Revises process for certain medical schools to receive authorization to operate clinical clerkship programs in New Jersey.

A1985

ASSEMBLY, No. 1985

STATE OF NEW JERSEY

222nd LEGISLATURE

�

PRE-FILED FOR INTRODUCTION IN THE 2026 SESSION

Sponsored by:

Assemblywoman ANNETTE QUIJANO

District 20 (Union)

SYNOPSIS

���� Revises process for certain medical schools to
receive authorization to operate clinical clerkship programs in New Jersey.

CURRENT VERSION OF TEXT

���� Introduced Pending Technical Review by Legislative
Counsel.

��

An Act
concerning clinical clerkship programs and amending
P.L.2003, c.133.

����
Be It
Enacted
by the Senate and General Assembly of
the State of New Jersey:

���� 1.� Section 2 of P.L.1997,
c.390 (C.18A:64H-2) is amended to read as follows:

���� 2.� There is hereby
established the Advisory Graduate Medical Education Council of New Jersey,
which shall be responsible to the
[
Commission
on Higher Education
]

Department of Health
.� The purpose of this council shall be to make
recommendations for the support, through federal, State and private funds, of
graduate medical education programs in private nonprofit and public hospitals
in the State, and to make recommendations for the development and
implementation of new graduate medical education programs which will meet the
needs of the citizens of the State.� The functions of the council shall
include, but not be limited to:�

���� a.� Obtaining and evaluating
information concerning the graduate medical manpower needs of the citizens of
the State;�

���� b.� Recommending standards and
criteria for participation by private nonprofit and public hospitals in the
State;�

���� c.��� Reviewing individual
institutional applications and recommending awards of support to particular
institutions based on conformance with the identified needs of the citizens of
the State and the standards and criteria recommended by the council;�

���� d.� Annually reviewing the
educational programs provided by participating hospitals;�

���� e.� Annually
[
reporting
]

submitting

to the Governor and the
[
Education
]

Senate and
General Assembly Health
Committees of the New Jersey Legislature
a
report
on the council's activities pursuant to the provisions of
[
this act
]

P.L.1977,
c.390 (C.18A:64H-1 et seq.), which report shall include information on:

����
(1)�� the number of
institutions that applied, and received approval, to operate a clinical
clerkship program in a hospital in the State, by the hospital�s status as a
nonprofit, for-profit, or public hospital and by the jurisdiction in which the institution
is located; and

����
(2)� the number of students
who applied for, and were accepted to, clinical clerkships in this State, by
institution, race, ethnicity, gender and age.

����
The council shall
promulgate and maintain a Code of Ethics that is modeled upon the Code of
Judicial Conduct of the American Bar Association, as amended and adopted by the
Supreme Court of New Jersey.� The Code of Ethics promulgated and maintained by
the council shall not be in conflict with the laws of this State, except,
however, that the Code of Ethics may be more restrictive than any law of this
State
.

(cf: P.L.1994, c.48, s.171)

���� 2.� Section 5 of P.L.1977,
c.390 (C.18A:64H-5) is amended to read as follows:

�� 5.� The
[
Commission on
Higher Education
]

Commissioner of Health
, upon the advice of the Advisory Council,
[
with the
concurrence of the Commissioner of Health,
]

shall:�

� a.� Plan for the development and
implementation of graduate medical education programs in the State;�

� b.� Set standards for
qualification for participation by public and private nonprofit hospitals in
the State;�

� c.� Establish standards for the
use and expenditures of funds appropriated pursuant to this act;�

� d.� Determine the number and type
of graduate medical education programs which should be supported in particular
hospitals in relation to total State needs.�

(cf: P.L.1994, c.48, s.174)

���� 3.� Section 8 of P.L.1977,
c.390 (C.18A:64H-8) is amended to read as follows:

���� 8. �The
[
Commission on
Higher Education
]

Commissioner of Health
shall promulgate such rules as are necessary to
carry out the purpose of
[
this
act
]

P.L.1977,
c.390 (C.18A:64H-1 et seq.)
.�

(cf: P.L.1994, c.48, s.175)

���� 4.� Section 1 of P.L.2003,
c.133 (C.18A:64H-9) is amended to read as follows:

���� 1.� a.� There is created,
within the
[
Office
of the Secretary of Higher Education
]

Department of Health
, the "Advisory Committee on Alternatively
Accredited Medical School Clinical Clerkships."

