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*sb0489*
SENATE BILL 489
J2 6lr3472
By: Senator Lam Senators Lam, Lewis Young, Beidle, Hayes, and A. Washington
Introduced and read first time: February 2, 2026
Assigned to: Finance
Committee Report: Favorable with amendments
Senate action: Adopted
Read second time: March 6, 2026
CHAPTER ______
AN ACT concerning 1
Health Occupations – Physicians Trained in International Medical Schools 2
Foreign Countries – Exemption From Educational Requirements and Limited 3
License 4
FOR the purpose of establishing that certain applicants for a physician license are exempt 5
from certain educational requirements if the applicant submits certain evidence of 6
international postgraduate medical education training accredited by a certain entity; 7
authorizing certain licensed physicians trained in international medical schools to 8
practice medicine during their initial license term only under supervision; altering 9
the exemption f rom certain educational requirements required for a license to 10
practice medicine for certain applicants who have studied at an international 11
medical school; authorizing the State Board of Physicians to issue a limited license 12
to practice medicine to a phys ician trained and licensed in a foreign country under 13
certain circumstances; and generally relating to physicians trained in international 14
medical schools foreign countries. 15
BY repealing and reenacting, without amendments, 16
Article – Health Occupations 17
Section 14–101(a) 18
Annotated Code of Maryland 19
(2021 Replacement Volume and 2025 Supplement) 20
BY repealing and reenacting, with amendments, 21
Article – Health Occupations 22
Section 14–308(b)(6)(i) and 14–314(a) 14–101(g) and 14–308 23
2 SENATE BILL 489
Annotated Code of Maryland 1
(2021 Replacement Volume and 2025 Supplement) 2
BY adding to 3
Article – Health Occupations 4
Section 14–308 5
Annotated Code of Maryland 6
(2021 Replacement Volume and 2025 Supplement) 7
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 8
That the Laws of Maryland read as follows: 9
Article – Health Occupations 10
14–308. 11
(b) An applicant for a license is exempt from the educational requirements of § 12
14–307 of this subtitle, if the applicant: 13
(6) Meets one of the following requirements: 14
(i) The applicant graduated from any international medical school 15
and submits evidence acceptable to the Board of successful completion of 2 years of training 16
in a postgraduate medical education program accredited by [an] THE ACCREDITATION 17
COUNCIL FOR GRADUATE MEDICAL EDUCATION–INTERNATIONAL (ACGME–I) OR 18
ANOTHER accrediting organization recognized by the Board; or 19
14–314. 20
(a) (1) [Except] SUBJECT TO PARAGRAPH (2) OF THIS SUBSECTION A ND 21
EXCEPT as otherwise provided in th is title, a license authorizes the licensee to practice 22
medicine while the license is effective. 23
(2) A LICENSEE WHO QUALIFI ES UNDER § 14–308(B)(6)(I) OF THIS 24
SUBTITLE MAY PRACTIC E MEDICINE DURING TH E LICENSEE ’S INITIAL LICENSE 25
TERM ONLY UNDER SUPERVISION, AS REQUIRED BY THE BOARD. 26
14–101. 27
(a) In this title the following words have the meanings indicated. 28
(g) (1) “License” means, unless the context requires otherwise, a license issued 29
by the Board to practice medicine or an allied health profession regulated by the Board. 30
(2) “LICENSE” INCLUDES, UNLESS THE CONTEXT R EQUIRES 31
OTHERWISE, A LIMITED LICENSE ISSUED UNDER § 14–308 OF THIS TITLE. 32
SENATE BILL 489 3
[14–308.] 14–307.1. 1
