4734-6-04 Preceptorships.

(A) The board may approve the limited practice of chiropractic in this state by a student intern of a board authorized chiropractic educational institution that offers an approved preceptorship program. The chiropractic educational institution, the intern, and the practice of chiropractic by the intern must meet the criteria established by the board.

(B) Definitions.

(1) Preceptorship program is a clinical program in which chiropractic interns participate under direct supervision of a licensed chiropractic physician who has been approved by an authorized chiropractic educational institution and the board to serve as a preceptor.

(2) Authorized chiropractic educational institution is a board approved chiropractic educational institution permitted to engage in preceptorship programs under these rules.

(3) Approved program is a preceptorship program approved by the board and conducted under the auspices of an authorized chiropractic educational institution as outlined in section 4734.21 of the Revised Code.

(4) Preceptor or extension faculty member is a licensed chiropractic physician who has been appointed to the extension faculty of an authorized chiropractic educational institution and has been approved by the board.

(5) Intern is an individual enrolled in an authorized chiropractic educational institution who has completed all requirements for the doctor of chiropractic degree except for the final clinical phase of the program.

(6) A limited license is a certificate issued by the board to an applicant who has successfully completed all requirements for the doctor of chiropractic degree except for the final clinical phase of the program and who has met the requirements of section 4734.27 of the Revised Code and this chapter of the Administrative Code.

(7) Direct supervision of an intern means initial and ongoing direction, procedural guidance, observation, and evaluation by a licensed chiropractic physician who shall remain on the premises and shall supervise and monitor the intern's performance.

(8) Board shall mean the Ohio state chiropractic board.

(C) Preceptorship program approval.

(1) The board shall consider the degree of consumer protection provided by the defined standards and practices of the chiropractic educational institution's preceptor program, as well as the degree of consumer protection demonstrated by the actual operation of the chiropractic educational institution's preceptor program.

(2) The board shall approve a chiropractic educational institution preceptorship program that meets all of the following criteria:

(a) The preceptorship program is conducted by a chiropractic educational institution approved by the board.

(b) The preceptorship program is an established component of the curriculum of the chiropractic educational institution.

(c) The preceptorship program operates in a setting where chiropractic services are typically and traditionally provided.

(d) The preceptorship program is certified by the chiropractic educational institution, on forms prescribed by the board, to meet all the following:

(i) All interns who participate in the preceptorship program are in the last semester, trimester or quarter of their education and have met all requirements for graduation from the chiropractic educational institution except for the completion of the preceptorship period;

(ii) No chiropractic physician who is a preceptor shall supervise more than one intern simultaneously;

(iii) All chiropractic physicians who participate as preceptors are faculty or extension faculty of the chiropractic educational institution; and

(iv) That the preceptor and the intern have agreed on the goals of the preceptorship program to be completed by the intern.

(3) The chiropractic educational institution shall send quarterly lists to the board identifying the preceptor and intern participants in the approved peceptorship program.

(D) Preceptor approval.

(1) The board shall approve a chiropractic physician to be a preceptor if the chiropractic physician certifies to the board, on forms prescribed by the board, that he or she meets all of the following conditions:

(a) The preceptor has been continuously licensed and actively practicing in Ohio for the previous seven years, that there are no pending disciplinary actions or malpractice claims against the preceptor, and that there have been no disciplinary actions taken against the preceptor.

(b) The preceptor is a member of the faculty or extension faculty of the chiropractic educational institution from which the preceptor will accept an intern into a preceptorship program.

(c) The preceptor will assume responsibility for the practice of the intern.

(d) The preceptor shows proof of current valid malpractice insurance.

(2) The preceptor's practice must provide the intern with an adequately diverse, broad, and extensive clinical experience.

(3) The preceptor utilizes practice procedures that include appropriate history, physical examinations and diagnostic procedures.

(4) The preceptor is approved by the intern's chiropractic educational institution and subject to the board's approval.

(a) The preceptor understands and agrees that the board shall have the right to refuse to allow, or withdraw its approval for, any licensee to act as a preceptor at any time.

(E) Intern approval.

(1) Each applicant for a limited license to participate in a board-authorized preceptorship program shall submit on board prescribed forms satisfactory evidence of his or her qualifications as prescribed by section 4734.27 of the Revised Code and this rule. Applications shall be signed by the applicant in his or her own handwriting and acknowledged before a notary public. Incomplete applications will not be considered and will be returned to the applicant with the notation application incomplete.

(2) It shall be the responsibility of the applicant to furnish the necessary credentials as the board deems necessary or as required by law. Submission of credentials does not guarantee acceptance.

(3) A complete application including a non-refundable application fee in the amount of seventy five dollars made payable to the treasurer, state of Ohio, and all required credentials must be filed with the board postmarked no later than fourteen days before the intended initiation of the scheduled preceptorship.