���� The advisory committee shall
consist of 11 members as follows: the Commissioner of Health
[
and Senior
Services
]

or
[
his
]

the
commissioner�s
designee, who shall serve ex officio; four members appointed
by the Governor who include one representative of the Medical Society of New
Jersey, one representative of the New Jersey Association of Osteopathic
Physicians and Surgeons, one representative of the New Jersey Hospital
Association and one representative of an alternatively accredited medical
school; two members appointed by the President of the Senate who include one
representative of the New Jersey Council of Teaching Hospitals and one
representative of a teaching hospital in New Jersey that has students from an
alternatively accredited medical school participating in a clinical clerkship
program; two members appointed by the Speaker of the General Assembly who
include one representative of an alternatively accredited medical school and
one representative of a teaching hospital in New Jersey that has students from
a medical school of Rutgers, The State University in a clinical clerkship
program; one member appointed by the State Board of Medical Examiners; and one
member appointed by the President of Rutgers, The State University. No two
members of the advisory committee shall be representatives of the same medical
school or hospital.

���� b.��� Members shall serve for
a term of three years from the date of their appointment and until their
successors are appointed and qualified, except that of the members first
appointed, four members shall serve for a term of one year, three members shall
serve for a term of two years and three members shall serve for a term of three
years. Vacancies shall be filled for the balance of the unexpired term in the
same manner as the original appointments were made. A member of the advisory
committee shall be eligible for reappointment.

���� c.��� The members of the
advisory committee shall serve without compensation, but shall be reimbursed
for necessary and reasonable expenses actually incurred in the performance of
their duties, within the limits of funds appropriated or otherwise made
available to the advisory committee for this purpose.

���� d.��� The advisory committee
shall select a
[
chairman
]

chair

from among its members, who shall serve a one-year term but may serve
successive terms. The advisory committee shall meet upon the call of the
[
chairman
]

chair

or of a majority of its members. A majority of the members of the advisory
committee shall constitute a quorum, and no action of the advisory committee
shall be taken except upon the affirmative vote of a majority of the members of
the entire advisory committee.

���� e.��� As used in
[
this act
]
P.L.2003,
c.133 (C.18A:64H-9 et seq.)
, "alternatively accredited medical
school" means a medical school located outside the United States
provided
that the medical school
:

���� (1)�
is
in a country
that applies accreditation standards that have been determined by the National
Committee on Foreign Medical Education and Accreditation within the United
States Department of Education to be comparable to the accreditation standards
applied to medical schools located within the United States;
or

���� (2)�
[
that continues
to meet
]

is accredited by an accrediting body recognized by the World Federation for
Medical Education as having accreditation standards comparable to the Liaison
Committee on Medical Education or the American Osteopathic Association; and

����
(3) meets
the
accreditation standards of
[
that
]

the

country
[
;
and

���� (3)� has medical school
students participating in a clinical clerkship program in New Jersey prior to
the effective date of this act, or is approved by the Advisory Graduate Medical
Education Council of New Jersey pursuant to section 4 of this act to operate a
clinical clerkship program in this State
]

in which the medical school is located
.

(cf: P.L.2012, c.45, s.78)

���� 5.� Section 4 of P.L.2003,
c.133 (C.18A:64H-12) is amended to read as follows:

���� 4.� a.� A medical school
located outside of the United States: (1) in a country that applies
accreditation standards that have been determined by the National Committee on
Foreign Medical Education and Accreditation within the United States Department
of Education to be comparable to the accreditation standards applied to medical
schools located within the United States;
[
and
]

or
(2)

that is accredited by an accrediting body recognized by the World Federation
for Medical Education as having accreditation standards comparable to the
accreditation standards applied to medical schools located within the United
States; and (3)
� that continues to meet the accreditation standards of
[
that
]

the

country
in which the medical school is located
, but is not an
alternatively accredited medical school
, as that term is defined in� Section
1 of P.L.2003, c.133 (C.18A:64H-9),
or
authorized to operate a clinical
clerkship program in this State
on the effective date of
[
this act
]

P.L.��� ,
c.��� (C.������� ) (pending before the Legislature as this bill)

[
, as that term
is defined in this act,
]

may apply to the Advisory Graduate Medical Education Council of New Jersey,
pursuant to this section, to be approved to operate a clinical clerkship
program in this State
, provided that the medical school meets the criteria
for an alternatively accredited medical school as defined in subsection e. of section
4 of P.L.2003, c.133 (C.18A:64H-12)
.

