Duties of PIT holders to Report

If you are a Physician in Training (PIT) permit holder, you must report, in writing, to the Executive Director of the board, the following circumstances within thirty days of their occurrence:

• the opening of an investigation or disciplinary action taken against you by any licensing entity other than the Texas Medical Board by completing Form U from the Texas Medical Board website;
• an arrest, fine (over $100), charge or conviction of a crime, indictment, imprisonment, placement on probation, or receipt of deferred adjudication by completing Form R. Note: For traffic citations/violations, we only need the permit holder's report along with a copy of the citation(s).; and
• diagnosis or treatment of a physical, mental or emotional condition, which has impaired or could impair your ability to practice medicine. To report this, you must complete Form W.
  

Failure to comply with the provisions of this chapter (22 Tex. Admin. Code, Section 171) or Tex. Occ. Code, Sec. 160.002 and 160.003 may be grounds for disciplinary action as an administrative violation. Duties of PIT holders to report are specified in 22 Tex. Admin. Code, Section 171.5.

Mailing Address:
Texas Medical Board
P.O. Box 2018
Austin, TX 78768-2018

If you have any questions regarding this request, please feel free to contact our office. You can contact the Customer Information Center at (512) 305-7030, by fax at (512) 305-7009, or by e-mail at pits@tmb.state.tx.us