[(a) (1) In this section the following terms have the meanings indicated. 2
(2) “Fifth pathway program” means a program that the Board approves in 3
its regulations for a student who: 4
(i) Has studied medicine at an international medical school; 5
(ii) Was a United States citizen when the student enrolled in the 6
international medical school; and 7
(iii) Has completed all of the formal requirements for graduation 8
from the internatio nal medical school, except for any social service or postgraduate 9
requirements. 10
(3) “International medical school” means a medical school located outside 11
of the United States, its territories or possessions, Puerto Rico, or Canada. 12
(b)] An applicant for a license is exempt from the educational requirements of § 13
14–307 of this subtitle, if the applicant: 14
(1) Has studied medicine at an international medical school; 15
(2) Is certified by the Educational Commission for Foreign Medical 16
Graduates or by its successor as approved by the Board; 17
(3) Passes a qualifying examination for international medical school 18
graduates required by the Board; 19
(4) Meets any other qualifications for international medical school 20
graduates that the Board establishes in its regulation for licensing of applicants; 21
(5) Submits acceptable evidence to the Board of the requirements set in the 22
Board’s regulations; and 23
(6) [Meets one of the following requirements: 24
(i) The applicant graduated] GRADUATED from any international 25
medical school and submits evidence acceptable to the Board of successful completion of 2 26
years of POSTGRADUATE training in [a postgraduate medical education program ] AN 27
accredited TRAINING PROGRAM [by an accrediting organization recognized by the Board; 28
or 29
4 SENATE BILL 489
(ii) The applicant successfully completed a fifth pathway program 1
and submits evidence acceptable to the Board that the applicant: 2
1. Has a document issued by the international medical school 3
certifying that the applicant completed all of the formal requirements of that school for the 4
study of medicine, except for the postgraduate or social service components as required by 5
the international country or its medical school; 6
2. Has successfully completed a fifth pathway program; and 7
3. Has successfully completed 2 years of training in a 8
postgraduate medical education program following completion of a Board approved fifth 9
pathway program]. 10
14–308. 11
(A) IN THIS SECTION, “HEALTH CARE FACILITY” MEANS: 12
(1) A LOCAL HEALTH DEPARTMENT; 13
(2) A SCHOOL OF MEDICINE; 14
(3) A FEDERALLY QUALIFIED HEALTH CENTER; 15
(4) A HEALTH SYSTEM; 16
(5) A HOSPITAL; 17
(6) A HOSPITAL–BASED FACILITY; OR 18
(7) A FREESTANDING EMERGENCY FACILITY. 19
(B) THIS SECTION DOES NOT APPLY TO A PHYSICIAN WHO: 20
(1) HAS COMPLETED: 21
(I) A RESIDENCY ACCREDITED BY THE ACCREDITATION 22
COUNCIL FOR GRADUATE MEDICAL EDUCATION; 23
(II) A RESIDENCY ACCREDITED BY THE AMERICAN 24
OSTEOPATHIC ASSOCIATION; OR 25
(III) ROYAL COLLEGE OF PHYSICIANS AND SURGEONS 26
ACCREDITED RESIDENCY TRAINING IN CANADA; OR 27
SENATE BILL 489 5
(2) PREVIOUSLY HELD A MED ICAL LICENSE ISSUED IN THE UNITED 1
STATES OR CANADA. 2
(C) BEGINNING OCTOBER 1, 2028, THE BOARD MAY ISSUE A LIM ITED 3
LICENSE TO PRACTICE MEDICINE TO A PHYSIC IAN TRAINED AND LICE NSED IN A 4
FOREIGN COUNTRY WHO MEETS THE REQUIREMENTS OF THIS SECTION. 5
(D) TO BE ELIGIBLE FOR A LIMITED LICENSE UNDE R THIS SECTION , AN 6
APPLICANT SHALL: 7
(1) BE OF GOOD MORAL CHARACTER; 8
(2) HAVE RECEIVED A DEGRE E OF DOCTOR OF MEDIC INE OR ITS 9