���� b.��� The council shall adopt
regulations specifying the criteria for approval of a foreign medical school to
operate a clinical clerkship program in the State. The criteria shall include,
but not be limited to, satisfactory evaluation
[
,
]
pursuant to a
site visit
[
,
]
of the
applicant's institution, including both its main campus and any clinical
facilities in locations other than the main campus.

���� c.��� The applicant shall be
responsible for all costs incurred by persons designated by the council, who
are experienced in medical education program evaluation, for
[
conducting the
site visit, and by the council for
]

reviewing and processing the application.

���� d.��� After a medical school
is approved by the council to operate a clinical clerkship program, it may
apply to the council for authorization to operate a specific clinical clerkship
program in this State, in accordance with standards adopted by the council.�
The standards shall include, but not be limited to, those standards listed in
paragraphs (1) through (9) of subsection b. of section 5 of
[
this act
]
P.L.2003,
c.133 (C.18A:64H-13)
.

���� e.��� A medical school that
has been approved by the council, pursuant to
[
this
act
]
P.L.2003,
c.133 (C.18A:64H-9 et seq.)
, to operate a specific clinical clerkship
program in this State shall be deemed an alternatively accredited medical
school for the purposes of
[
this
act
]
P.L.2003,
c.133 (C.18A:64H-9 et seq.) and authorized to operate a clinical clerkship
program in this State
, provided it

maintains its accreditation status as provided in subsection e. of
section 1 of
[
this
act
]
P.L.2003,
c.133 (C.18A:64H-9)
.

���� f.����
[
A
]

An
alternatively accredited
�medical school authorized to operate a specific
clinical clerkship program pursuant to this section may apply to the council to
increase the number of students participating in the clinical clerkships or to
increase the number of programs operated by the school, pursuant to the
requirements of section 5 of
[
this
act
]
P.L.2003,
c.133 (C.18A:64H-13)
.

���� 6.� Section 5 of P.L.2003,
c.133 (C.18A:64H-13) is amended to read as follows:

���� 5.��� The Advisory Graduate
Medical Education Council of New Jersey shall review each application made by
an alternatively accredited medical school to increase the number of students
participating in clinical clerkships or to increase the number of programs operated
by the school.� The application shall be made in a form and manner prescribed
by the council.

���� a.��� The council shall notify
the applicant, in writing, of the approval or disapproval of an application
within 90 days; except that, if the council determines that the application is
not complete or additional information is required before the council can make
a determination, the council shall notify the applicant in writing and shall
have an additional 90 days after receipt of the requested information to
approve or disapprove the application.� If the council does not affirmatively
approve or disapprove the application, or request additional information
concerning the application, within 90 days of its submission, the application
shall be deemed approved.

���� b.��� The council shall
approve an application if the applicant demonstrates that it meets the
registration standards comparable to those promulgated by the Liaison Committee
on Medical Education, which include, but are not limited to: (1) a requirement
that a medical student who will participate in a clinical clerkship program
shall have successfully completed the United States Medical Licensing
Examination-Step 1
and provided proof of the successful completion of the
exam within 3 months of the start of the student�s clinical clerkship
; (2)
the hospital is accredited by the Joint Commission on Accreditation of
HealthCare Organizations
or a comparable U.S. HealthCare Accreditation
Organization
; (3) the clinical clerkship program shall take place in a
hospital with an approved Accreditation Council for Graduate Medical Education
or American Osteopathic Association residency training program in the clinical
area of instruction for which credit is sought; (4) clinical instruction shall
be supervised by a Director of Medical Education; (5) clinical instruction
shall be provided pursuant to a written agreement that includes a written
curriculum for each individual clinical subject; (6) the hospital shall insure
that there is a minimum daily census in each clerkship area that will meet the
instructional needs of the clinical subject; (7)
[
the hospital
]

a medical
student who will participate in a clinical clerkship program
shall have
[
on the
premises
]

access to
� a library
[
facility
]
that has
adequate resources to support clinical clerkships in each core area; (8) each
department chair shall be board certified in the specialty area in
[
his
]

the
chair�s
department; and (9) the hospital shall ensure a ratio of no less
than one medical resident for every two clinical clerkship students.

