Match Day 2024

Tomorrow is probably the second most stomach turning day for any medical student – it’s Match Day – March 15, 2024 – every student participating in Match will be anxiously awaiting news that the residency program they desire also desires them. Congratulations to all the new residents – tomorrow!!

Beware of promises! A Texas physician license takes time.

Physicians beware of promises made by licensing companies! This week I received a call from a physician asking about our services. As I explained how we did things the physician stopped me and asked me how long would getting the license in Texas take. I said in the best of circumstances 4-6 months. The physician was surprised and told me thanks but no thanks and hung up.

Here at Garanflo and Meyer we don’t make up time and we don’t make promises we can’t keep. No one and I mean no one, outside of perhaps a powerful legislator or the governor or a board member can speed a physician license application along. There are so many variables to getting a license – how long will your form L’s take? How long will it take for your medical school to respond and Lord forbid you are an IMG and don’t have FCVS.

If a licensing company tells you they can do it faster than 4 months I would love to know who they are are how they are doing it because it just doesn’t happen. When the Texas Medical board staff reports that they have licensed someone under 40 or so days that’s not the whole story. That 40 day number is only after your application and it’s associated materials leave screen. And then once you move to licensure is depends on what analyst you have – what does that analysts work load look like – remember the Licensure staff handles many license types so it’s just not all abut physicians.

If you are an applicant whose past five year history includes affiliations with more than three hospitals, you are gonna have a delay. If you have more than two malpractice events, you are gonna have a delay. If you have any history of disciplinary action, no matter how old it is, you are gonna have a delay.

G&M will do whatever we can to speed along your process but we are not miracle workers. Good luck!

Texas Medical Board News December 2023

The Texas Medical Board’s latest bulletin is full of news related to licensure. FY2023 saw another increase in licenses issued – a record 7,060 licenses. And the Interstate Compact process saw 1,607 licenses issued. Texas now has over 100,000 licensees. This is an incredible milestone given the changes Licensure staff had to endure in moving from all hands on deck to licensure staff spread across Texas. Kudos to Grace Unterborn and staff for continuing amazing work. The average processing days remain around 28 days.

Let’s address this 28 day processing time. As most applicants will tell you it takes way longer than 28 days to have their application processed. The 28 day processing time does not include the number of days that an applicant sits in Screen. Although a great idea many legislative sessions ago it has become glaringly obvious that staff members in Screen have taken on a greater role of analyst, reviewing documents as opposed to checking them of LIST. This can be very helpful if the Screen staff member is somewhat senior but many times adds unwarranted delays. I have addressed this with Licensure management but to no avail. I’ll continue to push for change in this area come the 2025 legislative session.

So here at G&M Consulting we will continue to stay on top of changes not only in law and rule but also in process at the board.

Medical school graduates – Texas ranks third in 2022.

In the latest article found in Becker’s Hospital Review Texas ranks third in the United States with the number of medical school graduates. The reported data comes from 2022 reports listing a total number of new medical school graduates, allopathic and osteopathic at 28,753. New York continues to rank first with 2,628, Pennsylvania in second with 1,902 and Texas third with 1,897 medical school graduates. When I joined the Texas Medical Board back in 1985 Texas only had eight medical schools. Today in 2023 Texas now has sixteen, thirteen allopathic and three osteopathic. The newest schools located in Huntsville, Fort Worth, San Antonio and the latest will be in Tyler. Of these four locations two of the schools are allopathic and two are osteopathic. The growth of medical schools has been exciting but there is still a great need for more post graduate training in Texas. It will be exciting to see Becker’s numbers in the future as Texas continues to be a hot bed for medical education!

Governor Abbott ends Covid 19 license

On June 15, 2023 Governor Greg Abbott ended the Covid 19 waivers related to physicians. The Texas Medical Board will be working to notify those physicians holding such temporary licenses that within the next 30 days they will need to make other arrangements regarding their continued practice in Texas. Below you will find the Texas Medical Board’s press release. Please call G&M Consulting at 888-400-1580 if you have questions or concerns regarding your eligibility to practice in Texas.

