Assigned to HHS AS PASSED BY COMMITTEE
ARIZONA STATE SENATE
Fifty-Sixth Legislature, Second Regular Session
REVISED
AMENDED
FACT SHEET FOR S.B. 1406
international medical licensees; provisional licensure
Purpose
Allows, effective January 1, 2025, the Arizona Medical Board (AMB) to grant a
provisional medical license to an international medical licensee who meets outlined criteria and
who is licensed to practice in a country other than the United States, as prescribed.
Background
An applicant for a medical license in Arizona must: 1) graduate from an approved school
of medicine or receive a medical education that the AMB deems to be of equivalent quality;
2) successfully complete an approved 12-month hospital internship, residency or clinical
fellowship program; 3) have the physical and mental capability to safely engage in the practice of
medicine; 4) have a professional record that indicates that the applicant has not committed any act
that would constitute grounds for disciplinary action; 5) not have surrendered a license, currently
be under investigation, suspension or restriction or have had a medical license revoked by a
medical regulatory board in another jurisdiction that constitutes unprofessional conduct; 6) pay all
AMB-required fees; 7) complete an AMB-prescribed training unit; 8) submit a five-year medical
employment history including verification of licensure from every state in which the applicant has
ever held a medical license; and 9) submit a full set of fingerprints to the AMB for a state and
federal criminal records check (A.R.S. § 32-1422). An applicant for a medical license in Arizona
who has graduated from an unapproved school of medicine must meet additional outlined
requirements (A.R.S. § 32-1423).
The primary duty of the AMB is to protect the public from unlawful, incompetent,
unqualified, impaired or unprofessional practitioners of allopathic medicine through licensure,
regulation and rehabilitation of the profession in Arizona. The powers and duties of the AMB
include: 1) initiating investigations and determining whether a doctor has engaged in
unprofessional conduct, provided incompetent medical care or is mentally or physically unable to
engage in the practice of medicine; 2) reviewing the credentials and abilities of applicants whose
professional records or physical or mental capabilities do not meet licensure requirements;
3) developing and recommending standards governing the profession; 4) engaging in a full
exchange of information with licensing boards, disciplinary boards and medical associations of
other states, foreign countries and the Arizona Medical Association; 5) adopting rules for licensure
and regulation of doctors of medicine; and 6) establishing fees and penalties (A.R.S. § 32-1403).
FACT SHEET – Amended/Revised
S.B. 1406
Page 2
The Joint Legislative Budget Committee (JLBC) fiscal note on S.B.1406 estimates the bill
would increase the AMB's operating costs and revenues, though the magnitude would depend on
the number of new provisional licenses. The AMB estimates that S.B.1406 would increase annual
operating costs by $766 per application received. To the extent that the AMB collects additional
licensing fees, current law requires 90 percent of that revenue to be deposited into the AMB Fund
and 10 percent into the state General Fund. JLBC estimates that fee revenues retained by the AMB
for provisional licenses would be sufficient to fund any increased administrative costs (JLBC).
Provisions
International Medical Licensee Provisional Licensure
1. Allows the AMB to grant a provisional license only to an international medical licensee:
a) who has an offer for employment as a physician at any health care provider that operates
in a medically underserved area, as designated by the Arizona Department of Health
Services;
b) whose federal immigration status allows the person to work as a physician in the US; and
c) who meets the statutory requirements for medicine and surgery licensure and if applicable,
the additional requirements for students graduating from an unapproved allopathic school
of medicine.
2. States that the AMB is not required to license an international medical licensee who does not
provide:
a) evidence of substantially similar medical training as required by Arizona law;
b) evidence of satisfactory passage of exams;
c) a complete license application; and
d) payment of all required licensing fees.
3. Allows the AMB to require an applicant international medical licensee to submit:
a) any necessary supporting application materials so that the AMB may properly evaluate the
applicant for licensure; and
b) at the applicant's expense, medical education information through the Educational
Commission for Foreign Medical Graduates or another third-party records service.
4. Allows the AMB to establish licensing and renewal fees for provisional licenses.
5. Requires a provisional licensee to do both of the following:
a) work under the supervision of a physician who is licensed as an osteopathic physician or
surgeon or in medicine and surgery; and
b) comply with continuing education requirements, as outlined.
6. Requires the provisional license to be renewed annually.
7. Requires the international medical licensee's employer to notify the AMB if the licensee is
terminated or leaves employment for any reason.
8. Requires the AMB, within five days of notification of the licensee's termination or departure
from employment, to terminate the licensee's provisional license unless the licensee notifies
the AMB that the licensee is working for another employer in an area that is designated as
medically underserved. FACT SHEET – Amended/Revised
S.B. 1406
Page 3
9. Allows the AMB to discipline an international medical licensee or revoke a provisional license
based on clear and convincing evidence, after conducting a disciplinary action investigation.
10. Allows a licensee to appeal a revocation decision to the Maricopa County Superior Court
within the timeframe allowed for judicial review of administrative decisions.
11. Requires the Maricopa County Superior Court to reinstate a revoked provisional license if the
court finds that the AMB's actions did not meet the prescribed standards.
12. Requires a provisional license to automatically be converted into a full medical license after
four years if the licensee meets both of the following:
a) engages in the practice of medicine in Arizona for four years in an area that is designated
as medically underserved; and
b) is not disciplined by the board during the four-year period of the provisional license.
Miscellaneous
13. Defines international medical licensee as an individual who:
a) has been granted a medical doctorate or a substantially similar degree by an international
medical program of good standing;
b) has completed a residency or substantially similar postgraduate medical training in the
country where the individual was granted a medical doctorate or a substantially similar
degree as prescribed;
c) possesses basic fluency in the English language at a level sufficient to communicate with
patients about medical conditions and treatments;
d) has been licensed to practice medicine within the preceding five years in at least one of the
following countries:
i. Australia;
ii. Hong Kong;
iii. Ireland;
iv. Israel;
v. New Zealand;
vi. Singapore;
vii. South Africa;
viii. Switzerland;
ix. the United Kingdom;
x. Canada; or
xi. any additional countries added by the AMB; and
e) has practiced medicine in the licensing country for at least five years after completing the
postgraduate training as outlined.
14. Defines international medical program as any medical school, residency program, medical
internship program or entity that provides physicians with a medical education or training
outside of the U.S. that is substantially similar to that required to practice as a physician in
Arizona.
15. Exempts the AMB from statutory rulemaking requirements for one year.
16. Defines terms.
17. Becomes effective on January 1, 2025. FACT SHEET – Amended/Revised
S.B. 1406
Page 4
Amendments Adopted by Committee
1. Requires an international medical licensee to practice under the supervision of a licensed
physician, as prescribed.
2. Requires international medical licensees to be fluent in the English language at a level
sufficient to communicate with patients about medical conditions and treatment.
3. Allows the AMB to discipline an international medical licensee or revoke a provisional license
based on clear and convincing evidence, rather than clear and compelling evidence as outlined.
4. Allows a licensee to appeal a revocation decision to the Maricopa County Superior Court
within the timeframe allowed for judicial review of administrative decisions, rather than within
120 days of the decision to revoke the license.
Revised
• Updates the fiscal impact statement.
Senate Action
HHS 2/6/24 DPA 4-3-0
Prepared by Senate Research
February 19, 2024
MM/KS/slp