BILL ANALYSIS                                                                                                                                                                                                    �



                                                                      



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          |SENATE RULES COMMITTEE            |                  AB 1533|
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                                 THIRD READING


          Bill No:  AB 1533
          Author:   Mitchell (D)
          Amended:  3/21/12 in Assembly
          Vote:     21

           
           SENATE BUSINESS, PROF. & ECON. DEVELOP COMM  :  9-0, 6/11/12
          AYES:  Price, Emmerson, Corbett, Correa, Hernandez, Negrete 
            McLeod, Strickland, Vargas, Wyland

           SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8

           ASSEMBLY FLOOR  :  74-0, 4/26/12 - See last page for vote


           SUBJECT  :    Medicine:  trainees:  international medical 
          graduates

           SOURCE  :     Medical Board of California
                      University of California 


           DIGEST  :    This bill, until January 1, 2019, authorizes 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.   
          This bill allows IMGs to engage in hands-on clinical 
          training during their participation in the IMG pilot 
          program they meet specified requirements. 

           ANALYSIS  :    Existing law:

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          1.The Medical Practice Act provides for licensing and 
            regulation of physicians and surgeons by the Medial Board 
            of California (Board).

          2.Requires an applicant for a license as a physician or a 
            surgeon to complete specified medical curriculum, 
            clinical instruction program and training program. 

          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. 

          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 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 

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               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.

          1.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.

          2.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.

          3.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. 

           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 (Business and Professions Code (BPC) 
          Section 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 Section 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 Board for 

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          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 assigned to these 
          settings 16-24 weeks.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes   
          Local:  No

           SUPPORT  :   (Verified  6/25/12)

          Medical Board of California (co-source) 
          University of California (co-source) 
          California Academy of Family Physicians
          California Medical Association
          California State Rural Health Association
          Los Angeles County Board of Supervisors

           ARGUMENTS IN SUPPORT  :    The bill's 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.


           ASSEMBLY FLOOR  :  74-0, 4/26/12
          AYES:  Achadjian, Alejo, Allen, Ammiano, Atkins, Beall, 
            Bill Berryhill, Block, Blumenfield, Bonilla, Bradford, 
            Brownley, Buchanan, Butler, Charles Calderon, Campos, 
            Carter, Chesbro, Conway, Cook, Davis, Dickinson, 
            Donnelly, Eng, Feuer, Fletcher, Fong, Fuentes, Beth 
            Gaines, Galgiani, Garrick, Gatto, Gordon, Gorell, Grove, 

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            Hagman, Hall, Hayashi, Roger Hern�ndez, Hill, Huber, 
            Hueso, Huffman, Jeffries, Knight, Lara, Logue, Bonnie 
            Lowenthal, Ma, Mansoor, Mendoza, Miller, Mitchell, 
            Monning, Morrell, Nestande, Nielsen, Norby, Olsen, Pan, 
            Perea, V. Manuel P�rez, Portantino, Silva, Skinner, 
            Solorio, Swanson, Torres, Valadao, Wagner, Wieckowski, 
            Williams, Yamada, John A. P�rez
          NO VOTE RECORDED:  Cedillo, Furutani, Halderman, Harkey, 
            Jones, Smyth


          JJA:n  6/26/12   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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