Statewide COVID-19 Disaster Expiration

Governor Abbott’s statewide disaster declaration related to the COVID-19 pandemic expired on June 15, 2023. As a result, ALL rule waivers are no longer active as of this date. 

Emergency Visiting Physician Temporary Permits will remain in effect for an additional 30 days after the termination of the disaster declaration to allow permit holders and health care entities to properly plan. Therefore, current authorized Emergency VPTPs, and any emergency reactivations for retired or cancelled licenses, will terminate on July 14, 2023, and permit holders who do not have an active permit or license with the Board must cease practice in Texas. 

The following additional rule waivers are no longer in effect as of 6/15/2023: 

  • Telemedicine Waiver: allowed providers to establish a physician-patient relationship via telephone (audio-only) and enabled phone consults to diagnose, treat, order tests, and prescribe. 
  • Limits on Number of Delegates: waived the delegate limit of seven PAs or APRNs that a physician could supervise and delegate to regardless of location or setting. 
  • PITs: allowed Texas hospitals and facilities associated with Graduate Medical Education (GME) training programs to be able to utilize Physician in Training (PIT) permit holders in areas outside of their GME training program to respond to COVID-19. 

Denise L. Meyer

More on the Texas Medical Board’s Move

It’s going to be a rough few weeks beginning NOW!!! As someone that has been through two moves with the board it is never easy and it appears that this one seems a big more complicated that the two in the past. I am hoping that the staff will enjoy their new digs but it will take time to adjust to the new area of Austin, although it is not that far from their present location. There will be new parking issues, new offices, etc. So, if you are dealing with staff please offer staff a great deal of grace. Below is an email attachment that I received this morning, October 18, 2022.

TMB offices will begin the process of relocating to the George H.W. Bush state office building (1801 Congress Ave.) starting Monday, Oct. 24 through Monday, Oct. 31. Offices will be closed to visitors during this time and online services will be unavailable starting Saturday, Oct. 22 until the conclusion of the move. We apologize for the disruption caused by the move.  

The following applicant services will be unavailable starting October 22nd

·All Online applications, 

·MyTMB/SSO – this includes: 


·JP Exam study guide, and  

·Access to the JP exam through our vendor 

·The Licensure Inquiry System of Texas (LIST) – this includes: 

·Lacking items list and details, 

·Messaging, and 

·Document upload system 

[email protected][email protected], and licensure analyst staff emails will be able to receive emails; however, as our internal systems will also be unavailable, staff will be out during this time and will be unable to respond to email messages until the system is restored online.

We ask that you not email attachments for lacking items or documents that are submittable through the LAMAS or LIST document upload system. Please wait until all internal systems have been restored online in order to submit these documents through these portals properly. 

Staff will also be unable to scan and distribute incoming mail during this time or send out any mail, Fed Ex, etc. Also, couriers may not be able to access the building during this time so please do not schedule delivery services for documents such as FedEx, UPS, or DHL during this time.  

Please also be aware that it will take time for staff to process the backlog of incoming email and mail correspondence received during this time. Correspondence and mail will be processed in the order they were received, and there may a delay in processing. Again, we apologize for the disruption. Thank you for your cooperation.

Texas Medical Board is Moving!!!

The Texas Medical Board will be vacating their offices in the Hobby Towers the end of October. The board will be moving into the new George HW Bush offices located at 1801 Congress Avenue. The move will cause a bit of disruption to normal staff work for perhaps a couple of weeks while phones and computer services are moved. The last time we moved was from North Austin to downtown. It was a fun and exhilarating move. We had to boot the Texas Insurance Board out of some of their space – and boy did they have space. The insurance folks had spread far and wide across the Hobby Towers and you would have thought we were the settlers encroaching on their territory! I am excited for the move for the med board staff but there will be some angst as folks figure out new parking, new driving routines, etc. So please be patient as they transition.

Here comes the Interstate Licensure Compact!

As promised in the 2021 Texas Legislative Session the Texas Medical Board is launching the Interstate Licensure Compact on March 1, 2022. The board released the following announcement on February 23rd.

