BILL NUMBER: SB 1410 AMENDED
BILL TEXT
AMENDED IN SENATE MAY 19, 2010
INTRODUCED BY Senator Cedillo
FEBRUARY 19, 2010
An act to amend Section 2177 of, and to add Sections 2177.5 and
2177.7 to, the Business and Professions Code, relating to medicine,
and declaring the urgency thereof, to take effect immediately.
LEGISLATIVE COUNSEL'S DIGEST
SB 1410, as amended, Cedillo. Medicine: licensure examinations.
Existing law, the Medical Practice Act, requires the Medical Board
of California to issue a physician's and surgeon's certificate to a
qualified applicant. Under the act, an applicant for a physician's
and surgeon's certificate is required to include specified
information with his or her application and to obtain a passing score
on an entire examination or on each part of an examination. Existing
law authorizes applicants to take the written examinations conducted
or accepted by the board in separate parts , and requires the
board to adopt by resolution the passing score for each examination
or each part of an examination . Existing law requires an
applicant to obtain a passing score on Part
Step III of the United States Medical Licensing Examination
within not more than 4 attempts of taking that part of the
examination.
This bill would delete the prohibition on taking Part
Step III of the United States Medical Licensing
Examination more than 4 times, and would make that change retroactive
to January 1, 2007. The bill would also require the board to accept
as a passing score from an applicant the passing score that was
adopted by the board and in effect on the date the applicant
registered for that examination or part of the examination, and would
make that requirement retroactive to January 1, 2007. The bill would
further require the board to adopt a formal process for
determining whether to adopt recommended passing scores from the
Federation of State Medical Boards act by passing a
resolution every time it adopts a passing score for an entire
examination or for each part of an examination that is required for
certification, subject to specified requirements and in conformity
with the court's holding in Marquez v. Medical Board of California
(2010) 182 Cal.App.4th 548 .
This bill would declare that it is to take effect immediately as
an urgency statute.
Vote: 2/3. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature finds and declares all of the
following:
(a) Under Section 2177 of the Business and Professions Code, an
applicant who is seeking a physician's and surgeon's certificate in
California must obtain a passing score on Part
Step III of the United States Medical Licensing
Examination (USMLE) within not more than four attempts in order to be
eligible for a certificate. The examination has three parts
steps . However, only Part
Step III has a limit on the number of times that an
applicant may attempt to pass the part step
.
(b) The USMLE is administered by the Federation of State Medical
Boards (FSMB), a national nonprofit entity. Periodically, the FSMB
recommends passing scores to the various state medical boards. It is
left to the discretion of each state board to determine whether to
adopt the recommended score. Historically, the Medical Board of
California (MBC) has not had a formal procedure regarding adoption of
the FSMB recommended passing score.
(c) When an applicant registers for the USMLE, he or she has an
eligibility period of three months in which to take the examination.
Multiple examination dates are available within the three-month
period. The lack of a formal adoption process within the MBC ,
combined with a three-month window to take the examination
after registration , has created some confusion as the MBC
may increase the accepted passing score at any time without public
record, input, or notification to applicants that
who have already registered for the examination.
In fact, there is an instance where an applicant registered for the
USMLE under one passing score and found out after her examination
date that the accepted passing score had been increased without her
knowledge. This applicant would have passed the examination under the
criteria in place when she registered for the examination but
because the passing score was increased between the time she
registered and sat for the examination, she did not pass.
(d) Furthermore, prior to the enactment of Chapter 843 of the
Statutes of 2006 (AB 1796), California did not limit the number of
times an applicant may take any part of the USMLE. Under the new law,
which places an arbitrary limit of attempts on Part
Step III of the examination, highly qualified
and much needed physicians and surgeons are being denied a license to
practice medicine in California. Their only option is to move to
another state, become licensed and practice there, and return four
years later.
(e) Failing to pass the USMLE under an arbitrary cap on the number
of attempts does not translate into a lack of competency in
providing high-quality medical care. Furthermore, existing law does
not take into consideration learning disabilities, a history of poor
performance on standardized tests, hardships, or other variables that
may impede the ability of an individual to pass the examination,
essentially discriminating against certain applicants.
(f) Twenty-eight Twenty-seven states
in the United States and one territory two
territories have more lenient policies regarding the USMLE,
which may include having no cap or allowing for more attempts than
California. Those states and the one territory
territories include AL, AZ, CO, CT, DE, FL, GU, HI, IA,
IL, KS, MA, MI, MN, MS, MT, NM, NV, NJ, NY, NC, ND, OH, OK, PA, TN,
VA, VI, and WY. In fact, AZ, CO, CT, DE, GU, HI, IA, KS, MA, MI, MN,
MS, MT, NJ, NY, NC, ND, OH, PA, TN, VI, VA, and WY have no limit on
the number of times an applicant may take the examination.
