Senate Bill 5414

Z-0240.
_____________________________________________
SENATE BILL 5414
_____________________________________________
State of Washington
By Senators Schlicher,
Department of Health
Read first time 01/29/13.
63rd Legislature
Becker,
Bailey,
2013 Regular Session
and Keiser;
by request
of
Referred to Committee on Health Care .
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AN ACT Relating to the requirements of allopathic physician

licensure; amending RCW 18.71.050, 18.71.051, 18.71.055, and 18.71.095;
and adding a new section to chapter 18.71 RCW.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
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Sec. 1. RCW 18.71.050 and 1994 sp.s. c 9 s 307

read as follows:
(1) Each applicant who has graduated from a
located in any state, territory, or possession of
the District of Columbia, ((or)) the Dominion of
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are each amended to

school of medicine
the United States,
Canada, the United
Kingdom, Australia, New Zealand, France, Germany, or South Africa,

shall file an application for licensure with the commission on a form
prepared by the secretary with the approval of the commission or
another commission-approved method. Each applicant shall furnish proof
satisfactory to the commission of the following:
(a) That the applicant has attended and graduated from a school of
medicine approved by the commission. The commission must adopt by rule
the list of commission-approved medical schools;
(b) That the applicant has successfully completed ((two years of))
a postgraduate medical training ((in a)) program acceptable to the
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commission((, provided that applicants graduating before July 28, 1985,

may complete only one year of postgraduate medical training)).
The
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commission must define by rule the requirements for commission-approved

postgraduate medical training programs;
(c) That the applicant has successfully completed the exam
requirements set forth by the commission by rule;
(d) That the applicant, if a graduate of a medical school outside
of the United States, the District of Columbia, or the Dominion of
Canada, has completed the certification process with the educational
commission on foreign medical graduates;
(e) That the applicant has the ability to read, write, speak,
understand, and be understood in the English language at a level
acceptable for performing competent medical care in all practice
settings;
(((c))) (f) That the applicant is of good moral character; and
(((d))) (g) That the applicant is physically and mentally capable
of safely carrying on the practice of medicine. The commission may
require any applicant to submit to such examination or examinations as
it deems necessary to determine an applicant's physical and/or mental
capability to safely practice medicine.
(2) Nothing in this section shall be construed as prohibiting the
commission from requiring such additional information from applicants
as it deems necessary. The issuance and denial of licenses are subject
to chapter 18.130 RCW, the Uniform Disciplinary Act.
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Sec. 2. RCW 18.71.051 and 2011 c 138 s 1 are each amended to read
as follows:
Applicants for licensure to practice medicine who have graduated
from a school of medicine located outside of the states, territories,
and possessions of the United States, the District of Columbia, ((or))
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the Dominion of Canada, the United Kingdom, Australia, New Zealand,

France, Germany, or South Africa, shall file an application for
licensure with the commission on a form prepared by the secretary with
the approval of the commission or another commission-approved method.
Each applicant shall furnish proof satisfactory to the commission of
the following:
(1) That he or she has completed in a school of medicine a resident
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course of professional instruction equivalent to that required in this

chapter for applicants generally;
(2)(((a) Except as provided in (b) of this subsection, that he or
she meets all the requirements which must be met by graduates of the
United States and Canadian school of medicine except that he or she
need not have graduated from a school of medicine approved by the
commission;
(b) An applicant for licensure under this section is not required
to meet the requirements of RCW 18.71.050(1)(b) if he or she furnishes
proof satisfactory to the commission that he or she has:
(i)(A) Been admitted as a permanent immigrant to the United States
as a person of exceptional ability in sciences pursuant to the rules of
the United States department of labor; or
(B) Been issued a permanent immigration visa; and
(ii) Received multiple sclerosis certified specialist status from
the consortium of multiple sclerosis centers; and
(iii) Successfully completed at least twenty-four months of
training in multiple sclerosis at an educational institution in the
United States with an accredited residency program in neurology or
rehabilitation;
(3))) That he or she has satisfactorily passed the ((examination
given)) certification process by the educational ((council)) commission
for foreign medical graduates or has met the requirements in lieu
thereof as set forth in rules adopted by the commission;
(3) That the applicant has successfully completed the exam
requirements set forth by the commission by rule; and
(4) That ((he or she has the ability to read, write, speak,
understand, and be understood in the English language)) the applicant
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has the ability to read, write, speak, understand, and be understood in