���� c.��� If the council
disapproves the application, the notification of disapproval shall specify each
deficiency, including the reason the applicant failed to meet the registration
standards, and shall provide information on remedial steps that applicant must
take to meet the standard.� An applicant shall be provided the opportunity to
submit evidence of remediation, within a time period specified by the council.

���� d.��� The applicant shall be
responsible for all costs incurred by the council for reviewing and processing
the application.

(cf: P.L.2003, c.133, s.5)

���� 7.� Section 7 of P.L.2003,
c.133 (C.18A:64H-15) is amended to read as follows:

���� 7.��� The
[
Commission on
Higher Education
]

Commissioner of Health
, in consultation with the Advisory
Graduate Medical Education Council of New Jersey, shall adopt regulations
pursuant to the "Administrative Procedure Act," P.L.1968, c.410
(C.52:14B-1 et seq.) necessary to carry out the purposes of
[
this act
]

P.L.2003,
c.133 (C.18A:64H-9 et seq.)
.

(cf: P.L.2003, c.133, s.7)

���� 8.� This act shall take effect
immediately.

STATEMENT

���� This bill revises the requirements
for certain medical schools located outside of the United States to operate
clinical clerkship programs in New Jersey by amending P.L.2003, c.133.

���� Under current law, unless a
medical school is already considered an alternatively accredited medical
school, a medical school located outside of the United States can only apply
for the authorization to operate a clinical clerkship program in the State if
the medical school:� (1) is in a country that applies certain accreditation
standards, which have been determined by the National Committee on Foreign
Medical Education and Accreditation (NCFME) within the United States Department
of Education to be comparable to the accreditation standards applied to medical
schools located within the United States; and (2) that continues to meet the
accreditation standards of that country.� Any medical school that satisfies
this criteria and is approved by the Advisory Graduate Medical Education
Council of New Jersey to operate a clinical clerkship program in this State is
deemed to be an �alternatively accredited medical school.�

���� This bill amends these
requirements and permits certain medical schools located outside of the United
States that are accredited by an accrediting body recognized by the World
Federation for Medical Education (WFME) as having accreditation standards
comparable to the Liaison Committee on Medical Education (LCME) or the American
Osteopathic Association (AOA), to apply for the authorization to operate a
clinical clerkship program in the State.

���� The bill revises the
requirements for an alternatively accredited medical school to increase the
number of students participating in clinical clerkships or to increase the
number of programs operated by the school.

���� The bill establishes the Advisory
Graduate Medical Education Council of New Jersey and Advisory Committee on
Alternatively Accredited Medical School Clinical Clerkships within the
Department of Health.� Under current law, these entities were established under
the Commission of Higher Education.

���� The bill requires the council
to promulgate and maintain a Code of Ethics.� The bill revises the reporting
requirements provided under current law to require the council to annually
submit a report to the Governor and the Senate and General Assembly Health
Committees of the New Jersey Legislature on the council's activities, which
report will include information on:

���� (1)�� the number of
institutions that applied, and received approval, to operate a clinical
clerkship program in a hospital in the State, by the hospital�s status as a
nonprofit, for-profit, or public hospital and by the jurisdiction in which the
institution is located; and

���� (2)� the number of students
who applied for, and were accepted to, clinical clerkships in this State, by
institution, race, ethnicity, gender and age.

���� It is the sponsor�s intent
that this bill will broaden the pool of medical schools that might be eligible
to operate a clinical clerkship program in the State, by accepting and
considering the applications of medical schools that have been accredited by standards
that have been recognized by either the NCFME or the WFME.� It is the sponsor�s
belief that this bill might increase the number of clinical clerkship
opportunities in the State and the number of medical school students who
complete their medical school training in New Jersey, which would increase the
likelihood that a student will continue to pursue residency and employment
opportunities in New Jersey and thereby increase the supply of physicians in
the State.