HOUSE BILL REPORT

2SSB 5846

As Reported by House Committee On:

Health Care & Wellness

Title: An act relating to the integration of international medical graduates into Washington's health care delivery system.

Brief Description: Concerning the integration of international medical graduates into Washington's health care delivery system.

Sponsors: Senate Committee on Ways & Means (originally sponsored by Senators Saldaña, Hasegawa, Randall, Nguyen, Wilson, C., Keiser, Das, Cleveland and Dhingra).

Brief History:

Committee Activity:

Health Care & Wellness: 3/22/19, 3/27/19 [DPA].

Majority Report: Do pass as amended. Signed by 14 members: Representatives Cody, Chair; Macri, Vice Chair; Schmick, Ranking Minority Member; Caldier, Assistant Ranking Minority Member; Chambers, Davis, DeBolt, Harris, Jinkins, Riccelli, Robinson, Stonier, Thai and Tharinger.

Staff: Jim Morishima (786-7191).

Background:

Physicians are licensed by the Medical Quality Assurance Commission (MQAC). A physician who graduates from a medical school within the United States or Canada must meet qualifications, including passage of an examination, completion of two years of post-graduate medical training approved by the MQAC, good moral character, and the ability to safely practice medicine.

Graduates from foreign medical schools must meet all of the requirements applicable to graduates from domestic medical schools. In addition, such 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 post-graduate 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;

• 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.

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Summary of Amended Bill:

Subject to the availability of funds appropriated for the specific purpose, the International Medical Graduate Work Group (IMGWG) is established with the following members appointed by the Governor:

• a representative from the Medical Quality Assurance Commission (MQAC);

• a representative from the Department of Health's Health Systems Quality Assurance Division;

• a representative from the University of Washington School of Medicine's graduate medical education program;

• a representative from the Washington State University Elson S. Floyd College of Medicine's graduate medical education program;

• a representative from the Pacific Northwest University of Health Sciences College of Osteopathic Medicine's graduate medical education program;

• a representative from a statewide organization representing physicians;

• a representative from the Washington State Family Medicine Residency Network;

• a representative from a primary health care employer 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 international medical graduates;

• a representative from an organization representing community and migrant health centers; and

• at least two international medical graduates.

By December 1, 2019, the IMGWG must submit a report to the Governor and the Legislature regarding:

• strategies and recommendations for reducing barriers for international medical graduates obtaining residency position in Washington, including pre-residency training;

• recommendations for the appropriate number of residency positions to be designated for international medical graduates and the locations and specialties of those positions; and

• recommendations on the post-residency service requirements for international medical graduates who graduate from a designated residency position.

The work group is staffed by the MQAC and expires on June 30, 2020.

Amended Bill Compared to Second Substitute Bill:

The amended bill changes the due date for the International Medical Graduate Work Group's report from June 30, 2020, to December 1, 2019.

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Appropriation: None.

Fiscal Note: Available.

Effective Date of Amended Bill: The bill takes effect 90 days after adjournment of the session in which the bill is passed.

Staff Summary of Public Testimony:

(In support) International medical graduates are highly qualified individuals who often have extensive medical training and have passed all required examinations. These graduates are capable of delivering care to underserved communities in a linguistically and culturally appropriate manner. These graduates face barriers to full licensure, however. For example, it can be difficult for international medical graduates to find residency slots. When they do find residency slots, they must often pay for the residencies out of their own pockets. This results in these graduates being underemployed. Many international medical graduates move to other states, where licensure is easier. This bill will help identify pathways to help meet unmet needs in Washington. The bill will help communities stay healthy and address health crises like the opioid crisis or the measles outbreak.

(Opposed) None.

Persons Testifying: Senator Saldaña, prime sponsor; and Yulia Sledneva, Mahmoud Omar, Mohamed Khalif, Marwa Saad, Oksana Nesterenko, and Anab Abdullahi, International Medical Graduates.

Persons Signed In To Testify But Not Testifying: None.