SENATE BILL REPORT

SHB 1874

As of March 20, 2015

Title: An act relating to the requirements of allopathic physician licensure.

Brief Description: Regarding the requirements of allopathic physician licensure.

Sponsors: House Committee on Health Care & Wellness (originally sponsored by Representatives Tharinger, Cody and Riccelli; by request of Department of Health).

Brief History: Passed House: 3/09/15, 98-0.

Committee Activity: Health Care: 3/19/15.

Staff: Evan Klein (786-7483)

Background: Physician Licensure in General. The Medical Quality Assurance Commission (MQAC) is responsible for the licensure and discipline of physicians. A physician who graduates from a medical school within the United States or Canada must meet a variety of qualifications, including the following:

• passage of an examination;

• completion of two years of postgraduate medical training;

• good moral character; and

• the ability to safely practice medicine.

The two years of post-graduate training – which includes internships, residencies, and fellowships – must be in a program acceptable to the MQAC. The MQAC only approves programs accredited by the Accreditation Council for Graduate Medical Education, the Royal College of Physicians and Surgeons of Canada, or the College of Family Physicians of Canada.

Foreign Medical School Graduates. Graduates of foreign medical schools – other than those in Canada – must meet all of the requirements as graduates from domestic schools, including the two years of post-graduate medical training. In addition foreign medical school graduates must pass the examination given by the Educational Council for Foreign Medical Graduates and be able to read, write, speak, understand, and be understood in English.

A foreign medical school graduate is exempt from the two-year post-graduate medical training requirement if the graduate:

• has been admitted as a permanent immigrant to the United States as a person of exceptional ability in the sciences pursuant to the rules of the United States Department of Labor or been issued a permanent immigration visa;

• received multiple sclerosis certified specialist status from the Consortium of Multiple Sclerosis Centers; and

• successfully completed at least 24 months of training in multiple sclerosis at an educational institution in the United States with an accredited residency program in neurology or rehabilitation.

Limited Licenses. The MQAC may issue a limited license without examination to persons who meet certain qualifications. For example, an applicant who has been nominated by the University of Washington School of Medicine or by the chief executive officer of a health care facility may be issued a limited license if the applicant is invited to serve as a teaching-research member of the institution's instructional staff. The applicant must be licensed or otherwise privileged to practice medicine at the applicant's location of origin. The applicant may practice medicine only within the confines of the instructional program.

Summary of Bill: Physician Licensure in General. The MQAC must adopt by rule a list of approved medical schools and postgraduate medical training programs as defined by their accrediting bodies. The requirement that the applicant be able to read, write, speak, understand, and be understood in English is made applicable to all applicants, not just foreign medical school graduates.

Foreign Medical School Graduates. The MQAC is granted the authority to approve medical schools in other countries. Foreign medical school graduates must complete the certification process with the Educational Commission for Foreign Medical Graduates – instead of only passing the examination.

The special licensing requirements for multiple sclerosis specialists are eliminated. The MQAC may grant a license to an applicant upon a finding that the applicant's practice in Washington would benefit the public welfare, based on the applicant's exceptional education, training, and practice credentials. Applicants must:

• be considered individually;

• submit an application; and

• undergo a background check.

Limited Licenses. The holder of a teaching-research license is eligible for full licensure if the holder:

• successfully completes the examination requirements specified in rules adopted by the MQAC;

• is able to read, write, speak, understand, and be understood in English;

• has continuously held a position of associate professor or higher at a recognized Washington medical school for at least three years;

• has no disciplinary actions taken against the holder in the previous five years; and

• passes the certification process by the Educational Committee for Foreign Medical Graduates, if the holder attended a foreign medical school.

The prohibition against a fellowship license being renewed for more than two years is eliminated.

Appropriation: None.

Fiscal Note: Available.

Committee/Commission/Task Force Created: No.

Effective Date: Ninety days after adjournment of session in which bill is passed.

Staff Summary of Public Testimony: PRO: This bill is trying to help address the physician shortage in Washington and provide better access to care. This simplifies redundant structures and adds pathways to licensure that were previously unavailable under the current structure. There is a need to adopt an updated list of approved medical schools and graduate medical programs.

Persons Testifying: PRO: Representative Tharinger, prime sponsor; Micah Matthews, WA Medical Commission.

Persons Signed in to Testify But Not Testifying:  No one.