Washington State

House of Representatives

Office of Program Research

BILL

ANALYSIS

Health Care & Wellness Committee

HB 1409

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

Brief Summary of Bill

Eliminates the general requirement that graduates of foreign medical schools meet all medical licensing standards applicable to graduates of domestic medical schools and specifies that they must meet examination requirements and be certified by the Educational Commission for Foreign Medical Graduates.
Establishes an alternative standard for receiving a license to practice medicine for applicants with exceptional credentials.
Establishes a process for those who hold a limited license for teaching-research to obtain a full license to practice medicine.

Background:

The Medical Quality Assurance Commission (Commission) establishes requirements for applicants for a license to practice medicine. Applicants who have graduated from a medical school located in the United States or Canada must show that they:

graduated from a Commission-approved school of medicine;
completed two years of postgraduate medical training;
are of good moral character; and
are able to physically and mentally practice medicine safely.

Applicants for a license to practice medicine who graduated from a medical school located outside of the United States or Canada must have:

completed a course of instruction equivalent to that required for other applicants;
met all requirements applicable to graduates of United States or Canadian medical schools;
passed the examination given by the Educational Commission for Foreign Medical School Graduates; and
demonstrated that he or she can understand and be understood in English.

An applicant from a foreign medical school who has not completed the required two years of postgraduate medical training requirement may alternatively provide proof of: (1) being a permanent immigrant of exceptional ability in the sciences or holding a permanent immigration visa; (2) certification as a Multiple Sclerosis specialist; and (3) completion of at least 24 months of training in Multiple Sclerosis at a United States educational institution with a residency program in neurology or rehabilitation.

The Commission may issue a limited license to practice medicine under specific circumstances. The situations relate to individuals:

licensed in another state or Canada who have been accepted for employment by the Department of Social and Health Services, the Department of Corrections, or a local health jurisdiction;
appointed as a resident physician in a program of postgraduate clinical training; or
nominated by the dean of the University of Washington School of Medicine or the chief executive officer of a hospital to serve as a teaching-research member of the institution's instructional staff.

Summary of Bill:

The standards for an applicant for a license to practice medicine who graduated from a medical school located in the United States or Canada are applicable also to graduates of medical schools located in the United Kingdom, Australia, New Zealand, France, Germany, and South Africa. For these applicants, the Medical Quality Assurance Commission (Commission) must adopt, by rule, a list of medical schools approved by the Commission. The requirement that a postgraduate medical training program last for two years is eliminated and the Commission is directed to define the requirements for such training in rule. These graduates must successfully complete the examination requirement established by the Commission in rule and provide proof of the ability to understand and be understood in English. If the applicant graduated from a medical school outside of the United States or Canada, he or she must complete the certification process of the Educational Commission for Foreign Medical School Graduates (ECFMSG).

For applicants for a license to practice medicine who graduated from a medical school located outside of the United States, Canada, the United Kingdom, Australia, New Zealand, France, Germany, or South Africa, the requirement to meet all standards applicable to graduates of United States and Canadian medical schools is replaced with specific requirements to pass the Commission's examination. The requirement to pass the examination of the ECFMSG is expanded to require certification from that organization.

An alternative standard for receiving a license to practice medicine is established for applicants who establish (1) exceptional education, training, and practice credentials, and (2) that his or her practice in Washington would benefit the public welfare. The Commission shall adopt rules to determine what qualifications may be considered exceptional.

Individuals who hold a limited license as a resident physician may practice outside of the scope of the residency if the graduate medical education program approves and files that approval with the Commission. Individuals who hold a limited license for teaching-research are eligible for full licensure if they have completed the Commission's examination requirement, demonstrated the ability to understand and be understood in English, held a position of associate professor or higher at a Washington medical school for at least three years, and practiced without any disciplinary action in the prior five years. If the applicant holding a limited license for teaching-research graduated from a medical school outside of the United States or Canada, he or she must complete the certification process of the ECFMSG.