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Rules and Regulations of the American Board of Eye Surgery

RULE I

PURPOSE

 

1.1 The principal purpose of the American Board of Eye Surgery (the “Board”) is to develop procedures to evaluate the professional activities, knowledge and skills of a candidate who seeks certification by the Board, to develop standards of professional practice, surgical experience, and surgical skill, to implement the evaluation processes designed to validate a candidate’s surgical experience and surgical skill, to review and assess the credentials of a candidate, and to award certificates to those candidates who fulfill the requirements defined by the Board.

1.2 These Rules and Regulations set forth the requirements and procedures for issuance of certificates by the Board and revocation thereof. The certification process involves two parts. Part I requires the submission of certain information and a review of operative data and records of consecutive surgical cases. Part II requires an audit of records and successful completion of a surgical examination.

1.3 The Board reserves the right to amend these Rules and Regulations from time to time in such manner as it deems appropriate.

RULE II

NATURE OF CERTIFICATE

2.1 The Board shall issue a certificate, which shall be valid for the period established by the Board, which represents certification in one or more of the following subspecialties: cataract/implant surgery, cornea-refractive, glaucoma, ocuplastic, retinal-vitreous, and strabismus surgeries. The current form of certificate is as follows:

THE AMERICAN BOARD OF EYE SURGERY

hereby certifies that

 


has satisfactorily fulfilled this Board’s requirements for certification in the subspecialty of

 


(e.g., cataract/lens implant surgery, refractive surgery, cornea surgery).

(Date and Seal) (Signatures of Directors of the Board or their Designees)

 

2.2 A certificate shall expire seven (7) years after the date of its issuance. During that period, the Applicant must satisfactorily complete a recertification process as set forth in Rule VIII herein.

2.3 Issuance of a certificate only entitles the certificate-holder to represent to the public the he/she is “Certified by the American Board of Eye Surgery” or “Certified in [Cataract/Implant] Surgery by the American Board of Eye Surgery.”

 

RULE III

APPLICATION PROCESS

3.1 An applicant who wishes to be examined by the Board shall complete, sign and file with the Executive Director an application on the official form then in use by the Board. The application shall be considered complete only when all supporting data required by the application, and a non-refundable application fee, are also filed with the Executive Director. Applications can be obtained from the Office of the Board. An application, whenever postmarked, which is incomplete in any respect, including omission of required supporting data, shall remain open for completion for a period of one year from the date on which the application is received by the Board. The Executive Director shall send the applicant a notice after an initial review of the application of any deficiencies contained therein. If the application is completed within a one (1) year period by the submission of information postmarked on or before the last day of that period, the application and all required supporting data shall be deemed to be valid; but if the application is not completed within that one (1) year period, the application will no longer be valid. The Executive Director may, in his/her sole discretion, grant a waiver with respect to the one (1) year completion deadline if there is a delay in obtaining verifications described in Rule IV which can be documented as attributable to factors beyond the applicant’s control.

3.2 The application presently contains an agreement by the applicant reading as follows:

APPLICANT’S APPLICATION AND AGREEMENT

 

I hereby apply to the American Board of Eye Surgery, for examination and certification/recertification in the subspecialty of (e.g., cataract/lens implant) surgery upon successfully completing the operative experience requirements and passing the examinations required by the Board, all in accordance with and subject to the Rules and Regulations of the aforesaid Board described in the Candidate’s Booklet of Information for Certification in Eye Surgery. Upon the issuance of a certificate, I agree to and do become bound by the Rules and Regulations and the Canons of Ethics of the aforesaid Board, copies of which have been provided to me. I understand that any certification or recertification issued will be valid for a limited time period.

I agree to disqualification from examinations of surgical skill and from the issuance of a certificate of qualification, or to forfeiture and redelivery of such certificate to the Secretary of the Board, in the event that any of the statements hereinafter made by me are false or in the event that any of the rules governing such examinations are violated by me. All information and responses contained in the application shall be subject to verification by the Board, as provided for in Rule 3.2 of the Rules and Regulations. I agree to hold said American Board of Eye Surgery, its members, examiners, officers, and agents, free from any damage or complaint by reason of any action they or any of them may take in connection with this application, such examinations of surgical skill, the evaluation made with respect to any of the surgical skill examinations, and/or the failure of said corporation to issue me such certificate.

