Arizona 2025 2025 Regular Session

Arizona Senate Bill SB1108 Comm Sub / Analysis

Filed 01/24/2025

                    Assigned to RAGE 	FOR COMMITTEE 
 
 
 
 
ARIZONA STATE SENATE 
Fifty-Seventh Legislature, First Regular Session 
 
FACT SHEET FOR S.B. 1108 
 
international medical licensees; provisional licensure 
Purpose 
Effective January 1, 2026, allows the Arizona Medical Board (AMB) and the Arizona 
Board of Osteopathic Examiners in Medicine and Surgery (ABOE) 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 
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 medical profession in Arizona (A.R.S. § 32-1403). 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).  
The ABOE licenses and regulates medical physicians who practice osteopathic medicine, 
a system of medical treatment that emphasizes the inter-relationship of the body’s muscles, bones 
and joints with other body systems as an adjunct to invasive or chemically based treatment. The 
ABOE's responsibilities include: 1) issuing licenses; 2) conducting hearings; 3) placing physicians 
on probation; 4) entering stipulated orders; and 5) issuing letters of concern and decrees of censure 
(A.R.S. §§ 32-1801 and 32-1803). 
If establishing new fees for provisional licensure results in a change to board revenues 
otherwise directed to the state General Fund, there may be a fiscal impact to the state General 
Fund.   FACT SHEET 
S.B. 1108 
Page 2 
 
 
Provisions 
International Medical Licensee Provisional Licensure 
1. Allows the AMB and ABOE 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 county with a population of fewer than 1,000,000 persons; 
b) whose federal immigration status allows the person to work as a physician in the United 
States;  
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; and 
d) who satisfies statutory requirements relating to applications for medical licensure, 
including submitting a full set of fingerprints for a state and federal criminal records check.  
2. States that the AMB and ABOE are 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;  
d) payment of all required licensing fees; and 
e) satisfactory proof of a federal immigration status that allows the individual to work as a 
physician in the United States. 
3. Allows the AMB and ABOE to require an applicant international medical licensee to submit: 
a) any necessary supporting application materials so that the applicable licensing board 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 and ABOE to establish, by rule, 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 AMB and ABOE to adopt rules regarding required supervision, including 
requirements: 
a) for submittal of a supervision agreement; 
b) to make reports to the applicable licensing board; 
c) to obtain medical malpractice liability insurance; 
d) regarding health insurance coverage; and 
e) regarding procedures for failure to adhere to the terms of the supervision agreement.  FACT SHEET 
S.B. 1108 
Page 3 
 
 
7. Requires the provisional license to be renewed annually. 
8. Requires the international medical licensee's employer to notify the AMB or ABOE if the 
licensee is terminated or leaves employment for any reason. 
9. Requires the AMB and ABOE, within five days of notification of the licensee's termination or 
departure from employment, to terminate the licensee's provisional license unless the licensee 
provides notification that the licensee is working for another employer in a county with a 
population of fewer than 1,000,000 persons. 
10. Requires the new employer to comply with the rules of the applicable licensing Board related 
to issuing a new supervision agreement. 
11. Allows the employer of a provisional licensee to require the licensee to take a competency test 
anytime during employment.  
12. Allows the AMB and ABOE to discipline an international medical licensee or revoke a 
provisional license based on clear and convincing evidence, after conducting a disciplinary 
action investigation. 
13. Allows a licensee to appeal a revocation decision to the Maricopa County Superior Court 
within the timeframe allowed for judicial review of administrative decisions. 
14. Requires the Maricopa County Superior Court to reinstate a revoked provisional license if the 
court finds that the actions of the AMB or ABOE did not meet the prescribed standards. 
15. Requires a provisional license to automatically be converted into a full medical license after 
four years if the licensee meets all of the following:  
a) engages in the practice of medicine in Arizona for four years in a county with a population 
of fewer than 1,000,000 persons; 
b) is not disciplined by the applicable licensing board during the four-year period of the 
provisional license; and 
c) the supervising physician submits a signed attestation to the applicable licensing board that 
it is the supervising physician's professional opinion that the provisional licensee meets 
Arizona standards for providing medical care. 
16. Requires the AMB and ABOE to adopt rules relating to the format and submission 
requirements of the supervising physician's attestation.  
Miscellaneous 
17. 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 
recognized by the licensing body of the country where the individual is licensed; 
c) possesses basic fluency in the English language at a level sufficient to communicate with 
patients about medical conditions and treatments;  FACT SHEET 
S.B. 1108 
Page 4 
 
 
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 or ABOE; and 
e) has practiced medicine in the licensing country for at least five years after completing the 
postgraduate training as outlined. 
18. 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 United States that is substantially similar to that required to practice as a 
physician in Arizona. 
19. Defines Board as the AMB or ABOE, as applicable. 
20. Exempts the AMB and ABOE from statutory rulemaking requirements for one year for 
purposes of licensing and regulating international medical licensees. 
21. Defines terms. 
22. Becomes effective on January 1, 2026. 
Prepared by Senate Research 
January 24, 2025 
JT/ci