Interstate Medical Licensure Compact Begins March 1st in Texas Physician applicants outside of Texas, and Texas physicians wishing to practice in another member state, can begin submitting applications to the Interstate Medical Licensure Compact Commission (IMLCC) on Tuesday, March 1.  The Interstate Medical Licensure Compact is a voluntary, expedited pathway to licensure for qualifying physicians who wish to practice in Compact member states.  For details on qualifying for Compact licensure, and Frequently Asked Questions, please visit: 

This is the culmination of years of planning and pushing and begging Texas legislators to fall in with so many other states to understand the necessity of physicians to be able to readily move quickly across state lines to practice. Texas became the 33rd state to join the compact. The Federation of State Medical Boards serves as the parent organization for the Interstate Medical Licensure Compact which began in 2017. The Compact which mirrors the compact license of nurses affords physicians who qualify an expedited avenue to licensure. This is not a way to skip around state to state or to escape an investigation or perhaps punishment for a reportable action but to allow good doctors the ability to quickly get to states that need assistance, such as Texas.

I for one am very excited to finally see Texas join the Compact – so bring it on Texas – it’s about time! Denise Meyer

May 2022 be the best year yet

Here’s hoping that all the extraordinary doctors coming to practice in Texas get here and licensed quickly! Maybe we can assist with that. Helping navigate through what can sometimes be a difficult process, we’ll handle the hard stuff and let you do what you need to do to keep your current practice humming.

Well, it’s about damn time!

Yesterday, June 7, 2021 Governor Greg Abbott signed into law that Texas has joined the Federation of State Medical Board’s Interstate Medical Licensure Compact. There will be much more information coming out, but for now read the press release found at this link

June 8, 2021
For Immediate Release
The Interstate Medical Licensure Compact Commission is pleased
to announce that on June 7, 2021, Governor Greg Abbott signed
into law House Bill 1616 which was passed by the Texas Legislature
on May 21, 2021.
Texas is the 33rd member jurisdiction to join the Compact.
The Compact now has 31 states, the District of Columbia and the
Territory of Guam as member jurisdictions. Legislation has passed
in Delaware, with the Governor’s signature expected shortly. There
is currently legislation pending in 8 states, including North Carolina
and Ohio.
Please contact Marschall Smith at [email protected]
with questions.

If you have never heard of the Compact or perhaps you have but have not looked at the requirements lately now is the time. This action is so overdue, in my opinion.

So come on physicians we need you in Texas!

Merry Christmas from Garanflo and Meyer Consulting

It is hard to believe that Garanflo and Meyer Consulting are about to celebrate ten years of consulting! It has been a great deal of satisfaction for Jaime and I to know that we have been able to help so many physicians with licensing in the state of Texas.

How Garanflo and Meyer Consulting Began

Many people ask how we decided to begin consulting. Neither of us had even considered being consultants. Not long after I retired I began getting calls. Calls came from attorneys, international medical schools, US medical schools and clinics asking for help. I was happy to help but had no idea where to begin. It was through some advice I received from a friend, who is an attorney, and had at one time been with the medical board that I began consulting.

When Jaime retired I asked her if she would join me, and she wholeheartedly agreed. We both knew that no one, except for current Texas Medical Board staff, knew licensure in Texas like we did. We also decided that our concentration would only be Texas, because that is what we knew. So Garanflo and Meyer Consulting, LLC began and the rest is history.! We both laugh when we encounter things in board rule or statute that we question until we realize that we are the ones that put most of this into place.

Garanflo and Meyer Consulting Today

Jaime no longer actively takes clients. She is always ready to talk through issues with me and help me remember why something is in rule or law and how to get around it. It is amazing that between the two of us we can remember so much about how things came about, what applicant started the change and what affect changes have had on others.

There are still impediments to licensure. I for one am hoping that this upcoming legislative session the House and Senate will make changes. In the meantime we will continue to aid as many physicians as possible.

Merry Christmas and a very Happy New Year – Denise Meyer