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AB-1646 Physicians and surgeons: postgraduate training: guest rotations.(2023-2024)

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Date Published: 09/28/2023 10:00 AM
AB1646:v93#DOCUMENT

Assembly Bill No. 1646
CHAPTER 257

An act to amend Section 2065 of the Business and Professions Code, relating to professions and vocations.

[ Approved by Governor  September 27, 2023. Filed with Secretary of State  September 27, 2023. ]

LEGISLATIVE COUNSEL'S DIGEST


AB 1646, Stephanie Nguyen. Physicians and surgeons: postgraduate training: guest rotations.
Existing law, the Medical Practice Act, establishes the Medical Board of California within the Department of Consumer Affairs and sets forth its powers and duties relating to the licensure and regulation of the practice of medicine by physicians and surgeons.
Existing law prohibits a postgraduate training licensee, intern, resident, postdoctoral fellow, or instructor from engaging in the practice of medicine, or receiving compensation for that practice, unless they hold a valid, unrevoked, and unsuspended physician’s and surgeon’s certificate issued by the board, except as provided. Among those exceptions, existing law authorizes a graduate of a board-approved medical school to engage in and receive compensation for the practice of medicine as a part of a postgraduate training program if, among other requirements, the graduate obtains a postgraduate training license, as provided. Existing law also authorizes a graduate who has completed the first year of postgraduate training, in an approved residency or fellowship, to engage in the practice of medicine as part of that residency or fellowship, and to receive compensation for that practice. If the resident or fellow fails to receive a license to practice medicine within 27 months from the commencement of the residency or fellowship, except as otherwise specified, or if the board denies their application for licensure, these privileges and exemptions automatically cease.
Under an existing regulation adopted by the board, all approved postgraduate training for which the applicant received credit counts toward the exemption period described above, including any training obtained within or outside of California, whether a full or partial year of training and regardless of whether the postgraduate training program was successfully completed. As an exception to that regulation, a board-approved medical school graduate who is engaged in approved postgraduate training outside of California is authorized to participate in guest rotations in an approved postgraduate training program in California, not to exceed a total of 90 days for all rotations.
Under this bill, a board-approved medical school graduate who is engaged in an Accreditation Council for Graduate Medical Education (ACGME)-accredited postgraduate training program outside of California, would similarly be authorized, as a participant in guest rotations in an approved postgraduate training program in California or a participating training site affiliated with an ACGME-accredited program, to engage in the practice of medicine as part of that training program, not to exceed a total of 90 days for all rotations, and to receive compensation for that practice without obtaining a postgraduate training license.
Existing law requires an applicant for a physician’s and surgeon’s license who received credit for 12 months of approved postgraduate training in another state or in Canada and who is accepted into an approved postgraduate training program in California to obtain their physician’s and surgeon’s license within 90 days after beginning that postgraduate training program.
This bill would extend the period for an applicant for a physician’s and surgeon’s license who received credit of postgraduate training, as described above, to 180 days after beginning the postgraduate training program.
This bill would incorporate additional changes to Section 2065 of the Business and Professions Code proposed by SB 815 to be operative only if this bill and SB 815 are enacted and this bill is enacted last.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

The people of the State of California do enact as follows:


SECTION 1.

 Section 2065 of the Business and Professions Code is amended to read:

2065.
 (a) Unless otherwise provided by law, a postgraduate training licensee, intern, resident, postdoctoral fellow, or instructor shall not engage in the practice of medicine, or receive compensation therefor, or offer to engage in the practice of medicine unless they hold a valid, unrevoked, and unsuspended physician’s and surgeon’s certificate issued by the board. However, a graduate of an approved medical school may engage in the practice of medicine whenever and wherever required as a part of a postgraduate training program under the following conditions:
(1) The medical school graduate has taken and passed the board-approved medical licensing examinations required to qualify the applicant to participate in an approved postgraduate training program.
(2) If the medical school graduate graduated from a foreign medical school approved by the board pursuant to Section 2084, the Educational Commission for Foreign Medical Graduates (ECFMG) has submitted an official ECFMG Certification Status Report directly to the board confirming the graduate is ECFMG certified.
(3) The medical school graduate is enrolled in a postgraduate training program approved by the board.
(4) The board-approved postgraduate training program has submitted the required board-approved form to the board documenting the medical school graduate is enrolled in an approved postgraduate training program.
(5) The medical school graduate obtains a physician’s and surgeon’s postgraduate training license in accordance with Section 2064.5.
(b) A medical school graduate enrolled in an approved first-year postgraduate training program in accordance with this section may engage in the practice of medicine whenever and wherever required as a part of the training program, and may receive compensation for that practice.
(c) A graduate who has completed the first year of postgraduate training may, in an approved residency or fellowship, engage in the practice of medicine whenever and wherever required as part of that residency or fellowship, and may receive compensation for that practice. The resident or fellow shall qualify for, take, and pass the next succeeding written examination for licensure. If the resident or fellow fails to receive a license to practice medicine under this chapter within 27 months from the commencement of the residency or fellowship, except as otherwise allowed under subdivision (g) or (h), or if the board denies their application for licensure, all privileges and exemptions under this section shall automatically cease.
(d) A graduate from a medical school approved pursuant to Section 2084 who is engaged in an Accreditation Council for Graduate Medical Education (ACGME)-accredited postgraduate training program outside of California may, as a participant in guest rotations in an approved postgraduate training program in California or a participating training site affiliated with an ACGME-accredited program, engage in the practice of medicine whenever and wherever required as part of that training program, not to exceed a total of 90 days for all rotations, and may receive compensation for that practice without obtaining a physician’s and surgeon’s postgraduate training license in accordance with Section 2064.5.
(e) All approved postgraduate training the medical school graduate has successfully completed in the United States or Canada shall count toward the 15-month license exemption for graduates of medical schools in the United States and Canada or 27-month license exemption for graduates of foreign medical schools approved by the board pursuant to Section 2084 other than Canadian medical schools, except as otherwise allowed under subdivision (g).
(f) The program director for an approved postgraduate training program in California shall report to the board, on a form approved by the board, and provide any supporting documents as required by the board, the following actions within 30 days of the action:
(1) A postgraduate training licensee is notified that they have received partial or no credit for a period of postgraduate training, and their postgraduate training period is extended.
(2) A postgraduate training licensee takes a leave of absence or any break from their postgraduate training, and they are notified that their postgraduate training period is extended.
(3) A postgraduate training licensee is terminated from the postgraduate training program.
(4) A postgraduate training licensee resigns, dies, or otherwise leaves the postgraduate training program.
(5) A postgraduate training licensee has completed a one-year contract approved by the postgraduate training program.
(g) Upon review of supporting documentation, the board, in its discretion, may grant an extension beyond 15 months to a postgraduate training licensee who graduated from a medical school in the United States or Canada, or beyond 27 months to a postgraduate training licensee who graduated from a foreign medical school approved by the board pursuant to Section 2084 other than a Canadian medical school, to receive credit for the 12 months of required approved postgraduate training for graduates of medical schools in the United States and Canada and 24 months of required approved postgraduate training for graduates of foreign medical schools other than Canadian medical schools.
(h) An applicant for a physician’s and surgeon’s license who has received credit for 12 months of approved postgraduate training in another state or in Canada and who is accepted into an approved postgraduate training program in California shall obtain their physician’s and surgeon’s license within 180 days after beginning that postgraduate training program or all privileges and exemptions under this section shall automatically cease.
(i) Upon review of supporting documentation, the board, in its discretion, may grant a physician’s and surgeon’s license to an applicant who demonstrates substantial compliance with this section.

SEC. 1.5.

