BILL ANALYSIS Ó
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ASSEMBLY THIRD READING
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97 (Bonilla)
As Amended September 1, 2015
Majority vote
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|Committee |Votes|Ayes |Noes |
| | | | |
| | | | |
| | | | |
|----------------+-----+----------------------+---------------------|
|Business & |14-0 |Bonilla, Jones, | |
|Professions | |Baker, Bloom, Campos, | |
| | |Chang, Dodd, Eggman, | |
| | |Gatto, Holden, | |
| | |Mullin, Ting, Wilk, | |
| | |Wood | |
| | | | |
| | | | |
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SUMMARY: Urges both private and public medical training
institutions to provide equal access to, and to work toward
greater acceptance and integration of, training and education
programs for both Osteopathic Physicians (DOs) and Allopathic
Physicians (MDs). Specifically, this bill:
1)Declares the following:
a) California has a significant shortage and inequitable
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distribution of physicians throughout the state due to the
aging population, current population growth and the
increasing number of insured;
b) According to a study by the Robert Graham Center in
2013, it was estimated that the state would need 8,243 more
primary care physicians by 2030 - a 32% increase of its
current workforce;
c) The state's ability to meet the need for primary care
DOs and MDs is directly affected by the number of medical
residency slots available in physician training programs
across the state, and the current number of graduate
medical education slots must be increased substantially;
d) DOs are one of the fastest growing segments of health
care professionals in the United States: by 2016, more
than 100,000 DOs are expected to be in active medical
practice;
e) Approximately 60% of practicing DOs specialize in
primary care fields such as family medicine, internal
medicine, and pediatrics and many DOs fill a critical need
by practicing in rural and other medically underserved
areas;
f) Beginning in 2020, DO and MD residency programs will be
overseen by a single unified accrediting body;
g) Quality medical training for DO and MD students is
critical to their success as fully trained and licensed
physicians and all medical schools should provide the
support necessary for their students to receive the best
possible medical training;
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h) Many public and private institutions have provided equal
access to the application process for their medical
training programs by all students and physicians, and have
trained exemplary DO and MD students by choosing those
candidates who best suit their programs;
i) In many areas of the state there are outstanding
examples of medical training programs that have been
integrated effectively and are providing DO and MD students
with exceptional training opportunities;
j) Business and Professions Code (BPC) Section 2064.2
states that no medical school or clinical training program
can deny access to elective clerkships or preceptorships in
any medical school or clinical training program in this
state solely on the basis that a student is enrolled in an
osteopathic medical school; and,
aa) BPC Section 2453 states that it is the policy of the
state that holders of DO degrees and MD degrees shall be
accorded equal professional status and privileges as
licensed physicians and surgeons.
2)Resolves that the Legislature urges both private and public
medical training institutions in the state to provide equal
access to DO and MD students to apply to training programs
while still maintaining the integrity and competitiveness of
their application process and the need to first serve enrolled
students.
3)Resolves that the Legislature urges osteopathic medical
schools, allopathic medical schools, and training institutions
to build on current successes of working toward greater
collaboration and coordination of education and training for
California's future physicians and for these medical schools
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to develop a plan to adequately support medical training for
their students and create positive partnerships with medical
training programs that are open to both DO and MD students and
graduates.
4)Resolves that the Legislatures urges efforts by training
institutions and DO and MD medical schools to work toward
greater acceptance and integration of DO and MD students in
their medical training programs.
5)Resolves the Chief Clerk of the Assembly transmit copies of
this resolution to the author for appropriate distribution.
FISCAL EFFECT: None. This bill is keyed non-fiscal by the
Legislative Counsel.
COMMENTS:
Purpose. This resolution is sponsored by the Osteopathic
Physicians and Surgeons of California. According to the author,
"California has a significant shortage and inequitable
distribution of physicians throughout the state due to the aging
population, population growth, and increasing number of insured.
Because of this, it is imperative that the state's training
institutions find ways to increase the accessibility and
availability of their training programs for all medical students
- working together with allopathic and osteopathic medical
schools to grow and enhance access to the great programs they
provide."
Osteopathic Physicians. DOs are similar to MDs in that both are
considered to be "complete physicians." A key difference
between the two professions is that DOs have an additional
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dimension in their training and practice, one not taught in
medical schools which grant MD degrees. Both DOs and MDs take
the prescribed amount of pre-medical training, graduate from an
undergraduate institution with an emphasis on science courses,
and receive four years of training in medical school.
Specifically, DOs must possess a Doctorate of Osteopathic
Medicine Degree from an accredited osteopathic medical school,
complete one year of post-graduate training, which includes at
least four months of general medicine, and complete all levels
of the National Board of Osteopathic Medical Examiners'
Comprehensive Osteopathic Medical Licensing Examination.
The same laws govern the required training for DOs and MDs who
are licensed in California. In recognition of this fact, BPC
Section 2453 states: "?it is the policy of this State that
holders of MD degrees and DO degrees shall be accorded equal
professional status and privileges as licensed physicians and
surgeons." Licensing examinations for DOs are also comparable
in rigor and comprehensiveness to those given to MDs.
Training Programs. Prior to DO or MD students completing their
medical school education and entering into residency programs,
they must first complete the degree requirements for medical
school which may include elective clerkships. As part of
osteopathic medical school education, after successful
completion of the first two years of classroom-based education,
DO students are eligible to apply for elective clerkships as
part of their medical school curriculum. These clerkships are
often "hands-on" rotations which help inform many students about
the area or areas of medicine in which they would like to
practice. Many DO students will apply for these elective
courses at training institutions outside of the two osteopathic
medical schools in California. According to the author, in the
last year, there have been a number of training institutions
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that have specifically excluded DO students from applying to
their programs for elective clerkships or rotations. Further,
the author notes that there was a fee differential for DO
students who applied for these programs compared to their MD
counterparts. Also, it was noted that DO student applicants
were required to have a higher United States Medical Licensing
Examination score compared to their MD counterparts.
BPC Section 2064.2 states that no medical school or clinical
training program shall deny access to elective clerkships or
training programs solely on the basis that a student is enrolled
in an osteopathic medical school. While this does not require
institutions to accept DO students, it makes it clear that DO
students should not be denied access to these elective programs
solely based on their choice of medical education.
In an effort to encourage equity for both allopathic and
osteopathic medical students who are entering into training
programs, this resolution simply urges both public and private
medical training institutions to provide equal access to both
osteopathic and allopathic students in applying for training
programs and urges training institutions, along with allopathic
and osteopathic medical schools, to work together toward greater
acceptance and integration of its osteopath and allopath
students.
Analysis Prepared by:
Elissa Silva / B. & P. / (916) 319-3301 FN:
0001899
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