BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 1533
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          Date of Hearing:   April 18, 2012

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Felipe Fuentes, Chair

                  AB 1533 (Mitchell) - As Amended:  March 21, 2012 

          Policy Committee:                              Business and 
          Professions  Vote:                            9-0

          Urgency:     No                   State Mandated Local Program: 
          No     Reimbursable:              No

           SUMMARY  

          This bill allows the University of California Los Angeles (UCLA) 
          medical school to, until 2019, provide hands-on clinical 
          training to international medical graduates (IMGs) who are 
          otherwise not allowed to engage in patient care activities.  

           FISCAL EFFECT  
           
           Negligible state fiscal impact.  The IMG program at UCLA is 
          already in existence and is currently funded by private sources. 
             This bill affects the content of the training UCLA can 
          provide to IMGs, but it does not expand or impact funding for 
          the program, or have a significant impact on physician supply or 
          access to health care. 

           COMMENTS  
           
          1)Rationale  . The Medical Board of California and the University 
            of California, co-sponsors of this legislation, state that 
            current law does not allow well-prepared graduates of 
            international medical schools to engage in hands-on clinical 
            training as part of their course of study.  Under current law, 
            this type of training can be offered to both medical students 
            and to medical residents, but IMGs do not fit in either of 
            these categories, since they have already graduated from 
            medical school in their country but are not yet medical 
            residents.  The sponsors indicate that obtaining a residency 
            slot in California is extremely competitive, and that a lack 
            of hands-on training in a U.S. practice setting puts otherwise 
            well-prepared bilingual IMGs at a disadvantage when competing 
            for a California slot in the National Residency Match Program. 








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          2)Background  .  To become a medical doctor in California, an 
            individual must complete the following basic steps: (1) 
            graduate from a medical school recognized by the state Medical 
            Board, (2) pass the United States Medical Licensing Exam 
            (USMLE) Steps 1 through 3, (3) obtain a residency slot and 
            complete a residency training program, and (4) become licensed 
            by the state Medical Board.  

            The UCLA IMG program recruits bilingual English/Spanish IMGs 
            and offers them comprehensive training designed to help them 
            pass the first two steps of the USMLE, and to prepare them to 
            compete for a California residency training program intern 
            position in family medicine.  The objective of the UCLA IMG 
            program is to increase the number of bilingual and bicultural 
            Hispanic family physicians practicing primary care in 
            underserved communities, in California in order to address a 
            shortage of such physicians.  Upon completion of their 
            residency, IMG graduates are also obligated to serve for 18-36 
            months in an underserved community in California.

            Currently, IMGs in the program are not allowed to examine 
            patients on their own without faculty supervision, and they 
            are required to function as observers. Removing this barrier 
            will allow the program to improve the effectiveness of its 
            clinical training for IMGs.  At this time, the program at UCLA 
            is unique statewide, and has placed more than 30 individuals 
            into residencies in California.

           3)Previous Legislation  .   AB 2260 (Negrete McLeod) Chapter 565, 
            Statutes of 2006, clarifies the requirements for unlicensed 
            foreign doctors to practice medicine in fellowship, faculty, 
            or department head or division chief capacity in a California 
            medical school.

            AB 1045 (Firebaugh) Chapter 1157, Statutes of 2002, 
            establishes the Licensed Physicians and Dentists from Mexico 
            Pilot Program to allow up to 30 licensed physicians and up to 
            30 licensed dentists from Mexico to practice medicine or 
            dentistry in California for up to three years, and establishes 
            a separate pilot program for IMGs.  According to the Medical 
            Board, AB 1045 was never implemented because private 
            philanthropic funding was not available to support 
            implementation as required by law.








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           Analysis Prepared by  :    Lisa Murawski / APPR. / (916) 319-2081