HB2435 - 572R

Be it enacted by the Legislature of the State of Arizona:

Section 1. Section 32-1424, Arizona Revised Statutes, is amended to read:

START_STATUTE32-1424. Fifth pathway program; pathway one; licensure; provisional licensure

A. In addition to the requirements for licensure prescribed in sections 32-1422 and 32-1423, an applicant for licensure under this article who attended a foreign school of medicine and successfully completed all the formal requirements to receive the degree of doctor of medicine except internship or social service, and who is accordingly not eligible for certification by the educational council commission for foreign medical graduates, may be considered for licensure under this chapter if the applicant meets 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 school of medicine in the United States.

2. Successfully completes an approved twenty-four month twenty-four-month internship, residency or clinical fellowship program upon on completion of the fifth pathway program.

B. A document granted by a foreign school of medicine signifying completion of all the formal requirements for graduation from such the foreign medical school except internship or social service training, or both, along with certification by the approved school of medicine in the United States of successful completion of the fifth pathway program is deemed the equivalent of a degree of doctor of medicine for purposes of licensure and practice as a physician in this state.

C. Notwithstanding subsections A and B of this section, an applicant for licensure who attended a school of medicine, who successfully completed all formal requirements for graduation from the school of medicine and who satisfies the requirements prescribed in pathway one of the educational commission for foreign medical graduates shall be granted a provisional license if the applicant:

1. complies with subsections D and E of this section and section 32-1424.01.

2. Holds a valid license to practice medicine that does not require direct supervision.

3. Has a federal immigration status that allows the person to work as a physician in the United States.

4. Has an offer for employment as a physician in a county with a population of less than one million persons.

5. Meets the requirements for licensure prescribed in section 32-1422, except for section 32-1422, subsection A, paragraphs 1 and 2.

D. An applicant for a provisional license pursuant to subsection C of this section shall provide the board with all of the following:

1. Evidence of having substantially similar medical training that the board deems to be of equivalent quality.

2. Evidence of satisfactorily passing exams as determined by the board.

3. Proof of holding certification from the educational commission for foreign medical graduates.

4. A complete license application.

5. Payment of all required licensing fees.

E. The board may require an applicant for a provisional license to submit either or both of the following:

1. Any supporting application materials necessary for the board to properly evaluate the applicant.

2. At the applicant's expense, medical education information through the educational commission for foreign medical graduates or another third-party records service. END_STATUTE

Sec. 2. Title 32, chapter 13, article 2, Arizona Revised Statutes, is amended by adding section 32-1424.01, to read:

START_STATUTE32-1424.01. Provisional licensure; fees; supervision agreement; rules; employment; discipline; conversion to full license; definitions

A. The board by rule may establish licensing and renewal fees for provisional licensees. A provisional license shall be renewed annually.

B. Each provisional licensee shall do both of the following:

1. While licensed pursuant to section 32-1424, work with a physician who provides indirect supervision with direct supervision immediately available, who practices in the same specialty as the provisional licensee and who is licensed pursuant to chapter 13 or 17 of this title. The board shall adopt rules relating to this supervision requirement, including requirements for provisional licensees to submit the supervision agreement to the board, to report to the board and to obtain medical malpractice liability insurance and requirements regarding health insurance coverage and procedures for failing to adhere to the terms of the supervision agreement.

2. Comply with the continuing education requirements prescribed in this chapter and the rules adopted pursuant to this chapter.

C. A provisional licensee's employer shall notify the board if the provisional licensee is terminated or leaves employment for any reason. Within five days after receiving the notification from the employer, the board shall terminate the provisional license unless the provisional licensee notifies the board that the provisional licensee is working for another employer in a county with a population of less than one million persons and the new employer notifies the board that the provisional licensee has accepted an offer of employment. The new employer shall comply with board rules related to issuing a new supervision agreement.

D. The employer of a provisional licensee may require the provisional licensee to take a competency test at any time during employment.

E. The board may discipline a provisional licensee or revoke a provisional license granted pursuant to section 32-1424 after an investigation conducted pursuant to section 32-1451. An international medical licensee may appeal the revocation of the provisional license to the superior court in Maricopa county pursuant to title 12, chapter 7, article 6. The court shall reinstate the provisional license if the court finds that the board's actions did not meet the standard prescribed in section 32-1451.04.

F. A provisional license is automatically converted to a full license to practice medicine in this state after four years if all of the following are met:

1. The provisional licensee engages in the practice of medicine in this state for four years in a county with a population of less than one million persons.

2. The provisional licensee is not disciplined by the board during the four-year period of provisional licensure.

3. The supervising physician with whom the provisional licensee has a supervision agreement submits a signed attestation to the board certifying that it is the supervising physician's professional opinion that the provisional licensee meets this state's standards for providing medical care. The board shall adopt rules related to the format and submission requirements for this attestation document.

G. For the purposes of this section:

1. "Indirect supervision with direct supervision immediately available" means the supervising physician is physically present within the hospital or other eligible entity site of patient care and is immediately available to provide direct supervision of the provisional licensee.

2. "Provisional licensee" means an applicant who has been granted a provisional license pursuant to section 32-1424, subsection C. END_STATUTE

Sec. 3. Section 32-1425, Arizona Revised Statutes, is amended to read:

START_STATUTE32-1425. Initial licensure

A. An applicant who meets the applicable requirements provided in section 32-1422, 32-1423 or 32-1424, has passed steps one and two of the United States medical licensing examination or one of the examination combinations prescribed in section 32-1426, subsection A, paragraph 6, subdivision (c), items (i) and (ii), has paid the fees required by this chapter and has filed a completed application found by the board to be true and correct is eligible for licensure as a doctor of medicine upon on successful passage of step three of the United States medical licensing examination with a scaled score of at least seventy-five if the applicant has passed all three steps within a seven year seven-year period.

B. An applicant for licensure applying pursuant to section 32-1422, 32-1423 or 32-1424 may take the examination only after successfully completing six months of a board approved board-approved hospital internship, residency or clinical fellowship or fifth pathway program or a pathway prescribed in section 32-1424, subsection c or serving as a full-time assistant professor or in a higher position in a board approved board-approved school of medicine in this state.

C. The board shall not grant a license until the applicant meets the requirements for licensure pursuant to this chapter. END_STATUTE