


	§ 58.010. STATEWIDE PRECEPTORSHIP PROGRAMS IN PUBLIC 
HEALTH SETTINGS.  (a) The Texas Higher Education Coordinating 
Board may contract with one or more organizations to operate a 
statewide preceptorship program in a public health setting for 
medical students enrolled in Texas medical schools.
	(b)  An organization eligible to receive funds under this 
subsection must:   
		(1)  qualify for exemption from federal income tax 
under Section 501, Internal Revenue Code of 1986 (26 U.S.C. Section 
501);  or
		(2)  be operated by a state accredited medical school 
as defined in Section 61.501(1).
	(c)  Students eligible to participate in the preceptorship 
programs under this section must indicate an interest in a career 
providing primary care.
	(d)  The board may create and appoint an advisory committee 
to assist the board in the operation of the program.

Added by Acts 1997, 75th Leg., ch. 787, § 1, eff. Sept. 1, 1997.  
Renumbered from § 58.009 by Acts 1999, 76th Leg., ch. 62, § 
19.01(13), eff. Sept. 1, 1999.