 Section 2065 of the Business and Professions Code is amended to read:

2065.
 (a) Unless otherwise provided by law, a postgraduate training licensee, intern, resident, postdoctoral fellow, or instructor shall not engage in the practice of medicine, or receive compensation therefor, or offer to engage in the practice of medicine unless they hold a valid, unrevoked, and unsuspended physician’s and surgeon’s certificate issued by the board. However, a graduate of an approved medical school may engage in the practice of medicine whenever and wherever required as a part of a postgraduate training program under the following conditions:
(1) The medical school graduate has taken and passed the board-approved medical licensing examinations required to qualify the applicant to participate in an approved postgraduate training program.
(2) If the medical school graduate graduated from a foreign medical school approved by the board pursuant to Section 2084, the Educational Commission for Foreign Medical Graduates (ECFMG) has submitted an official ECFMG Certification Status Report directly to the board confirming the graduate is ECFMG certified.
(3) The medical school graduate is enrolled in a postgraduate training program approved by the board.
(4) The board-approved postgraduate training program has submitted the required board-approved form to the board documenting the medical school graduate is enrolled in an approved postgraduate training program.
(5) The medical school graduate obtains a physician’s and surgeon’s postgraduate training license in accordance with Section 2064.5.
(b) A medical school graduate enrolled in an approved postgraduate training program in accordance with this section may engage in the practice of medicine whenever and wherever required as a part of the training program, and may receive compensation for that practice.
(c) A graduate from a medical school approved pursuant to Section 2084 who is engaged in an Accreditation Council for Graduate Medical Education (ACGME)-accredited postgraduate training program outside of California may, as a participant in guest rotations in an approved postgraduate training program in California or a participating training site affiliated with an ACGME-accredited program, engage in the practice of medicine whenever and wherever required as part of that training program, not to exceed a total of 90 days for all rotations, and may receive compensation for that practice without obtaining a physician’s and surgeon’s postgraduate training license in accordance with Section 2064.5.
(d) All approved postgraduate training the medical school graduate has successfully completed in the United States or Canada shall count toward the postgraduate training requirement to obtain a physician’s and surgeon’s license under Section 2096.
(e) The program director for an approved postgraduate training program in California shall report to the board, on a form approved by the board, and provide any supporting documents as required by the board, the following actions within 30 days of the action:
(1) A postgraduate training licensee is notified that they have received partial or no credit for a period of postgraduate training, and their postgraduate training period is extended.
(2) A postgraduate training licensee takes a leave of absence or any break from their postgraduate training, and they are notified that their postgraduate training period is extended.
(3) A postgraduate training licensee is terminated from the postgraduate training program.
(4) A postgraduate training licensee resigns, dies, or otherwise leaves the postgraduate training program.
(5) A postgraduate training licensee has completed a one-year contract approved by the postgraduate training program.
(f) Upon review of supporting documentation, the board, in its discretion, may grant an extension beyond 36 months to a postgraduate training licensee who graduated from a medical school approved by the board pursuant to Section 2084 to receive credit for the 12 months of required approved postgraduate training for graduates of medical schools in the United States and Canada and 24 months of required approved postgraduate training for graduates of foreign medical schools other than Canadian medical schools.
(g) An applicant for a physician’s and surgeon’s license who has either graduated from medical school in the United States or Canada and has received 12 months credit for 12 months of board-approved postgraduate training in another state or in Canada, or has graduated from a foreign medical school approved by the board pursuant to Section 2084 and has received 24 months credit of board-approved postgraduate training and who is accepted into an approved postgraduate training program in California shall obtain their physician’s and surgeon’s license within 180 days after beginning that postgraduate training program or all privileges and exemptions under this section shall automatically cease.
(h) Upon review of supporting documentation, the board, in its discretion, may grant a physician’s and surgeon’s license to an applicant who demonstrates substantial compliance with this section.

SEC. 2.

 Section 1.5 of this bill incorporates amendments to Section 2065 of the Business and Professions Code proposed by both this bill and Senate Bill 815. That section of this bill shall only become operative if (1) both bills are enacted and become effective on or before January 1, 2024, (2) each bill amends Section 2065 of the Business and Professions Code, and (3) this bill is enacted after Senate Bill 815, in which case Section 1 of this bill shall not become operative.