S4866

An Act concerning licensure of certain physicians and surgeons and supplementing Title 45 of the Revised Statutes.

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

1. As used in this act:

“Board” means the State Board of Medical Examiners.

“Health care provider” means an individual or entity that, acting within the scope of its licensure or certification, provides a covered service defined by the health benefits plan. “Health care provider” includes, but is not limited to, a physician, surgeon, and other health care professionals licensed pursuant to Title 45 of the Revised Statutes, and a hospital and other health care facilities licensed pursuant to Title 26 of the Revised Statutes.

“International medical graduate” means any individual who:

(1) has been granted a medical doctorate or substantially similar degree by a medical program of good standing within the last seven years;

(2) is in good standing with the medical licensing or regulatory institution of the resident country of the individual within the last seven years;

(3) has completed a residency or substantially similar post-graduate medical training in the resident country of the individual or has practiced as a medical professional performing the duties of a physician or surgeon in the resident country for no less than five of the last seven years; and

(4) possesses basic fluency in the English language.

“International medical program” means any medical school, residency program, medical internship program, or entity that provides physicians and surgeons with a medical education or training outside of the United States that is substantially similar to the education and training required to practice as a physician or surgeon in New Jersey as determined by the board.

“Physician or surgeon” shall be deemed to include practitioners in any branch of medicine or surgery or method of treatment of human ailment, disease, pain, injury, deformity, mental or physical condition. “Physician or surgeon” includes individuals who have a medical doctorate or substantially similar degree and have completed a residency program or otherwise practiced as a medical professional performing the duties of a physician or surgeon for at least two years.

2. a. The board shall grant a provisional license, which shall be valid for three years, to any international medical graduate to practice medicine in the State if the graduate:

(1) has an offer for employment as a physician or surgeon at any healthcare provider that is licensed to operate in the State; or

(2) is already licensed to practice medicine in certain countries, as determined by the board.

b. The board shall not grant a provisional license to practice medicine in the State to any international medical graduate unless the individual possesses a federal immigration status that authorizes the individual to practice as a physician or surgeon in the United States.

c. During the provisional licensure period, an individual with a provisional license shall practice as a physician or surgeon only under the direct supervision of a physician or surgeon fully licensed and in good standing to practice medicine in the State.

3. a. (1) The board may revoke a provisional license issued pursuant to subsection a. of section 2 of this act based on clear and compelling evidence that medical services provided by the licensee violated State medical safety, competency, or conduct standards established by the board.

(2) A provisional licensee may appeal the revocation of a provisional license to the board within 120 days of the revocation.

b. (1) A provisional license shall automatically convert to a full license to practice medicine in the State upon:

(a) the completion by an international medical graduate of three years working as a physician or surgeon under the provisional license; and

(b) without, as determined by the board, impairment, malpractice, fraud, or other misconduct reported to the board.

(2) Upon receipt of a full license to practice medicine, an international medical graduate shall not be required to maintain employment with the original hospital or health care facility where the graduate was employed under a provisional license.

c. Nothing in this section shall require the board to license, on a provisional basis or with a full license, an international medical graduate without having received evidence, as determined by the board, of:

(1) training equivalent to the requirements of individuals trained in the United States as required pursuant to R.S.45:9-1 et seq.;

(2) satisfactory passage of examinations as required by the Accreditation Council for Graduate Medical Education;

(3) legal status to work in the United States;

(4) satisfactory results of a background investigation, as required pursuant to section 2 of P.L.2002, c.104 (C.45:1-29);

(5) completion of an application; and

(6) payment of all required fees.

4. a. (1) No healthcare provider shall employ a physician or surgeon who obtained a primary medical degree outside of the United States, and who is licensed to practice medicine in the State pursuant to this act, at a rate of compensation that is less than 90 percent of the average annual compensation for physicians or surgeons practicing the same specialty within the same geographic region of the State.

(2) The average annual compensation shall be determined by the Department of Labor and Workforce Development based on data collected from publicly available sources, including, but not limited to, national physician compensation surveys and Medicare reimbursement data. The department shall publish and update this data annually.

b. Subsection a. of this section shall not apply to a physician or surgeon participating in a residency or fellowship program approved by the Accreditation Council for Graduate Medical Education or the American Osteopathic Association.

5. a. An international medical graduate granted a provisional license pursuant to this act shall provide a patient, prior to the provision of any medical services, with a written disclosure statement containing the following information:

(1) the name of the medical school from which the graduate graduated, the location of the school, and the year of graduation;

(2) the residency and any fellowship programs completed by the graduate, including the names of the institutions hosting the residency or fellowship and dates the graduate attended; and

(3) that the credential issued to the graduate was deemed, by the board, to be equivalent to the standards of physicians and surgeons in the United States.

b. The disclosure statement required pursuant to this section shall be provided only during the period in which the international medical graduate is practicing under a provisional license and shall be conspicuously displayed in the office of the supervising physician or surgeon and on the website, if applicable, for the practice of the supervising physician or surgeon.

6. This act shall take effect on the first day of the thirteenth month next following enactment and shall apply to applications submitted by international medical graduates on or after that date, except that the board may take any anticipatory administrative action in advance as shall be necessary for the implementation of this act.

STATEMENT

This bill establishes a pathway to licensure by the State Board of Medical Examiners for international medical graduates. “International medical graduate” is defined in the bill to mean any individual who: 1) has been granted a medical doctorate or substantially similar degree by a medical program of good standing within the last seven years; 2) is in good standing with the medical licensing or regulatory institution of the resident country of the individual within the last seven years; 3) has completed a residency or substantially similar post-graduate medical training in the resident country of the individual or has practiced as a medical professional performing the duties of a physician or surgeon in the resident country for no less than five of the last seven years; and 4) possesses basic fluency in the English language.

Under the bill, the board will grant a provisional license, valid for three years, to any international medical graduate to practice medicine in New Jersey if the individual: 1) has an offer for employment as a physician or surgeon at any healthcare provider that is licensed to operate in the State; or 2) is already licensed to practice medicine in certain countries, as determined by the board. The individual is to also possess a federal immigration status that authorizes the individual to practice as a physician or surgeon in the United States. During the provisional licensure period, the licensee is only to practice as a physician or surgeon under the direct supervision of a physician or surgeon fully licensed and in good standing to practice medicine in the State. The board is authorized to revoke a provisional license based on clear and compelling evidence that medical services provided by the licensee violated State medical safety, competency, or conduct standards established by the board and an appeals process in response to a revocation is also established for the licensee.

A provisional license automatically converts to a full license to practice medicine in New Jersey upon 1) the completion by an international medical graduate of three years working as a physician or surgeon under the provisional license and 2) without, as determined by the board, impairment, malpractice, fraud, or other misconduct reported to the board. The bill delineates the requirements the board is authorized to establish for the issuance of a provisional license, or the conversion of this license into a full license. This includes requiring an individual to 1) acquire training equivalent to the requirements of individuals trained in the United States and 2) satisfactorily pass examinations as required by the Accreditation Council for Graduate Medical Education. Lastly, the bill requires that a licensee with a provisional license disclose this information to patients, prior to the provision of any medical services.