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ARIZONA HOUSE OF REPRESENTATIVES57th Legislature, 2nd Regular Session |
House: HHS DPA 7-5-0-0 |
HB 2435: internationally trained physicians; licensure
Sponsor: Representative Bliss, LD 1
Caucus & COW
Overview
Requires applicants who attended a foreign school of medicine, successfully completed all formal graduation requirements and satisfied all requirements of Pathway One through the Educational Commission for Foreign Medical Graduates to be granted a medical license if the applicant meets all other applicable criteria.
History
Basic Requirements for Medical Licensure
The purpose of the Arizona Medical Board (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.
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.
Students Graduating from an Unapproved Allopathic School of Medicine
In addition to the basic requirements for licensure, any applicant who has graduated from an unapproved school of medicine must meet each of 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 Commission for Foreign Medical Graduates (ECFMG), complete a Fifth Pathway Program or complete 36 months as a full-time assistant professor or in a higher position in an approved school of medicine; and 3) successfully be enrolled in an approved 24-month hospital internship, residency or clinical fellowship program, in addition to the 12 months, 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 ECFMG, 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).
Educational Commission for Foreign Medical Graduates Pathway One
ECFMG is a private, non-profit organization that evaluates the qualifications of international medical graduates seeking to enter residency or fellowship programs in the U.S. Pathway One was established for international medical graduates who already hold or have held a license/ registration to practice medicine without supervision in another country on or after January 1, 2021. Individuals who have held only a license that requires supervised practice, such as a training, resident, or restricted license, are not eligible for this Pathway. (ECFMG – Pathway One).
Provisions
1. Requires applicants who attended a foreign school of medicine, successfully completed all formal graduation requirements and satisfied all requirements in ECFMG Pathway One to be granted a medical license if the applicant:
a. holds a valid license to practice medicine that does not require direct supervision;
b. has a federal immigration status that allows the person to work as a physician in the U.S.;
c. has an offer for employment as a physician at any health care provider that operated in a county with a population of less than 1,000,000 persons; and
d. meets the basic requirements for medical licensure. (Sec. 1)
2. Makes technical changes. (Sec. 1)
Amendments
Committee on Health & Human Services
1. Requires an applicant who has attended a school of medicine, has successfully completed all formal graduation requirements and satisfied all requirements of Pathway One through ECFMG to be granted a provisional medical license, if the applicant meets all other applicable criteria.
2. Authorizes the AMB to establish licensing and renewal fees for these provisional licenses.
3. Requires provisional licensees to practice under a supervision agreement with a physician who practices in the same specialty as the licensee.
4. Requires the AMB to adopt rules relating to the supervision requirement, including:
a) rules for provisional licensees to submit the agreement to AMB,
b) rules to report to the board and to obtain medical malpractice liability insurance; and
c) rules regarding requirements for health insurance coverage and procedures for failing to adhere to the terms of the supervision agreement.
5. Allows the AMB to require an applicant for a provisional license to submit either or both of the following:
a) any supporting application materials necessary to properly evaluate the applicant; or
b) medical education information through ECFMG or another third-party records service, at the applicant's expense.
6. Specifies that a provisional license must provide AMB:
a) evidence of substantially similar medical training that the AMB deems to be of equivalent quality;
b) evidence of satisfactory passage of exams as determined by the AMB;
c) proof of certification by the ECFMG;
d) a complete license application; and
e) payment of all required licensing fees.
7. Requires an international medical provisional license to automatically be converted to a full license to practice medicine in Arizona after four years if all the following is met:
a) the provisional licensee 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) the provisional licensee is not disciplined by the AMB 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 the AMB certifying that it is a supervising physician's professional opinion that the provisional licensee meets Arizona's standards for providing medical care.
8. Requires the AMB to adopt rules regarding the format and submission requirements for the supervising physician's attestation.
9. Requires the AMB, within five days of notification from the employer, to terminate the provisional license unless:
a) the licensee notifies the AMB that the licensee is working for another employer in a county with a population of less than 1,000,000 persons; and
b) the new employer notifies the AMB or BOEMS that the international medical licensee has accepted an offer of employment.
10. Requires the employer of the provisional licensee to notify the AMB if the provisional license is terminated or leaves employment for any reason.
11. Permits an employer of an international medical provisional licensee to require the licensee to take a competency test at any time during employment.
12. Permits the AMB to discipline a provisional licensee or revoke a granted provisional license after conducting a disciplinary action investigation.
13. Permits an international medical licensee to appeal the revocation of the provisional license to the Maricopa County Superior Court (Superior Court).
14. Requires the Superior Court to reinstate the provisional license if the court finds that the actions of the AMB did not meet the standards for revocation as outlined in statute.
15. Defines provisional licensee.
16. Makes technical and conforming changes.
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Initials AG HB 2435
1/16/2026 Page 0 Caucus & COW
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