MD JURISPRUDENCE STUDY GUIDE 2025/2026 QUESTIONS
AND SOLUTIONS GRADED A+
✔✔What is delegating Authority? Who is responsible?
What can NPs or PAs do? - ✔✔A physician can delegate any task ("medical act") they
want to anyone acting under their "supervision" (loosely defined), such as *nurses,
techs, medical students, and mid-level practitioners such as NPs or PAs.*
NPs and PAs can even prescribe controlled substances (*schedule III and IV*) under
the license of their supervising physician.
Ultimately, any delegated actions and their consequences are entirely the *responsibility
of the supervising physician. *This is known as *vicarious liability.*
✔✔What are standing orders? - ✔✔THey must not require any independent medical
judgement.
i.e. obtain EKG and CXR for every patient in ER who says "chest pain"
or pregnancy test on every female under 50.
✔✔What are midlevels? - ✔✔Physician assistants, APRN (advance practice registered
nurses) and APNs (advanced practice nurses) and nurse practioners
✔✔How many midlevels can you have in outpatient? - ✔✔7 full time equivalents (i.e.
can have 14 half time)
In hospital or medically underserved area, no midlevel limit.
✔✔What must a doctor do to run a rural / medically underserved practice with mid
levels? - ✔✔Be remotely available
visit every 10 days
Review at least 10% of charts of each midlevel
Pt can request supervising physician.
Mid levels can prescribe sch III and IV
mid levels can prescribe sch II (Norco, morphine, vicodin) with intended stay of 24 hours
or greater, in a hospital based (not free standing ER), or for patients in hospice.
✔✔Who can bill for being a surgical assistant? - ✔✔Only *licensed* surgical assistants.
✔✔What happens if you are indicted for a felony? - ✔✔License is suspended.
If convicted, it is revoked.
3rd degree felony to practice medicine without a license.
,✔✔Violating the medical practice act is what degree felony/class misdemeanor
violation? - ✔✔Class A misdemeanor
✔✔A List of things that violates the MPA - ✔✔- Lying - Drug/alcohol abuse
- Felony convictions
- Mental incompetence (including psychiatric illness that impairs judgment/ability to
practice medicine) - False advertising
- Malpractice
- Dangerous prescribing (typically of controlled substances)
- "Unprofessional or dishonorable" conduct (not specifically defined) - Violating the MPA
TMB can punish you for mistakes made in other states / during military
✔✔What is deferred adjudication? - ✔✔Equivalent of pleading guilty / being found
guilty.
you still have to report the crime to the TMB even if the crime is eventually waived. You
can then petition to have your misdemeanor removed from the TMB website if
successfully adjudicated.
✔✔What does the TMB website post about you? - ✔✔usual demographic information
(who you are, what school you went to, what state(s) you have a medical license in,
etc),
but they'll also post felony and most *misdemeanor convictions* *(from any state),* ditto
analogous charges with deferred adjudication (until you fulfill the requirements and
petition), malpractice claims, formal complaints, and disciplinary action from the medical
board *(from any state).*
✔✔When does TMB remove records of formal complaints and malpractice
investigations? - ✔✔They will remove it after 5 years as long as it didn't amount to
anything and no action was taken against the physician.
✔✔What problem can you self-report and keep confidential? - ✔✔Forced rehab for self-
reported drug/alcohol problems or physical/mental illness is confidential/not public
(assuming you haven't hurt anyone yet through your impaired practice). This is to
incentivize physicians to seek help for substance use and mental health issues.
TMB can also privately *reprimand* you for a mistake which is also completely
confidential and not in your TMB file.
Internal peer review is confidential, but any practice restriction longer than 30 days must
be reported to the TMB.
, ✔✔When do you need to let the TMB know about conviction for felonies, drug
violations, Medicare/Medicaid fraud, or misdemeanors that involve moral turpitude
("moral turpitude" is counter to the standards of decency/conduct/etc.). - ✔✔30 days
✔✔When do you need to let the TMB know about misdemeanors? - ✔✔Regular
misdemeanors, including those eligible for deferred adjudication, should be reported
during the scheduled renewal process. It doesn't matter if the crime happened in
another state, the TMB still wants to know.
✔✔How many lawsuits triggers a review of your license? - ✔✔3 lawsuits in 5 years.
✔✔Do you need to report colleagues who are impaired? - ✔✔You have a duty to report
colleagues who you think are a "continuing threat to public welfare" to the TMB. There is
no precise definition of what a "continuing threat" is, leaving you the physician with
some wiggle room. There is no punishment for sounding the alarm for claims made in
good faith ("immune from civil liability").
✔✔When will the TMB tell your hospital you've been restricted or suspended? - ✔✔Day
1
✔✔What are your rights when investigated / suspended? - ✔✔- May be temporarily
suspended without notice or hearing if there is concern for a continuing danger to public
welfare (though must then be notified immediately, with a formal hearing to follow within
10 days)
- Due process (under the law) - 5th amendment protected (you never have to
incriminate yourself) - 30 days to appeal
✔✔Concept/Definition: What are infractions? Misdemeanors? Felonies? Jail v. Prison? -
✔✔*Infractions* are what everyone gets, tickets: jaywalking, speeding, illegal parking,
etc. These involve small fines, no jail time, and have no effect on your ability to practice
medicine.
*Misdemeanors* are smallish crimes (e.g. shoplifting, pimping, marijuana possession,
DUI without injury) with relatively small fines, less than 1 year of jail time, and no effect
on your civil liberties (can still vote, buy a gun, run for public office, etc.).
Severity is A > B > C.
*Felonies* are more serious (aggravated assault, murder, etc.) with jail time greater
than 1 year and complete loss of civil liberties.
