SB 5185 — Establishing preceptorship and hardship pathways to medical practice for international medical graduates.

S-4012.2S-0147.2 SUBSTITUTE SENATE BILL 5185 State of Washington 69th Legislature 20262025 Regular Session By Senate Health & Long-Term Care (originally sponsored by Senators Saldaña, Cortes, Cleveland, Wellman, Stanford, Nguyen, Chapman, Orwall, Dhingra, Valdez, Riccelli, Bateman, Hasegawa, and Nobles)Nobles READPrefiled FIRST01/08/25. TIME 02/02/26.

ANRead ACTfirst Relatingtime to01/13/25. establishing a pilot program that creates a pathway to physician licensure for international medical graduates;

Referred to Committee on Health & Long-Term Care.

AN ACT Relating to establishing preceptorship and hardship pathways to medical practice for international medical graduates;

and adding a new section to chapter 18.71 RCW;RCW.

and providing an expiration date.

Each((Each applicantapplicant)) shallThe furnishcommission proofrecognizes satisfactoryas equivalent to the commissionUnited ofStates medical school accreditation and national medical licensure examination standards the following:Canadian medical school accreditation and Canadian national medical licensure exam.

(a)(2) ThatApplicants heshall orfurnish sheproof hassatisfactory completedto inthe acommission school of medicinethe afollowing: resident course of professional instruction equivalent to that required in this chapter for applicants generally;

(b)(((i) Except as provided in (b)(ii) of this subsection, that)) That he or she meets all the requirements which must be met by graduates of the United States and Canadian school of medicine except p.

1 SSBSB 5185 that(a) heThat ((he or she needhas)) notthey have graduatedcompleted fromin a school of medicine approveda byresident thecourse commission;of professional instruction equivalent to that required in this chapter for applicants generally;

(b)(((i) Except as provided in (b)(ii) of this subsection, that he or she meets)) That they meet all the requirements which must be met by graduates of the United States and Canadian schools of medicine except that ((he or she)) they need not have graduated from a school of medicine approved by the commission;

and (C) Successfully completed at least twenty-four months of training in multiple sclerosis at an educational institution in the United States with an accredited residency program in neurology or rehabilitation;)) (c) That he((he or she hashas)) they have satisfactorily passed the examination given by the educational council for foreign medical graduates or has((has)) have met the requirements in lieu thereof as set forth in rules adopted by the commission;

(d) That he((he or she hashas)) they have the ability to read, write, speak, understand, and be understood in the English language.

(2)(((2))) (3) An applicant may obtain an exceptional qualification waiver, waiving requirements determined by the commission in rule,rule or statute, if they possess an acceptable body of work related to research, medical excellence, or employment, and have the recommendation of other national or international experts in the same specialty or field.

(3)(4) The commissioncommission, mayat adoptits rulessole todiscretion, establishmay aelect primaryto carewaive licenserequirements forin applicantsstatute whoand haverule successfullywhen completedconsidering theinternationally clinicaltrained experienceapplicants graduateexperiencing pilothardship program as outlined in sectionproviding 2required ofdocuments thisfor act.license applications.

The commission may also require alternate demonstrations of competence that may include examinations or specialty assessments, a period of supervised practice, or other tools as appropriate for evaluation of an applicant to the p.

2 SB 5185 satisfaction of the commission.

Hardship scenarios the commission may consider include, but may not be limited to, refugee status, persecution in the home country of the applicant due to beliefs, ethnicity, or other demographic considerations.

The commission may not consider as a hardship the inability of the applicant to complete the certification and examination processes administered by the educational commission on foreign medical graduates or the failure of required examinations.

(1) The commission shallmay establishcreate or approve a preceptorship pathway for international medical graduates to qualify for full and administerunrestricted thephysician clinicaland experiencesurgeon graduatelicensure pilotunder program.this chapter.

(2)Licensure Theunder pilotthis programpathway mustdoes allownot arequire medicalcompletion graduateof tothe participatepostgraduate intraining therequirement programspecified ifin theRCW applicant:18.71.050(1)(b).

(a)An Holdsindividual licensed and practicing under authority of this pathway is a clinicalfull experiencescope licenselicensed issuedphysician onfor orall beforepurposes Julyincluding 1,medical 2026;practice, employment role definition, malpractice coverage, credentialing, and insurance billing for plans described in, but not limited to, Title 48 RCW, unless disciplinary action limits the scope of a particular license.

p.Any scope limitations may also be imposed at the practice level consistent with standard credentialing processes and practice agreements between the licensee and the supervising physician.

2(2) SSBAn 5185internationally (b)trained Hasmedical completedgraduate twonot yearscurrently oflicensed continuousby supervisedthe clinicalcommission may demonstrate competence to the commission for eventual independent practice underand licensure through a clinicalrequired experienceperiod license;of supervised practice, supervisor assessments, and attestation of the supervisor submitted to the commission.

(c)(a) DoesThe notpathway haveconsists anyof active disciplinary action or significant disciplinary history as determined by the commission;following elements:

(d)(i) HasLicensure obtainedunder satisfactoryRCW clinical18.71.095(6) assessmentor evaluationsbe fromgranted the supervising physician in all categories in a clinicalhardship assessmentwaiver evaluationunder approvedRCW by18.71.051(3) the commission for thelicensure periodunder ofRCW supervised18.71.095(6); practice;

(e)(ii) HasFull-time obtainedpractice anas attestationa fromphysician in a clinical location or locations acceptable to the supervisingcommission physician;for not less than four years or 48 months;

and (f)(iii) HasA obtainedsatisfactory arating writtenin endorsementall fromcategories theby medical director of the practicesupervising sitephysician ifwith differenta thancommission theapproved supervisingclinical physician.assessment evaluation.

(3)(b) TheUpon Washingtonsatisfaction medicalof commission(a) shallof engagethis withsubsection, the Americanlicensee boardmay ofapply medicalfor specialtiesa tolicense considerissued aunder processthis forchapter boardby certificationproviding forthe programp. participants.

(4)3 TheSB pilot5185 programrequired shalldocumentation createof a pathwayminimum toof full,48 unrestrictedmonths of supervised full- time clinical practice at the level of a physician, satisfactory clinical assessment evaluations for the period of supervised practice required in (a)(ii) of this subsection, an attestation from the supervising physician, a written endorsement from the medical licensuredirector toof providethe primarypractice caresite uponif successfuldifferent completionthan the supervising physician, proof of board certification, and supplying any further information required by the following:commission.

(a)The Twocommission yearsaccepts ofonly supervisedABMS clinicaland experienceAAGP licenseboard practicecertifications. in addition to the two years of continuous supervised clinical practice under a clinical experience license needed to qualify for the pilot program;

(b)(3) RequirementsFor ofexceptionally qualified international medical graduates, the clinicalcommission experiencemay licenseestablish program;an abbreviated assessment program to determine competence and skill level for the purposes of issuing a full and unrestricted license.

(c)(4) StepThe 3commission ofmay theconduct Unitedrule Statesmaking medicalto licensingimplement examination;the requirements of this section.

and (d) Passing a clinical competency assessment approved by the commission.

(5) Practice sites eligible for the program include:

(a) Hospitals;

(b) Federally qualified health centers;

(c) Government entities;

(d) Private practices or physician employment groups with at least 10 full-time equivalent, board-certified physicians that deliver patient care in Washington state;

and (e) Mental and behavioral health facilities, upon approval by the commission.