Upon the issuance of a certificate, I agree to and do become bound by the Rules and Regulations and the Canons of Ethics of the aforesaid Board, copies of which have been provided to me.

Confidentiality. I also agree that the Board may release information, on an anonymous basis, obtained through the application process as may be required from time to time under the Rules and Regulations for compilation and evaluation in research and analysis by persons or organizations, and in accordance with procedures, approved by the Board.

By signing an application and filing it with the Board, each applicant agrees to abide by all the terms and conditions of such pledge and all information and responses contained in the application shall be subject to verification by the Board, as provided in Rule IV herein. Each applicant also agrees to immediately advise the Board of any changes to the responses to any question in the application which may have a material affect on the Board’s evaluation of the applicant, specifically including any changes to the responses to Question 7.

 

3.3 Part I of the certification process comprises the following elements:

(a) Application for Certificate completed and signed;

(b) the application fee then in effect (U.S. dollars);

(c) notarized copy of the candidate’s currently valid medical registration card (license);

(d) notarized copy of the candidate’s American Board of Ophthalmology certificate;

(e) names of three references, with complete addresses;

(f) one recent personal photograph, passport size (2″x2″) attached to the application;

(g) Operative Data Review Form(s) completed and signed (The Operative Data Review Form(s) documents a pre-determined amount of data, which varies according to the subspecialty for which the candidate has applied for certification, exclusive of surgeries performed during the candidate’s residency and/or fellowship. The cases must reflect surgeries completed within a pre-determined period of time, which varies according to the subspecialty for which the applicant has applied for certification. Information about the patient, preoperative data, operative data, initial post-operative data, last post-operative data, and secondary surgery is requested on the form. ALL CASE DATA MUST BE TYPED AND ACCURATELY IDENTIFIED. All data will be maintained as confidential, except that it can be released on an anonymous basis for compilation and evaluation in research and analysis. This data will be independently audited at the time of the on-site observation of eye surgery. On page 1 of the Operative Data Review Form(s) is a statement attesting to the accuracy of the reported data that the candidate must sign);

(h) completed Identification Form, including recent personal photograph and signature;

(i) Authorization to furnish documents, records, and recommendations completed and signed; and

(j) Agreement to abide by established videotape procedures.

No application will be considered to be complete until the fee and all required supporting data have been received by the Executive Director.

3.4 After all of the documents described in Rule 3.3 have been accepted in accordance with Rules IV and VI, the applicant will be notified that he/she passed Part I of the application process and is eligible to undergo Part II.

3.5 If an applicant fails to meet the Operative Data Review Form(s) requirements, or otherwise fails to complete Part I, as prescribed by the Board, the Board or its delagee may:

(a) Require the applicant to make necessary corrections to his/her application or records in order to meet the Board’s requirements and submit a revised application or records within thirty (30) days of such request for the Board’s review and approval;

(b) Require the applicant to submit new Operative Data Review Form(s) on a pre-determined amount of data, which varies according to the subspecialty for which the candidate has applied for certification, audit, and be received within sixty (60) days of the request;

(c) Require the applicant to provide any other information deemed necessary to render a decision on the applicant’s qualification for Part I, to be submitted within sixty (60) days of the date of the request; or

(d) Require the applicant to recommence the entire certification process, which can only be done after a one (1) year waiting period from the date of notice of the need to recommence.

If the Board exercises any of options (a) through (c) above and either does not receive the requested information in a timely fashion, or upon receipt, determines that the applicant still fails to satisfy the requirements of Part I, the Board then may exercise option (d) above.

3.6 For purposes of administrative convenience, and with the applicant’s consent, prior to completion of the review and verification of Part I of the certification process as is set forth in Rule IV herein, the Executive Director may authorize the applicant to undergo Part II of the certification process pursuant to Rules III and Rule V herein, with the understanding that the applicant still must successfully fulfill all requirements of Part I of the certification process in order to be certified.