Severity is 1st > 2nd > 3rd.
AND SOLUTIONS GRADED A+
✔✔What is delegating Authority? Who is responsible?
What can NPs or PAs do? - ✔✔A physician can delegate any task ("medical act") they
want to anyone acting under their "supervision" (loosely defined), such as *nurses,
techs, medical students, and mid-level practitioners such as NPs or PAs.*
NPs and PAs can even prescribe controlled substances (*schedule III and IV*) under
the license of their supervising physician.
Ultimately, any delegated actions and their consequences are entirely the *responsibility
of the supervising physician. *This is known as *vicarious liability.*
✔✔What are standing orders? - ✔✔THey must not require any independent medical
judgement.
i.e. obtain EKG and CXR for every patient in ER who says "chest pain"
or pregnancy test on every female under 50.
✔✔What are midlevels? - ✔✔Physician assistants, APRN (advance practice registered
nurses) and APNs (advanced practice nurses) and nurse practioners
✔✔How many midlevels can you have in outpatient? - ✔✔7 full time equivalents (i.e.
can have 14 half time)
In hospital or medically underserved area, no midlevel limit.
✔✔What must a doctor do to run a rural / medically underserved practice with mid
levels? - ✔✔Be remotely available
visit every 10 days
Review at least 10% of charts of each midlevel
Pt can request supervising physician.
Mid levels can prescribe sch III and IV
mid levels can prescribe sch II (Norco, morphine, vicodin) with intended stay of 24 hours
or greater, in a hospital based (not free standing ER), or for patients in hospice.
✔✔Who can bill for being a surgical assistant? - ✔✔Only *licensed* surgical assistants.
✔✔What happens if you are indicted for a felony? - ✔✔License is suspended.
If convicted, it is revoked.
3rd degree felony to practice medicine without a license.
,✔✔Violating the medical practice act is what degree felony/class misdemeanor
violation? - ✔✔Class A misdemeanor
✔✔A List of things that violates the MPA - ✔✔- Lying - Drug/alcohol abuse
- Felony convictions
- Mental incompetence (including psychiatric illness that impairs judgment/ability to
practice medicine) - False advertising
- Malpractice
- Dangerous prescribing (typically of controlled substances)
- "Unprofessional or dishonorable" conduct (not specifically defined) - Violating the MPA
TMB can punish you for mistakes made in other states / during military
✔✔What is deferred adjudication? - ✔✔Equivalent of pleading guilty / being found
guilty.
you still have to report the crime to the TMB even if the crime is eventually waived. You
can then petition to have your misdemeanor removed from the TMB website if
successfully adjudicated.
✔✔What does the TMB website post about you? - ✔✔usual demographic information
(who you are, what school you went to, what state(s) you have a medical license in,
etc),
but they'll also post felony and most *misdemeanor convictions* *(from any state),* ditto
analogous charges with deferred adjudication (until you fulfill the requirements and
petition), malpractice claims, formal complaints, and disciplinary action from the medical
board *(from any state).*
✔✔When does TMB remove records of formal complaints and malpractice
investigations? - ✔✔They will remove it after 5 years as long as it didn't amount to
anything and no action was taken against the physician.
✔✔What problem can you self-report and keep confidential? - ✔✔Forced rehab for self-
reported drug/alcohol problems or physical/mental illness is confidential/not public
(assuming you haven't hurt anyone yet through your impaired practice). This is to
incentivize physicians to seek help for substance use and mental health issues.
TMB can also privately *reprimand* you for a mistake which is also completely
confidential and not in your TMB file.
Internal peer review is confidential, but any practice restriction longer than 30 days must
be reported to the TMB.
, ✔✔When do you need to let the TMB know about conviction for felonies, drug
violations, Medicare/Medicaid fraud, or misdemeanors that involve moral turpitude
("moral turpitude" is counter to the standards of decency/conduct/etc.). - ✔✔30 days
✔✔When do you need to let the TMB know about misdemeanors? - ✔✔Regular
misdemeanors, including those eligible for deferred adjudication, should be reported
during the scheduled renewal process. It doesn't matter if the crime happened in
another state, the TMB still wants to know.
✔✔How many lawsuits triggers a review of your license? - ✔✔3 lawsuits in 5 years.
✔✔Do you need to report colleagues who are impaired? - ✔✔You have a duty to report
colleagues who you think are a "continuing threat to public welfare" to the TMB. There is
no precise definition of what a "continuing threat" is, leaving you the physician with
some wiggle room. There is no punishment for sounding the alarm for claims made in
good faith ("immune from civil liability").
✔✔When will the TMB tell your hospital you've been restricted or suspended? - ✔✔Day
1
✔✔What are your rights when investigated / suspended? - ✔✔- May be temporarily
suspended without notice or hearing if there is concern for a continuing danger to public
welfare (though must then be notified immediately, with a formal hearing to follow within
10 days)
- Due process (under the law) - 5th amendment protected (you never have to
incriminate yourself) - 30 days to appeal
✔✔Concept/Definition: What are infractions? Misdemeanors? Felonies? Jail v. Prison? -
✔✔*Infractions* are what everyone gets, tickets: jaywalking, speeding, illegal parking,
etc. These involve small fines, no jail time, and have no effect on your ability to practice
medicine.
*Misdemeanors* are smallish crimes (e.g. shoplifting, pimping, marijuana possession,
DUI without injury) with relatively small fines, less than 1 year of jail time, and no effect
on your civil liberties (can still vote, buy a gun, run for public office, etc.).
Severity is A > B > C.
*Felonies* are more serious (aggravated assault, murder, etc.) with jail time greater
than 1 year and complete loss of civil liberties.
Severity is 1st > 2nd > 3rd.