the English language at a level acceptable for performing competent
medical care in all practice settings.
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as follows:
The commission may approve any school of medicine which is located
in any state, territory, or possession of the United States, the
District of Columbia, ((or in)) the Dominion of Canada, the United
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Kingdom, Australia, New Zealand, France, Germany, or South Africa,

provided that it:
(1) Requires collegiate instruction which includes courses deemed
by the commission to be prerequisites to medical education;
(2) Provides adequate instruction in the following subjects:
Anatomy,
biochemistry,
microbiology
and
immunology,
pathology,
pharmacology, physiology, anaesthesiology, dermatology, gynecology,
internal medicine, neurology, obstetrics, ophthalmology, orthopedic
surgery,
otolaryngology,
pediatrics,
physical
medicine
and
rehabilitation, preventive medicine and public health, psychiatry,
radiology, surgery, and urology, and such other subjects determined by
the commission;
(3) Provides clinical instruction in hospital wards and outpatient
clinics under guidance.
Approval may be withdrawn by the commission at any time a medical
school ceases to comply with one or more of the requirements of this
section.
(4) Nothing in this section shall be construed to authorize the
commission to approve a school of osteopathic medicine and surgery, or
osteopathic medicine, for purposes of qualifying an applicant to be
licensed under this chapter by direct licensure, reciprocity, or
otherwise.
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NEW SECTION. Sec. 4. A new section is added to chapter 18.71 RCW

to read as follows:
The commission may grant a license to an applicant upon a finding
by the commission that, based on the applicant's exceptional education,
training, and practice credentials, the applicant's practice in the
state would benefit the public welfare.
Individually considered
applicants must submit an application as described in this chapter and
undergo the same background check processes required of all other
applicants for licensure. The commission shall adopt rules regarding
qualifications that may be considered exceptional.
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as follows:
The commission may, without examination, issue a limited license to
persons who possess the qualifications set forth herein:
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(1) The commission may, upon the written request of the secretary
of the department of social and health services or the secretary of
corrections, issue a limited license to practice medicine in this state
to persons who have been accepted for employment by the department of
social and health services or the department of corrections as
physicians; who are licensed to practice medicine in another state of
the United States or in the country of Canada or any province or
territory thereof; and who meet all of the qualifications for licensure
set forth in RCW 18.71.050.
Such license shall permit the holder thereof to practice medicine
only in connection with patients, residents, or inmates of the state
institutions under the control and supervision of the secretary of the
department of social and health services or the department of
corrections.
(2) The commission may issue a limited license to practice medicine
in this state to persons who have been accepted for employment by a
county or city health department as physicians; who are licensed to
practice medicine in another state of the United States or in the
country of Canada or any province or territory thereof; and who meet
all of the qualifications for licensure set forth in RCW 18.71.050.
Such license shall permit the holder thereof to practice medicine
only in connection with his or her duties in employment with the city
or county health department.
(3) Upon receipt of a completed application showing that the
applicant meets all of the requirements for licensure set forth in RCW
18.71.050 except for completion of ((two years of)) an approved
postgraduate medical training program, and that the applicant has been
appointed as a resident physician in a program of postgraduate clinical
training in this state approved by the commission, the commission may
issue a limited license to a resident physician. Such license shall
permit the resident physician to practice medicine only in connection
with his or her duties as a resident physician and shall not authorize
the physician to engage in any other form of practice. Each resident
physician shall practice medicine only under the supervision and
control of a physician licensed in this state, but such supervision and
control shall not be construed to necessarily require the personal
presence of the supervising physician at the place where services are
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rendered.
The holder of a limited resident license may practice
outside of the scope of the residency appointment, otherwise known as
moonlighting, if the following conditions are met:
(a)(i) The license holder has received approval from the graduate
medical education training program; and
(ii) The approval is filed with the commission by the graduate
medical education program at the time of appointment.
(b) The commission must be notified if the graduate medical
education program revokes the approval for any reason.
(4)(a) Upon nomination by the dean of the school of medicine at the
University of Washington or the chief executive officer of a hospital
or other appropriate health care facility licensed in the state of
Washington, the commission may issue a limited license to a physician
applicant invited to serve as a teaching-research member of the
institution's instructional staff if the sponsoring institution and the
applicant give evidence that he or she has graduated from a recognized
medical school and has been licensed or otherwise privileged to
practice medicine at his or her location of origin. Such license shall
permit the recipient to practice medicine only within the confines of
the instructional program specified in the application and shall
terminate whenever the holder ceases to be involved in that program, or
at the end of one year, whichever is earlier.
Upon request of the
applicant and the institutional authority, the license may be renewed.
The holder of a teaching-research license under this subsection (4)(a)
is eligible for full licensure if the following conditions are met:
(i) If the applicant has not graduated from a school of medicine
located in any state, territory, or possession of the United States,
the District of Columbia, or the Dominion of Canada, the applicant must
satisfactorily pass the certification process by the educational
commission for foreign medical graduates;
(ii) The applicant has successfully completed the exam requirements
set forth by the commission by rule;
(iii) The applicant has the ability to read, write, speak,
understand, and be understood in the English language at a level
acceptable for performing competent medical care in all practice
settings;
(iv) The applicant has continuously held a position of associate
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professor or higher at a recognized Washington state medical school for

