SENATE BILL REPORT
SHB 1129
As Reported by Senate Committee On:
Health & Long Term Care, March 22, 2021
Title: An act relating to the licensure of international medical graduates.
Brief Description: Concerning the licensure of international medical graduates.
Sponsors: House Committee on Health Care & Wellness (originally sponsored by Representatives Valdez, Stonier, Ortiz-Self, Goodman, Cody, Santos and Macri).
Brief History: Passed House: 2/24/21, 94-4.
Committee Activity: Health & Long Term Care: 3/15/21, 3/22/21 [DPA, DNP, w/oRec].
Brief Summary of Amended Bill
  • Authorizes the Washington Medical Commission to issue limited licenses to international medical graduates.
  • Authorizes the Washington Medical Commission to issue limited licenses to persons who have been accepted for employment as physicians by the Department of Children, Youth, and Families.
SENATE COMMITTEE ON HEALTH & LONG TERM CARE
Majority Report: Do pass as amended.
Signed by Senators Cleveland, Chair; Frockt, Vice Chair; Conway, Keiser, Randall, Robinson and Van De Wege.
Minority Report: Do not pass.
Signed by Senators Muzzall, Ranking Member; Holy, Rivers and Wilson, J.
Minority Report: That it be referred without recommendation.
Signed by Senator Padden.
Staff: Ricci Crinzi (786-7253)
Background:

Limited Licensure of International Medical Graduates.  International medical graduates are physicians who receive their medical school education outside the United States and Canada.

International medical graduates must go through medical licensing examinations and credential verifications to receive certification by the Educational Commission for Foreign Medical Graduates (ECFMG).  International medical graduates who receive ECFMG certification become eligible to enter the United States' graduate medical education process, where they provide supervised patient care.  The ECFMG certification is a requirement for international medical graduates to take Step 3 of the United States Medical Licensing Examination, as well as a prerequisite to obtaining an unrestricted license to practice medicine in the United States.
 
The Washington Medical Commission (Commission) may issue a limited license to an applicant for gaining clinical experience at an approved facility or program if the applicant:

  • does not qualify for licensure as a United States or Canadian medical graduate; and
  • meets the requirements established by the Commission. 

 
Limited Licensure of United States and Canadian Medical Graduates.  The Commission may, upon the written request of the secretary of the Department of Social and Health Services (DSHS) or the secretary of the Department of Corrections (Corrections), issue limited licenses to persons who work with patients, residents, or inmates of state institutions under the control and supervision of DSHS or Corrections.  In 2019, the Department of Children, Youth, and Families (DCYF) assumed control of programs previously administered by DSHS, including juvenile rehabilitation facilities, community facilities, and parole services.

Summary of Amended Bill:

Limited Licensure of International Medical Graduates.  The Commission may issue limited licenses to international medical graduates upon nomination by the chief medical officer of any licensed hospital or appropriate medical practice located in Washington State, DCYF, the DSHS, Corrections, or a county or city health department.
 
An international medical graduate applying for a limited license must:

  • be a state resident for at least one year;
  • provide proof of certification by ECFMG;
  • pass the United States Medical Licensing Examination; and
  • submit to the Commission background check as generally required of applicants.

 
An international medical graduate practicing with a limited license may only practice within the nominating facility or organization, under the control of a licensed supervising physician or osteopathic physician of the same or substantially similar clinical specialty.  An international medical graduate must also file a practice agreement with the Commission between the international medical graduate and the supervising physician.  A supervising physician is limited to supervising two limited license holders, unless the Commission grants an increase upon the supervising physician's request.
 
A limited license for an international medical graduate is valid for two years and may be renewed once by the Commission upon application by the nominating entity.
 
Limited Licensure of United States and Canadian Medical Graduates.  The Commission may, upon the written request of the secretary of DCYF, issue limited licenses to persons who work with patients, residents, or inmates of state institutions under the control and supervision of DCYF.

EFFECT OF HEALTH & LONG TERM CARE COMMITTEE AMENDMENT(S):
  • Allows any appropriate medical practice located in Washington to nominate a qualified international medical graduate for a limited license.
  • Adds osteopathic physicians to those who may supervise an international medical graduate holding a limited license.
Appropriation: None.
Fiscal Note: Available.
Creates Committee/Commission/Task Force that includes Legislative members: No.
Effective Date: Ninety days after adjournment of session in which bill is passed.
Staff Summary of Public Testimony on Substitute House Bill:

The committee recommended a different version of the bill than what was heard.  PRO:  International medical graduates are well qualified to practice safe medicine and can fill the shortage of medical professionals.  This bill would provide more access to care for people in Washington State since there is a medical professional shortage.  There is a need to encourage more bilingual medical doctors.  International medical graduates are qualified to provide care since they had to pass all the medical tests in their native country and then have to pass all the medical tests in the United States again.  There has not been a clear pathway to employment for international medical graduates until now.  Agencies like Corrections, or DSHS can now employ international medical graduates.  Increasing this diversity in care is essential to expanding access to health care.

Persons Testifying: PRO: Representative Javier Valdez, Prime Sponsor; Adriana Loscher-Blanco; Sindy Merchan; Syed Jamal Mustafa, Puget Sound Psychiatric Center; Syed Kamal Mustafa, Puget Sound Psychiatric Center; Khalid Ahmed, Puget Sound Psychiatric Center; Nadeem Mian, Puget Sound Psychiatric Center; Mohamed Khalif, Washington Academy for International Medical Graduates; Veaceslav Glijin.
Persons Signed In To Testify But Not Testifying: No one.