3.7 If the applicant qualifies to undergo Part II, the applicant must remit the examination of surgical skill fee then in effect in order to be scheduled by the Board on a date of mutual convenience for the audit of records and examination of surgical skill which constitute Part II of the application process. If the applicant does not remit such fee within one (1) year of the date of notification, the application will no longer be valid and the applicant will have to recommence the application process by paying the application fee then in effect and updating all application materials, including the Operative Data Review Form(s) if it is no longer current, i.e., does not include data on surgeries performed within the pre-determined amount of time, which varies according to the subspecialty for which the candidate has applied for certification.

3.8 If an applicant cancels or otherwise fails to complete the examination of surgical skill for which he/she has been scheduled, he/she will not be scheduled for another such test until he/she pays to the Board a separate cancellation assessment established by the Board which is then in effect. Said cancellation assessment shall include all out-of-pocket expenses and administrative costs incurred in the processing of the application and scheduling the examinations.

3.9 If an applicant fails to take the examination of surgical skill within one (1) year after the Board receives the applicant’s examination of surgical skill fee, he/she will have to recommence the certification process, as if no application had ever been received.

3.10 An applicant who takes and fails the examination of surgical skill may apply for re-examination and will be permitted to repeat the test upon payment of the current examination fee, provided that the Board received notification of the intent to retake the examination within one (1) year of the original date of notification of eligibility for Part II. If the Board does not receive such timely notice, the applicant will be required to recommence the certification process, as if no application had been received. In addition to retaking the examination of surgical skill, the applicant must submit an update to the Operative Data Review Form(s) sixty (60) days in advance of retaking the examination to include data from a pre-determined amount of data, which varies depending on the subspecialty for which the applicant has applied for certification. If an applicant does not repeat the test within twenty-four (24) months after such failure, he/she will be required to recommence the certification process, as if no application had ever been received. If an applicant does repeat the test within twenty-four (24) months after failing it, and again fails it, he/she will be required to recommence the certification process, and may be required to submit additional Operative Data Review records, and any other information deemed necessary by the Board, upon reapplication.

3.11 The fee for the examination of surgical skill shall be established annually by the Board of Directors on the basis of the actual and anticipated costs of the Board in the examination of applicants and the administration of its business.

RULE IV

REVIEW AND VERIFICATION OF APPLICATIONS

BY EXECUTIVE DIRECTOR

4.1 Each application timely received by the Board shall be reviewed by or under the supervision of the Executive Director for purposes of determining whether it is complete. The Executive Director shall cause the applicant to be promptly notified of any deficiencies in the application as provided for in Rule III and the applicant shall be subject to the time deadlines for completing the application set forth in Rule III.

4.2 Each completed application will be reviewed by or under the supervision of the Executive Director, and for this purpose the Executive Director will make or cause to be made inquiries of any and all persons and institutions reasonably believed by the Executive Director to have information bearing upon or relevant to a determination whether the applicant meets the Board’s requirements for examination, including, without limitation, persons and institutions named in the application. This process shall include a review of the Operative Data Review Form(s) to be conducted by an individual or individuals appointed by the Board who shall be supervised by and report to the Executive Director, as well as a verification of all information contained in the application. If a candidate is found to be involved in litigation or investigation regarding ethical or moral issues, further review and/or action by the Board may be suspended until the investigation or legal action is concluded.

A candidate who is otherwise qualified but who has had a history of chemical dependency which has not been under control for at least five (5) years will be eligible for certification only upon submission to the Board such information and documentation which establishes to the satisfaction of the Board that any history of chemical dependency has been under control for a period of time deemed reasonable in the sole discretion of the Board. The Executive Director shall specifically advise the Committee on Admissions, as set forth below, of the candidate’s request that such information and documentation, as may be supplemented by additional requests by the Executive Director, be accepted as demonstrating control of any prior chemical dependency. The Board may condition certification of a candidate with a history of chemical dependency upon submission of periodic reports documenting continued control of any prior chemical dependency for a period not to exceed five years from which such disease or condition is known to be under control.

As promptly as practicable after completing these inquiries, reviews, and receipt of all verifications, the Executive Director shall report to the Committee on Admissions (the “Committee”) whether or not the applicant appears to meet the Board’s requirements for Part I. The Committee shall notify the applicant of his/her eligibility to undergo an audit of records and take the examination of surgical skill (Part II of the certification process), as provided for in Rule V.

