BILL ANALYSIS �
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|Hearing Date:June 11, 2012 |Bill No:AB |
| |1553 |
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SENATE COMMITTEE ON BUSINESS, PROFESSIONS
AND ECONOMIC DEVELOPMENT
Senator Curren D. Price, Jr., Chair
Bill No: AB 1533Author:Mitchell
As Amended: March 21, 2012Fiscal: Yes
SUBJECT: Medicine: trainees: international medical graduates.
SUMMARY: Until January 1, 2019, would authorize a clinical
instruction pilot program for certain bilingual international medical
graduates (IMGs) at the University of California Los Angeles (UCLA) as
part of an existing pre-residency training program, at the option of
UCLA. Would allow IMBs to engage in hands-on clinical training
during their participation in the IMG pilot program they meet
specified requirements.
Existing law:
1) The Medical Practice Act provides for licensing and regulation of
physicians and surgeons by the Medial Board of California (Board).
(Business and Professions Code (BPC) � 2000)
2) Requires an applicant for a license as a physician or a surgeon to
complete specified medical curriculum, clinical instruction program
and training program. (BPC � 2080 et seq.)
3) Provides that nothing in the Medical Practice Act shall be
construed to prohibit a foreign medical graduate from engaging in
the practice of medicine subject to certain conditions. (BPC �
2066)
This bill:
1)Authorizes a clinical instruction pilot program for certain bilingual
international medical graduates at the David Geffen School of
Medicine of the UCLA as part of an existing pre-residency training
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program.
2)Provides that nothing in the Medical Practice Act shall be construed
to prohibit a foreign medical graduate participating in the pilot
program from engaging in the practice of medicine when required as
part of the pilot program.
3)Allows IMGs to participate in the pilot program if they meet the
following requirements:
a) Graduated from a medical school recognized by the Medical
Board of California.
b) Taken and passed the United States Medical Licensing
Examination Steps 1 and 2 (Clinical Knowledge and Clinical
Science).
c) Submitted an application and material to the Educational
Commission of Foreign Medical Graduates.
d) Receive all clinical instruction at health care facilities
operated by the UCLA or other approved teaching sites.
e) Participate in clinical instruction offered by the pilot
program for a 16 to 24 week time period.
f) Be supervised by a licensed physician on faculty at UCLA or
affiliated with UCLA.
g) Be evaluated on a regular basis by the supervising faculty.
4)Requires UCLA to provide the Board with identifying information about
the participants including but not limited to the names of the
participants, course successfully completed and dates of
instruction.
5)Authorizes the Board to consider participation in the clinical
instruction pilot program as remediation for medical education
deficiencies in a participant's subsequent application for licensure
as a physician and surgeon.
6)Requests that the UCLA report to the Board and the Legislature on or
before January 1, 2018, including the number of participants, those
who were issued a physician and surgeons certificate by the Board,
the number who practice in designated medically underserved areas
and the potential for retention or expansion of the program.
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FISCAL EFFECT: According to the Assembly Appropriations Committee
analysis dated April 18, 2012 this bill will have "negligible fiscal
impact" as the program is already in existence and is currently funded
by a private source.
COMMENTS:
1.Purpose. This bill is co-sponsored by the Medical Board of
California and the University of California . According to the
author, the David Geffen School of Medicine at UCLA has operated an
innovative program to prepare bilingual (English-Spanish speaking)
individuals who have graduated from an accredited medical school
outside the United states, to enter accredited family medicine
programs in California. This program functions as a pre-residency
training program. However, the program participants do not fall
within the provisions of existing law because they are not students
or medical residents. They are medical graduates in training for
residency programs. Because of this, they are not recognized by
state law as trainees who are authorized to engage in hands-on
clinical training as part of their course of study. Instead, they
function as observers of clinical practice. This bill will allow
trainees to be placed in approved clinical teaching environments
where they will be supervised by faculty who are licensed
physicians.
2.Background. California law allows for regularly matriculated medical
students to engage in the practice of medicine whenever and wherever
prescribed as part of their required/approved course of student (BPC
� 2064). However, for foreign trained medical students who complete
pre-residency training programs in the United States, they are not
covered under the provisions of BPC � 2064.
In 2006, the David Geffen school of Medicine at UCLA developed a
program to prepare bilingual IMGs to enter accredited family
medicine programs in California in order to pursue licensure and
Board certification as family physicians. The program recruits
proficient bilingual IMGs from international medical schools with
curricula that meet the educational requirements set forth by the
Medical Board of California for purposes of physician licensure. To
be eligible for the program, participants must have United States
citizenship, permanent resident or refugee status. As part of the
program, all participants complete a Clinical Observership program.
Trainees are placed in approved clinical teaching environments at
UCLA health care facilities or approved affiliates, which provide
and ensure supervision by licensed physician faculty. Students are
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assigned to these settings 16-24 weeks.
3.Arguments in Support. The Co-sponsors indicate that the addition of
the hands-on clinical practice experience will allows the UCLA IMGs
to receive valuable clinical learning opportunities that will ensure
they received the best training and chances for a family medicine
residency match. They also state that the program will benefit
California family medicine programs seeking to increase the
recruitment of bilingual physicians to their programs.
Additionally, because the graduate commit to 24-36 months of
post-residency employment in a California health care facility
located in a designated medically underserved area, the continued
success of the program offers long term benefits for underserved
communities throughout the state.
The California Academy of Family Physicians highlights California's
shortage of primary care physicians and general practice physicians
in underserved areas. They note that the program will help
alleviate the shortage of bilingual physicians in family medicine
programs.
The California State Rural Health Association indicates that there
is a need to address the stark shortages in the workforce in rural
setting. They note that the bill is also consistent with efforts at
the federal level to protect the supply of foreign trained
providers.
The County of Los Angeles Board of Supervisors state that the bill
would help to provide additional health care providers for medically
underserved areas, which is critical as California prepares to
implement Federal Health Care Reform in 2014.
The California Primary Care Association writes: "We need more
physicians especially primary care physicians who are bilingual and
make a commitment to serving the underserved. These populations are
growing in California and we need to create innovative programs that
will meet this demand."
4.Previous Legislation. AB 2260 (Negrete McLeod, Chapter 565, Statues
of 2006) clarified 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) established the
Licensed Physicians and Dentists from Mexico Pilot Program to allow
up to 30 licensed physicians and up to 30 licensed dentists from
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Mexico to practice medicine or dentistry in California for up to
three years, and established a separate pilot program for IMGs.
SUPPORT AND OPPOSITION:
Support:
Medical Board of California (Sponsor)
University of California (Sponsor)
California Academy of Family Physicians
California Medical Association
California State Rural Health Association
Los Angeles County Board of Supervisors
California Primary Care Association
Opposition:
None received as of June 4, 2012.
Consultant:Le Ondra Clark