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ARIZONA HOUSE OF REPRESENTATIVESFifty-sixth Legislature Second Regular Session |
Senate: HHS DPA 4-3-0-0 | 3rd Read 17-10-3-0
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SB 1406: international medical licensees; provisional licensure
Sponsor: Senator Shamp, LD 29
Caucus & COW
Overview
Allows the Arizona Medical Board (AMB) and the Arizona Board of Osteopathic Examiners in Medicine and Surgery (ABOE) to grant provisional medical licenses to international medical licensees who meet the outlined criteria, effective January 1, 2025.
History
Arizona Board of Osteopathic Examiners in Medicine and Surgery
The ABOE consists of seven members appointed by the Governor. One member of ABOE must be appointed each year for a term of five years, to begin and end on April 15. ABOE regulates the practice of osteopathic medicine by: 1) issuing licenses, conducting hearing and administering disciplinary actions; 2) maintaining a record of its acts and proceedings; and 3) adopting rules regarding the regulation and qualification of medical assistants (A.R.S. §§ 32-1801 and 32-1803).
Arizona Medical Board
The AMB was originally established by the Arizona State Legislature in 1913. AMB consists of 12 members who are appointed to serve a term of five years to begin and end on July 1. AMB's primary duty is to protect the public from unlawful, incompetent, unqualified, impaired or unprofessional practitioners of allopathic medicine through licensing and regulation (A.R.S. §§ 32-1402 and 32-1403).
Students Graduating from an Unapproved Allopathic School of Medicine
In addition to completing the basic statutory requirements for medicine and surgery licensure, any applicant who has graduated from an unapproved allopathic school of medicine must meet the following requirements:
1) be able to read, write, speak, understand and be understood in the English language;
2) hold a standard certificate issued by the Educational Council for Foreign Medical Graduates (Council), complete a Fifth Pathway Program, complete 36 months as a full-time assistant professor or in a higher position in an approved school of medicine; and
3) successfully complete an approved 24 month hospital internship, residency or clinical fellowship program, in addition to the statutorily required 12 month hospital internship, residency or clinical fellowship program, for a total of 36 months of training, unless the applicant successfully completed a Fifth Pathway Program or has served as a full-time assistant professor or in a higher position in an approved school of medicine for a total of 36 months (A.R.S. § 32-1423).
Fifth Pathway Program
In addition to completing the basic statutory requirements for medicine and surgery licensure and when graduating from an unapproved allopathic school of medicine, an applicant for a medical license who attended a foreign school of medicine and successfully completed all the formal requirements to receive the degree of Doctor of Medicine (M.D.) except internship or social service, and is accordingly not eligible for certification by the Council, may be considered for licensure if they meet the following conditions:
1) satisfactorily completes an approved Fifth Pathway Program of one academic year of supervised clinical training under the direction of an approved U.S. school of medicine; and
2) successfully completes an approved 24-month internship, residency or clinical fellowship program upon completion of the Fifth Pathway Program.
A document granted by a foreign school of medicine signifying completion of all formal requirements for graduation from such foreign medical school except internship or social service training, or both, along with certification by the approved U.S. school of medicine of successful completion of the Fifth Pathway Program is deemed the equivalent of an M.D. for purposes of licensure and practicing as a physician in Arizona (A.R.S. § 32-1424).
Provisions
1. Permits the AMB or ABOE, notwithstanding any other law, to grant a provisional license to engage in the practice of medicine in Arizona to any international medical licensee who meets all of the following:
a) has an offer for employment as a physician at any health care provider that operates in a county with a population of less than 1,000,000 persons;
b) has a federal immigration status that allows the person to work as a physician in the United States (U.S.); and
c) meet the requirements for licensure by AMB and ABOE. (Sec. 1)
2. Specifies that the AMB and ABOE are not required to grant a provisional license to an international medical graduate who does not provide:
a) evidence of substantially similar required medical training;
b) evidence of satisfactory passage of exams;
c) a complete license application;
d) payment of all required licensing fees; and
e) satisfactory proof of a federal immigration status that allows the individuals to work as a physician in the U.S. (Sec. 1)
3.
Requires a provisional license
to automatically be converted to a full license to practice medicine in Arizona
after four years if the provisional license meets all of the following:
a) engages in the practice of medicine in Arizona for four years in a county with a population of less than 1,000,000 persons;
b) is not disciplined by AMB or ABOE during that four-year period of the provisional license; and
c) the provisional licensee's supervising physician with whom there was a supervision agreement submits a signed attestation to AMB or ABOE certifying that it is a supervising physician's professional opinion that the provisional licensee meets Arizona's standards for providing medical care. (Sec. 1)
4. Requires the international medical licensee to do both of the following:
a) work under the supervision of a licensed physician; and
b) comply with the continuing education requirements. (Sec. 1)
5. Directs AMB and ABOE to adopt rules for the supervision requirement, including requirements:
a) to submit a supervision agreement;
b) to make reports to the AMB or ABOE;
c) to obtain medical malpractice liability insurance;
d) regarding health insurance coverage; and
e) for procedures for failure to adhere to the terms of the supervision agreement. (Sec. 1)
6. Requires the international medical licensee's employer to notify AMB or ABOE if the licensee is terminated or leaves employment for any reason. (Sec. 1)
7. Requires AMB or ABOE, within five days after receiving notification from the employer, to terminate the provisional license, unless:
a) the licensee notifies AMB or ABOE that they are working for another employer in a county with a population of less than 1,000,000 persons; and
b) the new employer notifies AMB or ABOE that the licensee has accepted an offer of employment. (Sec. 1)
8. Requires the new employer to comply with AMB or ABOE rules related to issuing a new supervision agreement. (Sec. 1)
9. Allows an employer of an international medical licensee to require the licensee to take a competency test at any time during employment. (Sec. 1)
10. Allows the AMB or ABOE to discipline a provisional licensee or revoke a granted provisional license based on clean and compelling evidence after a conducted investigation. (Sec. 1)
11. Permits a provisional licensee to appeal the revocation to the Maricopa County Superior Court. (Sec. 1)
12. Requires the Maricopa County Superior Court to reinstate the provisional license if the court finds that AMB or ABOE's actions did not meet the standards for revocation. (Sec. 1)
13. Requires the AMB and ABOE to adopt rules related to the format and submission requirements for the attestation document provided by a supervising physician. (Sec. 1)
14. Allows the AMB and ABOE to require an applicant international medical graduate to submit any necessary supporting application materials so that AMB and ABOE may properly evaluate the applicant for licensure. (Sec. 1)
15. Permits the AMB and ABOE to require an applicant international medical licensee, at the applicant's expense, to submit medical education information through the Educational Commission for Foreign Medical Graduates or another third-party records service. (Sec. 1)
16. Allows the AMB and ABOE by rule to establish licensing and renewal fees for provisional licensees. (Sec. 1)
17. Requires a provisional license to be renewed annually. (Sec. 1)
18. Defines the following terms:
a) board;
b) health care provider;
c) international medical licensee;
d) international medical program; and
e) physician. (Sec. 1)
19. Exempts the AMB and ABOE from rulemaking requirements for one year after the effective date. (Sec. 2)
20. Contains an effective date of January 1, 2025. (Sec. 3)
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SB 1406
Initials AG/MT Page 0 Caucus & COW
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