RULE V

EXAMINATION OF SURGICAL SKILL

AND AUDIT OF OPERATIVE DATA REVIEW

FORM(S) BY ON-SITE OBSERVER

5.1 Part II of the certification process consists of the:

(a) audit of the records summarized on the Operative Data Review Form(s) by an on-site observer appointed by the Committee in the subspecialty for which the candidate has applied for certification;

(b) conduct of a chart review of the patients being observed by the on-site observer;

(c) observation of a pre-determined number of complete surgical procedures, which varies according to the subspecialty for which the candidate has applied for certification, by the on-site observer;

(d) videotaping of a pre-determined number of procedures, which varies according to the subspecialty for which the candidate has applied for certification, observed by the on-site observer appointed by the Board. The candidate is responsible for the cost of the videotaping and video technician (if applicable), including per diem and travel. The videotaping must be conducted in accordance with procedures then in effect, as set forth in the Board’s Candidate’s Booklet of Information for Certification in Eye Surgery. The on-site observer must observe said procedures from start to finish, including all preoperative and post-operative procedures. After the completion of the examination of surgical skill, the candidate and the on-site observer must sign a form stating that the examination occurred on that date;

(e) evaluation of a pre-determined number of videotaped procedures, which varies according to the subspecialty for which the candidate has applied for certification, by a panel of two (2) ophthalmologists trained in evaluating videotaped procedures and appointed by the Committee from a list of panelists selected by the Board. In the event that the two panelists disagree on the tests, a third panelist appointed by the Committee will evaluate the said videotapes; and

(f) evaluation by the on-site observer of follow-up data for the procedures observed and videotaped which the applicant must submit within thirty (30) days of the end of the follow-up period. The on-site observer may request additional follow-up data if the initial information is not satisfactory, which the applicant must provide within ten (10) days of the date of the on-site observer’s request for such information.

5.2 The on-site observer shall report to the panel of ophthalmologists his/her findings on the applicant’s performance for its review and approval.

5.3 As promptly as practicable after reviewing the applicant’s videotape, follow-up data, and on-site observer’s report, the panel of ophthalmologists shall report to the Committee through the Executive Director whether or not the applicant appears to meet the Board’s requirements for the examination of surgical skill.

 

RULE VI

DECISION ON APPLICATION

BY COMMITTEE ON ADMISSIONS

6.1 The Committee is comprised of five (5) members appointed by the Board, three (3) of whom shall be ophthalmologists and may be members of the Board, one (1) of whom may be the Executive Director and the other of whom shall be experienced and trained in the provision of eye care, in either a professional or auxiliary capacity.

6.2 The Committee shall be responsible for making the determination as to whether each applicant meets the Board’s requirements for Parts I and II of the certification process. This determination shall be based upon a completed application, the report of the Executive Director, the results of any further inquiry into the facts and circumstances that the Committee determines to be necessary or appropriate, including, without limitation, making inquiries of persons and institutions referred to or described in Rule 4.2, and the reports of the on-site observer and panel of ophthalmologists. All applicants must fully comply with all Rules and Regulations of the Board which are in effect when the application is made, including those set forth in the Candidate’s Booklet Information for Certification in Eye Surgery, and with the Canons of Ethics. The Committee shall cause the applicant and the Board to be given prompt written notice of its determinations.

6.3 If the Committee determines that an applicant does not meet the Board’s requirements for either Part I or Part II, the notice to the applicant and the Board shall also specify the reasons why the applicant does not meet the Board’s requirements and the rights of the applicant to appeal the Committee’s determination to the Board of Directors for hearing at its next regularly-scheduled meeting and to attend and be represented by counsel at that hearing (See Rule IX). The notice may suggest steps for the applicant to take in an attempt to remedy each determined deficiency. A determination of the Committee as to the applicant’s failure to meet either Part I or Part II is final and conclusive unless that determination is appealed under Rule IX. Unless and to the extent that the Committee’s negative determination with respect to the application submitted by the applicant is modified or reversed in accordance with Rule IX, a subsequent application submitted by the applicant will not be considered by the Board for any purpose if it contains any of the same deficiencies determined by the Committee with respect to the prior application.