EQUIVALENT FROM A ME DICAL SCHOOL LOCATED OUTSIDE THE UNITED STATES 10
WITH RECOGNIZED ACCR EDITATION STATUS FRO M THE EDUCATIONAL 11
COMMISSION FOR FOREIGN MEDICAL GRADUATES; 12
(3) HAVE COMPLETED AT LEA ST 2 YEARS OF TRAINING IN A 13
RESIDENCY PROGRAM: 14
(I) ACCREDITED BY THE AMERICAN COUNCIL FOR GRADUATE 15
MEDICAL EDUCATION – INTERNATIONAL; 16
(II) IN A COUNTRY WHOSE GR ADUATE MEDICAL EDUCA TION 17
ACCREDITING AGENCY H AS BEEN RECOGNIZED B Y THE WORLD FEDERATION FOR 18
MEDICAL EDUCATION; OR 19
(III) ACCREDITED BY ANOTHER ACCREDITATION AUTHOR ITY 20
APPROVED BY THE BOARD; 21
(4) (I) HAVE BEEN IN GOOD STA NDING WITH THE MEDIC AL 22
LICENSING OR REGULAT ORY AUTHORITY IN THE FOREIGN COUNTRY AT T HE TIME 23
OF THE APPLICANT’S DEPARTURE; OR 24
(II) IF REASONABLE ATTEMPT S TO OBTAIN THE INDI VIDUAL’S 25
LICENSURE STATUS HAVE BEEN UNSUCCESSFUL, BE APPROVED BY THE BOARD ON 26
AN INDIVIDUAL BASIS; 27
(5) HAVE NO PENDING DISCIPLINARY MATTERS BEFORE A LICENSING 28
OR REGULATORY BODY; 29
(6) HAVE AN OFFER OF EMPL OYMENT WITH A PARTIC IPATING 30
HEALTH CARE FACILITY THAT WILL EVALUATE T HE APPLICANT ’S NONCLI NICAL 31
6 SENATE BILL 489
SKILLS AND FAMILIARITY WITH STANDARDS APPROPRIATE FOR MEDICAL PRACTICE 1
IN THE STATE; AND 2
(7) SATISFY ANY OTHER REQ UIREMENTS ESTABLISHE D BY THE 3
BOARD IN REGULATION, INCLUDING PRIOR PRACTICE EXPERIENCE. 4
(E) THE BOARD MAY DETERMINE A N APPLICANT INELIGIBLE FOR A 5
LIMITED LICENSE IF THE APPLICANT: 6
(1) WAS SUBJECT TO PREVIOUS DISCIPLINARY ACTION; 7
(2) HAD DISCIPLINE OR COM PETENCY PROBLEMS DUR ING THE 8
APPLICANT’S POSTGRADUATE TRAINING; OR 9
(3) FAILS TO SUBMIT EVIDE NCE ACCEPTABLE TO TH E BOARD THAT 10
THE APPLICANT MEETS THE REQUIREMENTS FOR A LIMITED LICENSE. 11
(F) TO APPLY FOR A LIMITED LICENSE, AN APPLICANT SHALL: 12
(1) SUBMIT AN APPLICATION TO THE BOARD ON THE FORM THAT THE 13
BOARD REQUIRES; AND 14
(2) PAY TO THE BOARD AN APPLICATION FEE SET BY THE BOARD. 15
(G) (1) THE TERM OF A LIMITED LICENSE MAY NOT EXCEED 3 YEARS. 16
(2) A LIMITED LICENSE MAY NOT BE RENEWED. 17
(H) A LIMITED LICENSE AUTHORIZES THE HOLDER TO PRACTICE MEDICINE 18
ONLY: 19
(1) WHILE EMPLOYED IN FUL L–TIME EMPLOYMENT BY T HE HEALTH 20
CARE FACILITY DESCRIBED IN SUBSECTION (D)(6) OF THIS SECTION; AND 21
(2) IN THE EMPLOYING HEAL TH CARE FACILITY OR A HEALTH CARE 22
FACILITY OPERATED BY THE EMPLOYING HEALTH CARE FACILITY. 23
(I) THE BOARD MAY REVOKE A LI MITED LICENSE ISSUED UNDER THIS 24
SECTION IF: 25
(1) THE LICENSEE PRACTICES OUTSIDE THE SCOPE OF THE LIMITED 26
LICENSE; 27
(2) THE LICENSEE IS NO LO NGER EMPLOYED BY THE HEALTH CARE 28
FACILITY DESCRIBED IN SUBSECTION (D)(6) OF THIS SECTION; 29
SENATE BILL 489 7
(3) THE LICENSEE PRACTICE S MEDICINE OUTSIDE T HE STATE 1
WITHOUT BEING LEGALLY AUTHOR IZED TO PRACTICE MED ICINE IN THE OTHER 2
JURISDICTION; 3
(4) THE LICENSEE HAS BEEN SUBJECT TO A DISCIPLINARY ACTION BY 4
THE HEALTH CARE FACILITY DESCRIBED IN SUBSECTION (D)(6) OF THIS SECTION OR 5
THE BOARD; OR 6
(5) THE LICENSEE IS NO LO NGER ELIGIBLE FOR THE LIMITED 7
LICENSE. 8
SECTION 2. AND BE IT FURTHER ENACTED, That the State Board of Physicians 9
shall consult with MedChi, the Maryland State Medical Society, on the development of 10
policies and regulations implementing this Act. 11
SECTION 2. 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 12
October 1, 2026. 13
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
President of the Senate.
________________________________________________________________________________
Speaker of the House of Delegates.