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ARIZONA STATE SENATE
Fifty-Sixth Legislature, Second Regular Session
AMENDED
international medical licensees; provisional licensure
Purpose
Allows, effective January 1, 2025, the Arizona Medical Board (AMB) to grant a provisional medical license to an international medical licensee who meets outlined criteria and who is licensed to practice in a country other than the United States, as prescribed.
Background
An applicant for
a medical license in Arizona must: 1) graduate from an approved school of
medicine or receive a medical education that the AMB deems to be of equivalent
quality;
2) successfully complete an approved 12-month hospital internship, residency or
clinical fellowship program; 3) have the physical and mental capability to
safely engage in the practice of medicine; 4) have a professional record that
indicates that the applicant has not committed any act that would constitute
grounds for disciplinary action; 5) not have surrendered a license, currently
be under investigation, suspension or restriction or have had a medical license
revoked by a medical regulatory board in another jurisdiction that constitutes
unprofessional conduct; 6) pay all AMB-required fees; 7) complete an
AMB-prescribed training unit; 8) submit a five-year medical employment history
including verification of licensure from every state in which the applicant has
ever held a medical license; and 9) submit a full set of fingerprints to the
AMB for a state and federal criminal records check (A.R.S.
§ 32-1422). An applicant for a medical license in Arizona who has graduated
from an unapproved school of medicine must meet additional outlined
requirements (A.R.S.
§ 32-1423).
The primary duty of the AMB is to protect the public from unlawful, incompetent, unqualified, impaired or unprofessional practitioners of allopathic medicine through licensure, regulation and rehabilitation of the profession in Arizona. The powers and duties of the AMB include: 1) initiating investigations and determining whether a doctor has engaged in unprofessional conduct, provided incompetent medical care or is mentally or physically unable to engage in the practice of medicine; 2) reviewing the credentials and abilities of applicants whose professional records or physical or mental capabilities do not meet licensure requirements; 3) developing and recommending standards governing the profession; 4) engaging in a full exchange of information with licensing boards, disciplinary boards and medical associations of other states, foreign countries and the Arizona Medical Association; 5) adopting rules for licensure and regulation of doctors of medicine; and 6) establishing fees and penalties (A.R.S. § 32-1403).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
International Medical Licensee Provisional Licensure
1. Allows the AMB to grant a provisional license only to an international medical licensee:
a) who has an offer for employment as a physician at any health care provider that operates in a medically underserved area, as designated by the Arizona Department of Health Services;
b) whose federal immigration status allows the person to work as a physician in the US; and
c) who meets the statutory requirements for medicine and surgery licensure and if applicable, the additional requirements for students graduating from an unapproved allopathic school of medicine.
2. States that the AMB is not required to license an international medical licensee who does not provide:
a) evidence of substantially similar medical training as required by Arizona law;
b) evidence of satisfactory passage of exams;
c) a complete license application; and
d) payment of all required licensing fees.
3. Allows the AMB to require an applicant international medical licensee to submit:
a) any necessary supporting application materials so that the AMB may properly evaluate the applicant for licensure; and
b) at the applicant's expense, medical education information through the Educational Commission for Foreign Medical Graduates or another third-party records service.
4. Allows the AMB to establish licensing and renewal fees for provisional licenses.
5. Requires a provisional licensee to do both of the following:
a) work under the supervision of a physician who is licensed as an osteopathic physician or surgeon or in medicine and surgery; and
b) comply with continuing education requirements, as outlined.
6. Requires the provisional license to be renewed annually.
7. Requires the international medical licensee's employer to notify the AMB if the licensee is terminated or leaves employment for any reason.
8. Requires the AMB, within five days of notification of the licensee's termination or departure from employment, to terminate the licensee's provisional license unless the licensee notifies the AMB that the licensee is working for another employer in an area that is designated as medically underserved.
10. Allows a licensee to appeal a revocation decision to the Maricopa County Superior Court within the timeframe allowed for judicial review of administrative decisions.
11. Requires the Maricopa County Superior Court to reinstate a revoked provisional license if the court finds that the AMB's actions did not meet the prescribed standards.
12. Requires a provisional license to automatically be converted into a full medical license after four years if the licensee meets both of the following:
a) engages in the practice of medicine in Arizona for four years in an area that is designated as medically underserved; and
b) is not disciplined by the board during the four-year period of the provisional license.
Miscellaneous
13. Defines international medical licensee as an individual who:
a) has been granted a medical doctorate or a substantially similar degree by an international medical program of good standing;
b) has completed a residency or substantially similar postgraduate medical training in the country where the individual was granted a medical doctorate or a substantially similar degree as prescribed;
c) possesses basic fluency in the English language at a level sufficient to communicate with patients about medical conditions and treatments;
d) has been licensed to practice medicine within the preceding five years in at least one of the following countries:
i. Australia;
ii. Hong Kong;
iii. Ireland;
iv. Israel;
v. New Zealand;
vi. Singapore;
vii. South Africa;
viii. Switzerland;
ix. the United Kingdom;
x. Canada; or
xi. any additional countries added by the AMB; and
e) has practiced medicine in the licensing country for at least five years after completing the postgraduate training as outlined.
14. Defines international medical program as any medical school, residency program, medical internship program or entity that provides physicians with a medical education or training outside of the U.S. that is substantially similar to that required to practice as a physician in Arizona.
15. Exempts the AMB from statutory rulemaking requirements for one year.
16. Defines terms.
17. Becomes effective on January 1, 2025.
Amendments Adopted by Committee
1. Requires an international medical licensee to practice under the supervision of a licensed physician, as prescribed.
2. Requires international medical licensees to be fluent in the English language at a level sufficient to communicate with patients about medical conditions and treatment.
3. Allows the AMB to discipline an international medical licensee or revoke a provisional license based on clear and convincing evidence, rather than clear and compelling evidence as outlined.
4. Allows a licensee to appeal a revocation decision to the Maricopa County Superior Court within the timeframe allowed for judicial review of administrative decisions, rather than within 120 days of the decision to revoke the license.
Senate Action
HHS 2/6/24 DPA 4-3-0
Prepared by Senate Research
February 7, 2024
MM/KS/slp