International medical grads

AN ACT Relating to updating the requirements for the clinical 1
experience license for international medical graduates; and amending 2
RCW 18.71.095. 3
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:4
Sec. 1. RCW 18.71.095 and 2023 c 14 s 1 are each amended to read 5
as follows: 6
The commission may, without examination, issue a limited license 7
to persons who possess the qualifications set forth herein:8
(1) The commission may, upon the written request of the secretary 9
of the department of social and health services, the secretary of 10
children, youth, and families, or the secretary of corrections, issue 11
a limited license to practice medicine in this state to persons who 12
have been accepted for employment by the department of social and 13
health services, the department of children, youth, and families, or 14
the department of corrections as physicians; who are licensed to 15
practice medicine in another state of the United States or in the 16
country of Canada or any province or territory thereof; and who meet 17
all of the qualifications for licensure set forth in RCW 18.71.050.18
Such license shall permit the holder thereof to practice medicine 19
only in connection with patients, residents, or inmates of the state 20
institutions under the control and supervision of the secretary of 21
S-0200.1
SENATE BILL 5118
State of Washington 69th Legislature 2025 Regular Session
By Senators Valdez, Orwall, Nobles, Saldaña, and Stanford
Prefiled 12/27/24. Read first time 01/13/25. Referred to Committee
on Health & Long-Term Care.
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the department of social and health services, the department of 1
children, youth, and families, or the department of corrections.2
(2) The commission may issue a limited license to practice 3
medicine in this state to persons who have been accepted for 4
employment by a county or city health department as physicians; who 5
are licensed to practice medicine in another state of the United 6
States or in the country of Canada or any province or territory 7
thereof; and who meet all of the qualifications for licensure set 8
forth in RCW 18.71.050. 9
Such license shall permit the holder thereof to practice medicine 10
only in connection with his or her duties in employment with the city 11
or county health department. 12
(3) Upon receipt of a completed application showing that the 13
applicant meets all of the requirements for licensure set forth in 14
RCW 18.71.050 except for completion of two years of postgraduate 15
medical training, and that the applicant has been appointed as a 16
resident physician in a program of postgraduate clinical training in 17
this state approved by the commission, the commission may issue a 18
limited license to a resident physician. Such license shall permit 19
the resident physician to practice medicine only in connection with 20
his or her duties as a resident physician and shall not authorize the 21
physician to engage in any other form of practice. Each resident 22
physician shall practice medicine only under the supervision and 23
control of a physician licensed in this state, but such supervision 24
and control shall not be construed to necessarily require the 25
personal presence of the supervising physician at the place where 26
services are rendered. 27
(4)(a) Upon nomination by the dean of an accredited school of 28
medicine in the state of Washington or the chief executive officer of 29
a hospital or other appropriate health care facility licensed in the 30
state of Washington, the commission may issue a limited license to a 31
physician applicant invited to serve as a teaching-research member of 32
the institution's instructional staff if the sponsoring institution 33
and the applicant give evidence that he or she has graduated from a 34
recognized medical school and has been licensed or otherwise 35
privileged to practice medicine at his or her location of origin. 36
Such license shall permit the recipient to practice medicine only 37
within the confines of the instructional program specified in the 38
application and shall terminate whenever the holder ceases to be 39
involved in that program, or at the end of one year, whichever is 40
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earlier. Upon request of the applicant and the institutional 1
authority, the license may be renewed. The holder of a teaching 2
research license under this subsection (4)(a) is eligible for full 3
licensure if the following conditions are met: 4
(i) If the applicant has not graduated from a school of medicine 5
located in any state, territory, or possession of the United States, 6
the District of Columbia, or the Dominion of Canada, the applicant 7
must satisfactorily pass the certification process by the educational 8
commission for foreign medical graduates; 9
(ii) The applicant has successfully completed the exam 10
requirements set forth by the commission by rule; 11
(iii) The applicant has the ability to read, write, speak, 12
understand, and be understood in the English language at a level 13
acceptable for performing competent medical care in all practice 14
settings; 15
(iv) The applicant has continuously held a position of associate 16
professor or higher at an accredited Washington state medical school 17
for no less than three years; and 18
(v) The applicant has had no disciplinary action taken in the 19
