HOUSE BILL REPORT

HB 1595

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.

Background:

The Medial 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:

graduation from medical school;
passage of an examination; and
completion of two years of post-graduate medical training.

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.

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.

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Summary of Substitute Bill:

A foreign medical school graduate is exempt from the two-year post-graduate medical training requirement if he or she has met the following three requirements:

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.

Substitute Bill Compared to Original Bill:

The original bill exempted a foreign medical school graduate from the two-year post-graduate medical training requirement if he or she 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; and
1. received multiple sclerosis certified specialist status from the Consortium of Multiple Sclerosis Centers; and
2. 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.

The substitute bill exempts a foreign medical school graduate from the two-year post-graduate medical training requirement if he or she 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 and;
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.

Staff Summary of Public Testimony:

(In support) Washington has a high incidence of multiple sclerosis and it is unclear why. The symptoms of this unpredictable disease are varied. People with multiple sclerosis therefore need access to specialists and there is a shortage of such people in Washington. Domestically-trained physicians often do not pick multiple sclerosis as a specialty because of low pay and a lack of students in the field. However, foreign-trained physicians choose this specialty more frequently. Unfortunately, multiple sclerosis specialists from other countries who completed the multiple sclerosis fellowship at the University of Washington cannot be licensed in Washington because the fellowship is unaccredited. Currently, these specialists can be granted limited licenses to practice, but this has the effect of limiting their practice and providing incentives to move to other countries or other states. This bill creates a narrow exception to the two-year post graduate training requirement for highly qualified multiple sclerosis specialists.

(With concerns) Education and training standards for physicians are fairly standard nationwide. There is therefore some concern about carving out an exception for specific treatments and diseases. The Medical Quality Assurance Commission licenses a large number of foreign medical school graduates. It therefore may be timely for the requirements for foreign-trained physicians to be revisited.

(Opposed) None.

Persons Testifying: (In support) Patricia Barnes, Dr. Annette Wundes, and Robin Fiscus, National Multiple Sclerosis Society; and Dr. Eugene May, National Multiple Sclerosis Society and Swedish Multiple Sclerosis Center.

(With concerns) Karen Jensen, Department of Health.