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SB 5185

Establishing preceptorship and hardship pathways to medical practice for international medical graduates.

2025-2026 Regular Session Introduced by Jess Bateman and 12 co-sponsors

The bill creates a preceptorship pathway allowing international medical graduates to obtain full, unrestricted Washington licensure after 48 months of supervised practice and satis

Delivered to Governor.
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Bill Summary · SB 5185

Summary: Senate Bill 5185 (S-0147) – Establishing preceptorship and hardship pathways to medical practice for international medical graduates

Overview

SB 5185 proposes new pathways for international medical graduates (IMGs) to obtain licensure to practice medicine in Washington state. The bill adds a hardship/exception framework to existing licensure rules and creates a distinct preceptorship pathway that could lead to a full, unrestricted physician license without the traditional postgraduate training requirement. The bill is currently in the Senate Health & Long-Term Care Committee, with executive sessions scheduled but no action taken to date. Public hearing occurred on January 31, 2025; first reading January 13, 2025; prefiled January 8, 2025.

What the bill would change (Key provisions)

Section 1: Amendments to RCW 18.71.051 (licensure standards for international medical graduates)

  • Recognizes Canadian medical school accreditation and the Canadian national licensure exam as equivalent to U.S. standards.
  • Requires IMG applicants to demonstrate:
    • Completion of professional instruction in an approved or non-approved medical school program equivalent to the state requirements.
    • Passing the ECFMG or equivalent examination (as determined by the commission) or meeting the rules adopted by the commission in lieu thereof.
    • English language proficiency (reading, writing, speaking, understanding).
  • Introduces a discretionary waiver:
    • The commission may waive statutory/rule requirements for applicants with an acceptable body of work in research or medical excellence and endorsements from recognized experts.
  • Establishes a hardship pathway option:
    • The commission may waive certain statute/rule requirements for internationally trained applicants experiencing hardship (e.g., refugee status, persecution).
    • The commission may require alternate demonstrations of competence (e.g., exams, specialty assessments, supervised practice).
    • Hardship cannot be based on the applicant’s inability to complete ECFMG or other required examinations.

Section 2: New section adding a preceptorship pathway for IMG licensure

  • Creates/aligns a preceptorship pathway enabling full and unrestricted licensure for IMGs without requiring the traditional postgraduate training (RCW 18.71.050(1)(b)).
  • A licensee via this pathway is a full-scope physician, subject to standard credentialing, malpractice coverage, and insurance billing practices, unless a practice-site or disciplinary action imposes limitations.
  • Pathway requirements (IMG not currently licensed in WA, per subsection):
    • Licensure under RCW 18.71.095(6) or a hardship waiver under RCW 18.71.051(3) to pursue the pathway.
    • Full-time clinical practice for at least 48 months (four years) in acceptable locations.
    • Satisfactory performance ratings in all supervised practice categories by a supervising physician, with the supervisor’s attestation.
  • Post-pathway license application requires:
    • Documentation of 48 months of supervised full-time practice at the physician level.
    • Satisfactory clinical assessments for the period of supervised practice.
    • Attestation from the supervising physician, a written endorsement from the practice site medical director (if different), proof of board certification (ABMS or AAGP only), and any other information required by the commission.
  • Exceptionally qualified IMGs may be eligible for an abbreviated assessment program to determine competence for a full, unrestricted license.
  • The commission may conduct rulemaking to implement these requirements.

Who/what would be affected

  • International medical graduates seeking medical licensure in Washington.
  • Supervising physicians and clinical sites hosting IMG preceptorships.
  • Washington Medical Commission (WMC) and state regulatory framework for medical licensure.
  • Medical boards/certification bodies (acceptance limited to ABMS and AAGP certifications under this pathway).
  • Potential patients and health systems, as new pathways could influence physician supply and credentialing processes.

Procedural and timeline aspects

  • Introduced: January 8, 2025 (prefiled); first reading January 13, 2025; referred to Health & Long-Term Care.
  • Public hearing: January 31, 2025.
  • Executive sessions: Scheduled but no action recorded on February 14, 2025 and February 18, 2025 (as of the latest actions provided).
  • Current status: In committee; no action taken at the noted executive sessions.

Potential impact and considerations

  • Aims to expand the physician workforce by enabling a structured, supervised pathway for IMGs to achieve full licensure.
  • Balances workforce needs with standards by requiring demonstrable supervised practice and supervisor attestations, while allowing waivers for hardship or exceptional qualifications.
  • Could affect eligibility criteria, examination requirements, and the credentialing process for IMG physicians.
  • The scope and implementation would depend on subsequent committee actions and potential rulemaking by the commission.

If you want, I can tailor this summary for policymakers, healthcare providers, or the public, or provide a quick comparison with current Washington licensure standards.

Compiled from official sources — confirm details with the bill’s official record.

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