previous five years. 20
(b) Upon nomination by the dean of an accredited school of 21
medicine in the state of Washington or the chief executive officer of 22
any hospital or appropriate health care facility licensed in the 23
state of Washington, the commission may issue a limited license to an 24
applicant selected by the sponsoring institution to be enrolled in 25
one of its designated departmental or divisional fellowship programs 26
provided that the applicant shall have graduated from a recognized 27
medical school and has been granted a license or other appropriate 28
certificate to practice medicine in the location of the applicant's 29
origin. Such license shall permit the holder only to practice 30
medicine within the confines of the fellowship program to which he or 31
she has been appointed and, upon the request of the applicant and the 32
sponsoring institution, the license may be renewed by the commission.33
All persons licensed under this section shall be subject to the 34
jurisdiction of the commission to the same extent as other members of 35
the medical profession, in accordance with this chapter and chapter 36
18.130 RCW. 37
Persons applying for licensure and renewing licenses pursuant to 38
this section shall comply with administrative procedures, 39
administrative requirements, and fees determined as provided in RCW 40
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43.70.250 and 43.70.280. Any person who obtains a limited license 1
pursuant to this section may apply for licensure under this chapter, 2
but shall submit a new application form and comply with all other 3
licensing requirements of this chapter. 4
(5) ((The commission may issue a time-limited clinical experience 5
license to an applicant who does not qualify for licensure under RCW 6
18.71.050 or chapter 18.71B RCW and who meets the requirements 7
established by the commission in rule for the purpose of gaining 8
clinical experience at an approved facility or program.9
(6)))(a) Upon nomination by the chief medical officer of any 10
hospital, appropriate medical practice or physician employment group 11
located in the state of Washington, the department of social and 12
health services, the department of children, youth, and families, the 13
department of corrections, or a county or city health department, the 14
commission may issue a limited license to an international medical 15
graduate if the applicant: 16
(i) ((Has been a Washington state resident for at least one year;17
(ii))) Provides proof the applicant is certified by the 18
educational commission for foreign medical graduates;19
(((iii))) (ii) Has passed ((all)) steps one and two of the United 20
States medical licensing examination; and 21
(((iv))) (iii) Submits to the commission background check process 22
required of applicants generally. 23
(b) The commission at its sole discretion may elect to require 24
alternative examinations, certifications, or assessments for those 25
applicants experiencing hardship as described in section 1, 26
chapter . . ., Laws of 2025 (Z-0078/25).27
(c) A license holder under this subsection may only practice:28
(i) Under the supervision and control of a physician who is 29
licensed in this state under this chapter or chapter 18.57 RCW and is 30
of the same or substantially similar clinical specialty; and31
(ii) Within the nominating facility or organization.32
(((c))) (d) A license holder must file with the commission a 33
practice agreement between the license holder and the supervising 34
physician who is of the same or substantially similar clinical 35
specialty prior to beginning practice under this license.36
(((d))) (e) A supervising physician may supervise no more than 37
((two)) four license holders under this subsection unless the 38
commission grants a request to increase this limit.39
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(((e))) (f) A limited license issued under this subsection is 1
valid for two years and may be renewed ((once)) three times by the 2
commission upon application for renewal by the nominating entity for 3
a total of eight years. 4
(((f))) (g) An individual licensed and practicing under authority 5
of this license is a full scope licensed physician for all purposes, 6
including medical practice, employment role definition, malpractice 7
coverage, credentialing, and insurance billing for plans described 8
in, but not limited to, Title 48 RCW, unless disciplinary action 9
limits the scope of a particular license.10
(h) All persons licensed under this subsection are subject to the 11
jurisdiction of the commission to the same extent as other members of 12
the medical profession, in accordance with this chapter and chapter 13
18.130 RCW. 14
(((g))) (i) Persons applying for licensure and renewing licenses 15
under this subsection shall comply with administrative procedures, 16
administrative requirements, and fees determined as provided in RCW 17
43.70.250 and 43.70.280. 18
(((h))) (j) The supervising physician shall retain professional 19
and personal responsibility for any act which constitutes the 20
practice of medicine as defined in RCW 18.71.011 or the practice of 21
osteopathic medicine and surgery as defined in RCW 18.57.001 when 22
performed by an international medical graduate practicing under their 23
supervision. 24
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