 

RULE VII

REPORTS

7.1 The Board shall have the right to periodically obtain from each certificate-holder data relating to the professional and surgical nature of the certificate-holder’s practice including, but not limited to, number of surgeries performed during the year, follow-up data on the videotaped procedures conducted in conjunction with Part II of the examination, and any pending or recent malpractice or disciplinary actions against the certificate-holder, to assure continuing eligibility and compliance with the Rules and Regulations of the Board.

7.2 The Executive Director shall have the authority to verify all data provided pursuant to Rule 7.1, through any lawful means.

RULE VIII

RECERTIFICATION

8.1 Not more than one (1) year nor less than six (6) months prior to the expiration of the certificate-holder’s certificate, the Board shall send the certificate-holder notice of such expiration and an application prescribed by the Board which the certificate-holder must complete if he/she wishes to extend his/her certificate for another seven (7) year period. The application may include, but need not be limited to, verification of completion of continuing education requirements, completion of an Operative Data Review Form(s) and demonstration of professional good standing.

8.2 The Executive Director shall review and verify the application and, for this purpose, will make or cause to be made inquiries of any and all persons and institutions reasonably believed by the Executive Director to have information bearing upon or relevant to a determination whether the applicant meets the Board’s requirements for examination, including, without limitation, persons and institutions named in the application. This process shall include a review of the Operative Data Review Form(s) to be conducted by an individual or individuals appointed by the Board who shall be supervised by and report to the Executive Director, as well as a verification of all information contained in the application. The Operative Data Review records of five percent of all candidates for recertification will be audited onsite; that is, a representative of ABES will conduct an office audit of the records under the same conditions as are implemented at the time of initial certification. In all other cases, candidates will be required to submit photocopies of the complete documentation for five cases randomly selected by ABES.

8.3 Should the candidate fail to meet the standards for the Operative Data Review, the candidate will be permitted to submit a second set of cases. All candidates required to submit a second set of records will automatically be required to participate in Part II of the certification program — an evaluation of surgical skills identical to that implemented in Part II of the initial certification program. (All costs for participation in Part II will be the responsible of the candidate.) As set forth in Rule V herein this will be subject to the same provisions as set forth in Rules 3.5 through 3.8.

8.4 The Committee shall determine whether each reapplicant meets the Board’s requirements for recertification, including compliance with all Rules and Regulations in effect when the reapplication is made, including those set forth in the Candidate’s Booklet of Information for Certification in Eye Surgery, and with the Canons of Ethics. The Committee shall cause the reapplicant and the Board to be given prompt written notice of its determination.

8.5 If the Committee determines that a reapplicant does not meet the Board’s requirements for recertification, the notice to the reapplicant and the Board shall also specify the reasons why the reapplicant does not meet the Board’s requirements and the rights of the reapplicant to appeal the Committee’s determination to the Board of Directors for hearing at its next regularly-scheduled meeting and to attend and be represented by counsel at that hearing (See Rule IX). The notice may suggest steps for the reapplicant to take in an attempt to remedy each determined deficiency. A determination of the Committee as to the applicant’s failure to become recertified is final and conclusive unless that determination is appealed under Rule IX. Unless and to the extent that the Committee’s negative determination with respect to the application submitted by the reapplicant is modified or reversed in accordance with Rule IX, a subsequent application submitted by the reapplicant will not be considered by the Board for any purpose if it contains any of the same deficiencies determined by the Committee with respect to the prior application.

 

RULE IX

APPEALS TO BOARD OF DIRECTORS

9.1 If the Committee determines that an applicant does not meet the Board’s requirements for either Part I or Part II in an initial application or that a reapplicant does not meet the requirements for recertification, the applicant/reapplicant (hereinafter the “applicant”) may, within sixty (60) days after the date of the Board’s notice of that determination, give written notice to the Board that he or she wishes to appeal the Committee’s determination to the Board of Directors, which written notice shall set forth the specific findings of the Committee which are alleged to be erroneous and shall indicate whether or not the applicant wishes to attend the hearing and to be represented at the appeals hearing by counsel.