(4) An application for a temporary license shall include the following:

(a) An attestment from the academic dean that the applicant is in good academic standing at the authorized chiropractic educational institution and has completed all requirements for the doctor of chiropractic degree except for the clinical phase of the program;

(b) Three letters of recommendation, on forms prescribed by the board, from two professors and a dean of the intern's authorized chiropractic educational institution, attesting to the intern's good moral character and clinical proficiency. Said letters shall be submitted directly to the board by the individuals making the recommendations.

(c) A passport type photograph taken within the preceding six months. The photo is to be signed by the applicant on the back of the photograph. All photographs shall be no smaller than two inches by two inches and no larger than three inches by five inches.

(5) Applicants for this limited license have an ongoing obligation to update and supplement all information provided to the board in writing within thirty days of any change.

(6) Each applicant for a limited license to participate in a board-authorized preceptorship program will be required to sign an affidavit under oath that they have fully reviewed and understand and will abide by Chapter 4734. of the Revised Code and agency 4734 of the Administrative Code.

(7) The board may refuse or deny an applicant for a limited license to participate in a board-authorized preceptorship program in this state if the applicant does not meet the licensure requirements as outlined in section 4734.27 of the Revised Code or this rule, or if the applicant has committed any act which indicates that the applicant does not possess the character and fitness to practice chiropractic, including any act that would be grounds for disciplinary action as outlined in section 4734.31 of the Revised Code. The burden of proof is on the applicant to prove by clear and convincing evidence to the board that he or she meets the conditions for licensure.

(8) Any applicant that the board proposes to refuse or deny limited licensure shall be entitled to a hearing on the question of such proposed refusal or denial. Notice and hearing requirements incident to such proposed refusal or denial shall be in compliance with the provisions of Chapter 119. of the Revised Code and Chapter 4734-4 of the Administrative Code.

(9) The board may take disciplinary action against any intern upon proof, satisfactory to the board, that the intern has engaged in practice in this state outside the scope of the preceptorship program for which he or she has been approved, or upon other proof, satisfactory to the board, that the intern has engaged in conduct that is grounds for action under Chapter 4734. of the Revised Code.

(10) Any violation of Chapter 4734. of the Revised Code or agency 4734 of the Administrative Code by the intern constitutes grounds for the board to:

(a) Prohibit the intern from taking the examination for licensure; and

(b) Take appropriate disciplinary action against the supervising preceptor.

(F) Preceptorship standards and procedures.

(1) The preceptor shall exercise direct on-premises supervision of the intern at all times during which the intern is engaged in any facet of patient care in the preceptorship program.

(2) The preceptor shall identify the intern to the patients of the preceptorship practice in such a way that no patient will be misled as to the status of the intern.

(3) The preceptor shall obtain written informed consent from each patient or parent or guardian of each patient prior to initiating examination and or treatment of that patient by the intern.

(4) At all times when an intern is providing direct chiropractic care to a patient the intern shall display a name badge identifying the intern's status as an intern.

(5) The preceptor must monitor and track the intern's activity and regularly evaluate the intern's performance.

(6) Interns may assist preceptors in the performance of those duties that are lawful and ethical under Chapter 4734. of the Revised Code and agency 4734 of the Administrative Code including but not limited to physical examinations, patient consultation, x-ray examinations, specific chiropractic adjustment procedures and physical therapeutics.

(7) Interns are required to document all patient encounters in a logbook. Entries shall be made for all patient encounters, including observation. These entries should accurately reflect patient identification, involvement, and services rendered.

(a) Copies of logbook entries may be requested by the state chiropractic board at any time.

(b) Failure to provide logbook copies upon request by the board or falsification of logbooks will result in punitive measures.

(8) It is the responsibility of the preceptor to maintain all logbook records for one year following graduation from the chiropractic educational institution or program.

(9) The board may conduct random inspections of a preceptor site, including inspection of all pertinent documents to determine whether the program maintains the minimum standards required by the board.

(G) Preceptorship prohibitions.

(1) In addition to the prohibitions set forth in Chapter 4734. of the Revised Code and agency 4734 of the Administrative Code, an intern shall not:

(a) Diagnose the condition of a patient;

(b) Establish a plan of treatment or prognosis for a patient;

(c) Perform any service, except at the direction and supervision of an approved preceptor;

(d) Bill independently of the supervising preceptor for any service rendered; or

(e) Sign insurance forms or any other forms which require a licensed chiropractic physician's signature.

(H) Preceptorship termination.

(1) A preceptorship shall terminate upon the occurrence of the earliest applicable of the following:

(2) An intern participating in a preceptorship program graduates from the chiropractic educational institution operating the program;

(3) An intern is formally charged with a criminal offense, the circumstances of which substantially relate to the practice of chiropractic.

(4) An intern is found to have violated the statutes or administrative rules pertaining to the practice of chiropractic.

(5) An intern is formally named in a civil or malpractice action.

(I) Any change in preceptor must be pre-approved by the board in writing.

Effective: 04/05/2009
R.C. 119.032 review dates: 11/07/2008 and 04/05/2014
Promulgated Under: 119.03
Statutory Authority: 4734.10 , 4734.27
Rule Amplifies: 4734.27
Prior Effective Dates: 9/3/02, 8/1/07