BILL ANALYSIS Ó
AB 1838
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CONCURRENCE IN SENATE AMENDMENTS
AB 1838 (Bonilla)
As Amended May, 14, 2014
Majority vote
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|ASSEMBLY: |71-0 |(March 28, |SENATE: |32-0 |(June 26, |
| | |2014) | | |2014) |
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Original Committee Reference: B., P. & C.P.
SUMMARY : Provides that accreditation by the Liaison Committee
on Medical Education (LCME) or the Committee on Accreditation of
Canadian Medical Schools (CACMS) is deemed sufficient to meet
existing state curriculum and clinical medical school
requirements for the licensure of physicians.
FISCAL EFFECT : None. This bill is keyed non-fiscal by the
Legislative Counsel.
The Senate amendments deem that a medical school or medical
school program accredited by the Commission on Osteopathic
College Accreditation also meets existing state curriculum and
clinical medical school requirements for the licensure of
physicians.
1)Purpose of this bill. This bill will permit the Medical Board
of California (MBC) to grant licensure to individuals who
attend an accelerated training program at an accredited
medical school. While all programs currently recognized by
MBC are accredited by either LCME or CACMS, current state law
also contains time requirements that make students
participating in such accelerated programs ineligible for
state licensure. This bill would simply deem all LCME and
CACMS accredited schools and programs compliant with state
curriculum and clinical requirements, thereby making
accelerated program graduates eligible for licensure
regardless of existing time requirements. This bill is
jointly sponsored by the University of California (UC) and
MBC.
2)Author's statement. According to the author, "AB 1838 creates
a clear path to licensure for graduates of accelerated medical
programs. This pathway will fix two problems: it will bring
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more physicians to California and it lessens the cost of
medical school for qualified students. The United States has
a significant physician shortage and Medical Economics
reported that California will need over 8,000 more primary
care physicians by 2030. AB 1838 will allow physicians that
have already graduated from accredited accelerated programs in
other states, as well as new California graduates, to be
licensed to practice in California. This is one step towards
reducing the physician shortage in California."
3)Accrediting agencies.
a) LCME. United States and Canadian medical education
programs are accredited by LCME, which is a voluntary,
peer-review process that determines whether a medical
program meets established standards. LCME does not
accredit institutions, but it does accredit medical
education programs. Accreditation by the LCME establishes
eligibility for certain federal grants and programs,
including Title VII funding administered by the United
States Public Health Service. To be eligible to take the
United States Medical Licensing Examination, students must
attend schools with LCME accreditation.
b) CACMS. Canadian medical education programs leading to
the Doctor of Medicine (MD) degree are accredited through a
partnership between LCME and CACMS. This partnership is
necessary so that Canadian programs have the flexibility to
address differences in some aspects of their medical
education programs in order to meet Canada's unique health
system requirements.
4)The existing medical education model. Nearly all medical
schools currently require a liberal arts degree for admission
and provide a four-year graded curriculum in medicine and
surgery. Many states also require candidates for a medical
license to complete a one-year internship in a hospital
setting after completing medical school. Four years of
medical school comes at a significant cost, as the median debt
for medical school graduates in 2013 was $175,000, according
to the Association of American Medical Colleges.
5)Accelerated programs. Currently, over 30 medical schools
operate six or seven year medical programs in which the
undergraduate training is reduced to two or three years.
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According to a 2012 article in the Journal of the American
Medical Association titled "Shortening Medical Training by
30%," this is similar to the European model, in which most
physicians receive six years of medical school training after
high school. There are also programs in existence today (see
below) that reduce time in medical school from four to three
years, or reduce the time spent studying specialty fields by
one year or more.
These programs do not replace the traditional medical school
training schedule, but rather enable uniquely qualified
students to receive the required amount of education in a
concentrated curriculum. This is done by creating a modified
year-round education schedule that often eliminates summer
breaks and involves reduced time for electives. These
programs are all relatively new, and it is not yet known how
many students have graduated from them. MBC reports that it
has not yet received any applications for California licensure
from accelerated program graduates.
a) Nationwide Programs. New York University, Texas Tech
University Health Sciences Center, and Columbia
University's College of Physicians and Surgeons already
have three-year programs for students who already know
which specialty they plan to enter and meet enhanced
admission requirements. For example, some entering
students may already have graduate degrees in sciences, or
substantial prior experience in health care. Many of these
accelerated programs allow students to save a year of
medical school tuition.
b) California and UC Programs. UC operates six of
California's nine MD-granting medical schools and provides
specialty training for nearly half of the state's medical
residents. The UC Davis (UCD) School of Medicine recently
created a new track, called the "Accelerated
Competency-based Education In Primary Care (ACE-PC)," which
was awarded an innovation grant from the American Medical
Association. This program plans to enroll its first class
of four students in summer 2014. The majority of UCD's
medical students will continue to be enrolled in the
traditional, four-year degree program.
Analysis Prepared by : Sarah Huchel / B., P. & C.P. / (916)
AB 1838
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319-3301 FN:
0004071