no less than three years; and
(v) The applicant has had no disciplinary action taken in the
previous five years.
(b) Upon nomination by the dean of the school of medicine of the
University of Washington or the chief executive officer of any hospital
or appropriate health care facility licensed in the state of
Washington, the commission may issue a limited license to an applicant
selected by the sponsoring institution to be enrolled in one of its
designated departmental or divisional fellowship programs provided that
the applicant shall have graduated from a recognized medical school and
has been granted a license or other appropriate certificate to practice
medicine in the location of the applicant's origin. Such license shall
permit the holder only to practice medicine within the confines of the
fellowship program to which he or she has been appointed and, upon the
request of the applicant and the sponsoring institution, the license
may be renewed by the commission ((for no more than a total of two
years)).
All persons licensed under this section shall be subject to the
jurisdiction of the commission to the same extent as other members of
the medical profession, in accordance with this chapter and chapter
18.130 RCW.
Persons applying for licensure and renewing licenses pursuant to
this
section
shall
comply
with
administrative
procedures,
administrative requirements, and fees determined as provided in RCW
43.70.250 and 43.70.280.
Any person who obtains a limited license
pursuant to this section may apply for licensure under this chapter,
but shall submit a new application form and comply with all other
licensing requirements of this chapter.
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Z-0240.

2013 Regular Session

Referred to Committee on Health Care .

AN ACT Relating to the requirements of allopathic physician

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

Sec. 1. RCW 18.71.050 and 1994 sp.s. c 9 s 307

are each amended to

Kingdom, Australia, New Zealand, France, Germany, or South Africa,

commission((, provided that applicants graduating before July 28, 1985,

commission must define by rule the requirements for commission-approved

the Dominion of Canada, the United Kingdom, Australia, New Zealand,

course of professional instruction equivalent to that required in this

has the ability to read, write, speak, understand, and be understood in

Kingdom, Australia, New Zealand, France, Germany, or South Africa,

NEW SECTION. Sec. 4. A new section is added to chapter 18.71 RCW

professor or higher at a recognized Washington state medical school for

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