9.2 The Board of Directors shall consider only timely appeals of determinations of the Committee and only at regularly-scheduled meetings of the Board of Directors and shall not call or hold a special meeting to consider any appeal. An applicant’s appeal, if timely, shall be considered at the next regularly-scheduled meeting of the Board of Directors. The applicant shall be notified of the date, time and place of the appeal hearing and the duration (not in excess of 60 minutes) of the hearing.

9.3 If an applicant timely appeals a determination of the Committee, the Board of Directors shall hold an appeal hearing as directed above in Rule 9.2, consider the matter, and decide the appeal. The Chairman of the Board of Directors shall preside at each appeal hearing and shall ensure that the only issue considered at the hearing is whether or not an applicant meets the Board’s requirements for either Part I or Part II and, if not, in what respects the applicant is deficient in meeting those requirements.

At the hearing, the burden shall be on the applicant to prove by a clear preponderance of the evidence that he or she meets the Board’s requirements for examination. The Board of Directors shall not be bound by technical rules of evidence which are usually applicable in legal proceedings, but may receive and consider any evidence it deems to be appropriate and relevant. The proceedings of the appeal hearing may be recorded or transcribed only if, and upon the terms and conditions and in the manner, determined by the Board. The applicant and the applicant’s counsel and the Board’s counsel may be present at the hearing. The Chairman of the Board of Directors shall summarize the determination of the Committee with respect to the application submitted by the applicant and the errors asserted by the applicant in appealing that determination and may make such other introductory factual remarks as he considers appropriate.

The Chairman of the Committee shall present the basis for the Committee’s determination, which may include documentary evidence and testimony of witnesses, and the Chairman of the Committee and any witness testifying shall be available for questioning by the applicant and the applicant’s counsel. The applicant and the applicant’s counsel may present documentary evidence and testimony of witnesses in support of the applicant’s position that he or she meets the Board’s requirements for examination. The applicant and each witness for the applicant shall be available for questioning by the Chairman of the Committee, members of the Board of Director and the Board’s counsel.

9.4 As promptly as practicable after the appeal hearing, the Board of Directors shall decide on the basis of the record before it, including evidence and testimony received at the appeal hearing, whether or not the applicant meets the Board’s requirements for examination, and shall give written notice of its decision to the applicant. The decision of the Board of Directors may affirm, reverse, or modify the determination of the Committee in whole or in any part and shall be final and conclusive. If the decision of the Board of Directors is that the applicant does not meet the Board’s requirements for examination, the notice of the decision given to the applicant shall specify the respects in which the applicant does not meet the Board’s requirements for examination and may suggest steps for the applicant to take in an attempt to remedy each determined deficiency.

RULE X

REVOCATION AND PROBATION

10.1 The Board shall have authority to revoke any certificate issued by it or to place the certificate-holder on probation for a fixed or indefinite time if:

(a) The certificate-holder was not eligible to receive, or has since become ineligible to hold, the certificate, based on the Rules and Regulations currently governing the Board, whether or not the facts constituting such ineligibility were known or could have been ascertained by the Board at or before the issuance of the certificate;

(b) The certificate-holder has violated any rule or regulation governing consideration for a certificate, at any time after the issuance of the certificate;

(c) The certificate-holder has been found liable in or has settled one or more malpractice actions, which, in the Board’s discretion, raise serious and substantial questions regarding the certificate-holder’s eligibility for certification by the Board;

(d) The certificate-holder has failed to cooperate with the Board in providing the Board with any information required pursuant to these Rules and Regulations or in any investigation undertaken pursuant to these Rules and Regulations;

(e) The certificate-holder has violated the Board’s Canons of Ethics or other generally accepted ethical standards with respect to the practice of medicine. The forfeiture, revocation or suspension of the physician’s license to practice medicine, of the expulsion from, or suspension from the rights and privileges of membership in a local, regional, or national organization of his/her professional peers shall be evidence of a violation of such standards of the ethical practice of medicine;

(f) The certificate-holder made any material misstatement or omission of fact to the Board in his/her application or other material presented to the Board, whether intentional or unintentional;

(g) The certificate-holder has been convicted by a court of competent jurisdiction of any felony or misdemeanor involving moral turpitude and, in the opinion of the Board, having a material relationship to the practice of medicine;

(h) The certificate-holder has used its certificate in an unfair, deceptive or misleading manner or otherwise has misrepresented the nature or purpose of the certification by the Board, including, but not limited to, any representation that his/her certificate applies to anyone or any entity other than the certificate-holder himself/herself, or otherwise has violated Rule 2.3 herein; or

(i) The certificate-holder has failed to fulfill any current continuing education requirements established by the Board.