(g) Lastly, even though AB Assembly Bill
1796 was signed by the Governor, he expressed concerns with the
measure. The Governor issued a signing message stating that
AB Assembly Bill 1796 failed to provide the
appropriate exceptions to the requirement that physicians and
surgeons applying for licensure pass Part
Step III of the USMLE within four attempts, and that AB
Assembly Bill 1796 may have unintended
consequences. The Governor requested that the MBC address his
concerns. Subsequently, the MBC requested that language be added to
Section 2177 of the Business and Professions Code that would
cross-reference Section 2135.5 of the Business and Professions Code
to exempt from the four-attempt limitation an applicant who holds an
unlimited and restricted license as a physician and surgeon in
another state and who has held that license continuously for a
minimum of four years prior to the date of application. This
amendment was added by Chapter 588 of the Statutes of 2007 (SB 1048),
which was an omnibus bill for the Senate Committee on Business and
Professions.
(h) The inclusion of those changes by SB
Senate Bill 1048 has proven to be an inadequate approach to
addressing the need for flexibility and consideration of other
factors that may contribute to an individual failing to pass
Part Step III of the USMLE within four
attempts. It is now viewed by the Legislature as unreasonable to
require an individual to leave the state, go through all the steps
necessary to obtain licensure in another state, and then return to
California after four years to obtain a license to practice medicine.
(i) It is further unreasonable for the MBC to change the passing
score for an examination once an applicant has registered for that
examination without any formal procedure or notification to the
applicant.
SEC. 2. Section 2177 of the Business and Professions Code is
amended to read:
2177. (a) A passing score is required for an entire examination
or for each part of an examination, as established by resolution of
the board.
(b) Applicants may elect to take the written examinations
conducted or accepted by the board in separate parts.
(c) An applicant shall have obtained a passing score on
Part Step III of the United States Medical
Licensing Examination in order to be eligible for a physician's and
surgeon's certificate.
(d) The changes made to subdivision (c) by the act adding this
subdivision shall apply retroactively to January 1, 2007.
SEC. 3. Section 2177.5 is added to the Business and Professions
Code, to read:
2177.5. (a) Notwithstanding subdivision (a) of Section 2177, the
board shall accept as a passing score on an examination or part of an
examination from an applicant the passing score that was adopted by
the board and in effect on the date the applicant registered for that
examination or part of the examination.
(b) This section shall apply retroactively to January 1, 2007.
SEC. 4. Section 2177.7 is added to the Business and Professions
Code, to read:
2177.7. The (a)
Pursuant to Sections 2177 and 2184, the board shall adopt a
formal process for determining whether to adopt recommended
passing scores from the Federation of State Medical Boards.
resolution every time the board adopts a passing score for an
entire examination or for each part of an examination that
is required for certification under this article.
(b) The resolution required pursuant to subdivision (a) shall be
adopted or readopted at a public meeting of the board, and subject to
public input and an affirmative vote of a majority of board members
present at the meeting constituting at least a quorum.
(c) The board shall not delegate to any other entity, whether by
contract or resolution, the responsibility to adopt the passing score
described in this section. If the board adopts the recommended
passing score of another entity as its passing score for an
examination or any part of an examination and that the entity
subsequently changes that recommended passing score, the board's
passing score shall not be changed unless the board readopts that
recommended passing score, or adopts some other score, by resolution
pursuant to this section.
(d) The passing score to be adopted pursuant to this section shall
be stated as a numerical score and shall not be stated as a
percentage of correct answers.
SEC. 5. (a) It is the intent of the
Legislature in enacting Section 4 of this act that the Medical Board
of California comply with the court's holding in Marquez v. Medical
Board of California (2010) 182 Cal.App.4th 548.
(b) Sections 2177 and 2184 of the Business and Professions Code
unambiguously require the Medical Board of California to establish a
passing score for Step III of the United States Medical Licensing
Examination and to do so by resolution.
(c) The board shall adopt a passing score by means of a formal,
memorialized public vote. This single, unambiguous statutory
requirement is intended to keep the board accountable to the
Legislature, the medical professions, medical license applicants, and
the public, and to prevent the board from delegating this
responsibility to anyone else.
SEC. 5. SEC. 6. This act is an
urgency statute necessary for the immediate preservation of the
public peace, health, or safety within the meaning of Article IV of
the Constitution and shall go into immediate effect. The facts
constituting the necessity are:
In order to allow for the licensure of competent physicians and
surgeons at the earliest possible time, it is necessary that this act
take effect immediately.