Background: The Washington Medical Commission (commission) regulates the licensure of physicians. The commission issues limited licenses and full licenses. Individuals eligible for a limited license include those entering residency training programs. To receive a full license, an applicant must have graduated from an accredited or approved medical school, passed all the steps of the United States Medical License Examination (USMLE) or the Licentiate of the Medical Council of Canada, completed at least two years of post-graduate training, have good moral character, and be physically and mentally capable of safely carrying on the practice of medicine. To receive a limited license, an applicant must meet the same requirements except they must have only passed USMLE Steps 1 and 2 and are not required to have completed at least two years of post-graduate training.

International medical graduates are individuals who graduated from a medical school outside the United States or Canada. In addition to the requirements for all applicants, international medical graduate applicants must also:

obtain a certification with an indefinite status granted by the Educational Commission for Foreign Medical Graduates; and
have the ability to read, write, speak, understand, and be understood in the English language.

To obtain certification by the Educational Commission for Foreign Medical Graduates, an individual must have graduated from an institution registered in the International Medical Education Directory and have passed USMLE Step 1, Step 2 Clinical Knowledge, and Step 2 Clinical Skills.

Summary: Subject to the amounts appropriated, the International Medical Graduates (IMG) Work Group is established.

The Governor will appoint the following members to the work group:

a representative from the Medical Quality Assurance Commission;
a representative from the Department of Health, Health Systems Quality Assurance Division;
a representative from the University of Washington School of Medicine Graduate Medical Education Program;
a representative from the Washington State University Elson S. Floyd College of Medicine Graduate Medical Education Program;
a representative from the Pacific Northwest University of Health Sciences College of Osteopathic Medicine Graduate Medical Education Program;
a representative from a statewide association representing physicians;
a representative from the Washington State Family Medicine Residency Network;
a representative from a primary care health care employer in a rural or underserved area of Washington;
a representative from a health carrier offering coverage in a rural or underserved area of Washington;
a licensed physician with experience working with international medical graduates;
a representative from an organization specializing in refugee advocacy in Washington;
a representative from an organization serving refugee physicians and IMGs;
a representative from an organization offering counseling and educational programs to internationally trained health professionals;
a representative from an organization representing community and migrant health centers; and
at least two international medical graduates.

The work group must develop strategies and recommendations for reducing barriers for IMGs to obtain residency positions in Washington, including preresidency training. The work group must also make recommendations on:

the appropriate number of residency positions designated for IMGs, and their locations and specialties; and
the postresidency service requirements for IMGs who graduate from a designated residency position.

The Medical Quality Assurance Commission must provide staff support to the work group. The work group must submit a report of its recommendations to the Governor and the Legislature by December 1, 2019.

These provisions expire on June 30, 2020.

Votes on Final Passage:

Senate	44	4
House	97	1	(House amended)
Senate	39	8	(Senate concurred)