10.2 If the Board receives information suggesting that there may be a basis under Rule 10.1

for revoking a certificate previously issued by it to a certificate-holder or for placing a certificate-holder on probation, the Board may investigate and gather facts concerning possible grounds for revocation or probation, including but not limited to review of copies of the certificate-holder’s medical records and opportunity to observe the certificate-holder’s surgical procedures. Failure of the certificate-holder to submit copies of relevant medical records or provide the opportunity to observe the certificate-holder’s surgical procedures shall be grounds for revocation of the certificate-holder’s certificate, as set forth in 10.1(d) above. If the Board, with or without an investigation, determines in its sole discretion that there is probable cause to believe that a basis does exist for revoking a certificate or for placing a certificate-holder on probation, the Board may institute proceedings for revocation or probation by mailing written notice to the certificate-holder that a hearing will be held by the Board of Directors to determine whether or not the certificate issued to the certificate-holder by the Board should be revoked or whether the certificate-holder should be placed on probation. The notice shall specify (a) the ground or grounds which are believed to establish a basis for revoking the certificate-holder’s certificate or for placing the certificate-holder on probation, (b) the date, time and place of the hearing, and (c) the right of the certificate-holder to attend the hearing and to be represented by counsel at the hearing. The notice shall be mailed to the certificate-holder not less than thirty (30) days prior to the date of the hearing.

The Board of Directors shall hold the scheduled hearing, consider the matter, and decide the issue presented whether or not the certificate-holder or the certificate-holder’s counsel is present at the hearing. The Chairman of the Board of Directors shall preside at the hearing and shall ensure that the only issue considered at the hearing is whether or not the certificate issued to the certificate-holder by the Board should be revoked or the certificate-holder should be placed on probation in accordance with Rule 10.1. The Board shall not be bound by technical rules of evidence which are usually applicable in legal proceedings, but may receive and consider any evidence it deems to be appropriate and relevant.

The proceedings of the hearing may be recorded or transcribed only if, and upon the terms and conditions and in the manner, determined by the Board. The certificate-holder and the certificate-holder’s counsel and the Board’s counsel may be present at the hearing. The Chairman of the Board of Directors, or a person designated by the Chairman, shall summarize the ground or grounds which are believed to establish a basis under Rule 10.1 for revoking the certificate-holder’s certificate or for placing the certificate-holder on probation and may make such other introductory factual remarks as the Chairman or the Chairman’s designate considers appropriate.

A person designated by the Board shall present the reasons for the Board’s determination that a basis exists under Rule 10.1 for revoking the certificate-holder’s certificate or for placing the certificate-holder on probation, including documentary evidence and testimony of witnesses, and that designate and those witnesses shall be available for questioning by the certificate-holder and the certificate-holder’s counsel. The certificate-holder and the certificate-holder’s counsel may present documentary evidence and testimony of witnesses in support of the certificate-holder. The certificate-holder and each witness for the certificate-holder shall be available for questioning by members of the Board of Directors and the Board’s counsel.

As promptly as reasonably practicable after the hearing, the Board shall decide whether or not the certificate-holder’s certificate shall be revoked or the certificate-holder shall be placed on probation and, if the decision is that the certificate-holder shall be placed on probation, the duration and other terms and conditions of the probation, and shall give written notice of its decision to the certificate-holder. The decision of the Board shall be final and conclusive. If the decision of the Board is that the certificate of the certificate-holder shall be revoked or that the certificate-holder shall be placed on probation, the notice of the decision given to the certificate-holder shall specify the factual basis for that decision under Rule 10.1.

10.3 If in any such proceeding the Board determines that a certificate-holder shall be placed on probation or that a certificate held by any certificate-holder shall be revoked, the certificate-holder, upon receipt of the notice of such determination, shall forthwith surrender his/her certificate to the Board and shall cease to represent that he/she is certified by the Board.