SB 1108
Initials AG/BG Page 1 House Engrossed
ARIZONA HOUSE OF REPRESENTATIVES
Fifty-seventh Legislature
First Regular Session
Senate: RAGE DP 6-1-0-0 | 3rd Read 26-4-0-0
House: HHS DPA 7-5-0-0
SB 1108: international medical licensees; provisional licensure
Sponsor: Senator Shamp, LD 29
House Engrossed
Overview
Enables the Arizona Medical Board (AMB) and the Arizona Board of Osteopathic Examiners
in Medicine and Surgery (BOEMS) to grant a provisional medical license to an international
medical licensee who is licensed to practice in a country other than the United States (U.S.)
and meets all of the prescribed criteria. Contains an effective date of January 1, 2026.
History
The AMB's primary duty 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 this state. Applicants pursuing a license to practice
medicine in Arizona must meet each of the following basic requirements: 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 or engaged in any conduct that would constitute grounds
for disciplinary action against a licensee; 5) not had a license revoked, be currently under
investigation, suspension or restriction by a medical regulatory board in another jurisdiction
in the U.S. for an act that occurred in that jurisdiction and that constitutes unprofessional
conduct; 6) pay all fees required by the AMB; 7) complete an AMB training unit; 8) submit a
five-year medical history report; and 9) submit a full set of fingerprints to the AMB for a state
and criminal records check (A.R.S. §§ 32-1403 and 32-1422).
Established in 1949, the BOEMS regulates the osteopathic profession by issuing and
renewing licenses, permits and registrations, investigating and resolving complaints and
providing information to the public about license, permit and registration holders. Its mission
is to protect the public by setting educational and training standards for licensure, and by
reviewing complaints made against osteopathic physicians, interns and residents to ensure
that their conduct meets the standards of the profession, as defined in law. The BOEMS
regulates the practice of osteopathic medicine by: 1) issuing licenses, conducting hearings
and administering disciplinary actions; 2) maintaining a record of its acts and proceedings;
and 3) adopting rules regarding the regulation and qualification of medical assistants (A.R.S.
§§ 32-1801 and 32-1803).
☐ Prop 105 (45 votes) ☐ Prop 108 (40 votes) ☐ Emergency (40 votes) ☐ Fiscal Note SB 1108
Initials AG/BG Page 2 House Engrossed
Provisions
International Medical Provisional Licensure Requirements
1. Permits the AMB or BOEMS, notwithstanding any other law, to grant a provisional
license to engage in the practice of medicine in Arizona to any international medical
licensee who meets all of the following:
a) has an offer for employment as a physician at any health care provider that operates
in a county with a population of less than 1,000,000 persons;
b) has a federal immigration status that allows the person to work as a physician in the
U.S.; and
c) meet the requirements for licensure by the AMB and BOEMS. (Sec. 1)
2. Specifies that the AMB and BOEMS is not required to grant a provisional license to an
international medical licensee who does not provide:
a) evidence of substantially similar medical training that the AMB or BOEMS deems to
be of equivalent quality;
b) evidence of satisfactory passage of exams as determined by the AMB or BOEMS;
c) proof of certification by the Educational Commission for Foreign Medical Graduates;
d) a complete license application;
e) payment of all required licensing fees; and
f) satisfactory proof of a federal immigration status that allows the individual to work
as a physician in the U.S. (Sec. 1)
3. Requires an international medical provisional license to automatically be converted to a
full license to practice medicine in Arizona after four years if all the following is met:
a) the provisional licensee engages in the practice of medicine in Arizona for four years
in a county with a population of less than 1,000,000 persons;
b) the provisional licensee is not disciplined by the AMB or BOEMS during that four-
year period of the provisional license; and
c) the provisional licensee's supervising physician with whom there was a supervision
agreement submits a signed attestation to the AMB or BOEMS certifying that it is a
supervising physician's professional opinion that the provisional licensee meets
Arizona's standards for providing medical care. (Sec. 1)
4. States that the AMB or BOEMS inability to obtain records may not be used as the sole
purpose for licensure denial. (Sec. 1)
5. Allows the AMB or BOEMS to require an applicant for an international medical
provisional license to submit either or both of the following:
a) any supporting application materials necessary for the AMB or BOEMS to properly
evaluate the applicant for licensure; or
b) medical education information through the Educational Commission for Foreign
Medical Graduates or another third-party records service, at the applicant's expense.
(Sec. 1)
6. Requires an international medical provisional licensee to do both of the following:
a) work under the supervision of an osteopathic or allopathic physician; and
b) comply with the continuing education requirements, as prescribed. (Sec. 1)
7. Allows the AMB and BOEMS to establish licensing and renewal fees for international
medical provisional licensees by rule. (Sec. 1)
8. Requires an international medical provisional licensee to be renewed annually. (Sec. 1) SB 1108
Initials AG/BG Page 3 House Engrossed
9. Requires the employer of the international medical provisional licensee to notify the AMB
or BOEMS if the provisional licensee is terminated or leaves employment for any reason.
(Sec. 1)
10. Directs the AMB or BOEMS to adopt rules relating to supervision, including
requirements for international medical provisional licensees:
a) to submit a supervision agreement to the AMB or BOEMS;
b) to report to the AMB or BOEMS;
c) to obtain medical malpractice liability insurance;
d) regarding health insurance coverage; and
e) for procedures for failing to adhere to the terms of the supervision agreement. (Sec. 1)
11. Requires the AMB and BOEMS, within five days of notification of the international
medical provisional licensee's termination or departure from employment, to terminate
the provisional license unless:
a) 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; and
b) the new employer notifies the AMB or BOEMS that the international medical licensee
has accepted an offer of employment. (Sec. 1)
12. Requires the new employer to comply with the AMB or BOEMS rules related to issuing a
new supervision agreement. (Sec. 1)
13. Permits an employer of an international medical provisional licensee to require the
licensee to take a competency test at any time during employment. (Sec. 1)
14. Permits the AMB and BOEMS to discipline a provisional licensee or revoke a granted
provisional license after conducting a disciplinary action investigation. (Sec. 1)
15. Permits an international medical licensee to appeal the revocation of the provisional
license to the Maricopa County Superior Court (Superior Court). (Sec. 1)
16. Requires the Superior Court to reinstate the provisional license if the court finds that the
actions of the AMB or BOEMS did not meet the standards for revocation as outlined in
statute. (Sec. 1)
17. Requires the AMB or BOEMS to adopt rules regarding the format and submission
requirements for the supervising physician's attestation. (Sec. 1)
Reporting Requirements
18. Directs the AMB and BOEMS, by January 1, 2033, to submit a report to the Governor
and the Health and Human Services Committees in the Senate and House of
Representatives or their successor committees (HHS Committees) that includes:
a) the number of license applications that the AMB or BOEMS has received, approved
and denied, including the reasons for the denials;
b) the number of complaints received against provisional licensees;
c) the number of complaints that were sustained, including the disciplinary and
nondisciplinary actions taken by the AMB and BOEMS;
d) the geographic locations where the provisional licensees are practicing or have
practiced in Arizona;
e) the medical specialty or specialties practiced by each provisional licensee; and
f) the number of provisional licenses that have been converted to a full license to practice
in Arizona and whether those licensees have continued to practice in Arizona. (Sec. 1) SB 1108
Initials AG/BG Page 4 House Engrossed
19. Requires the HHS Committees, or their successor committees, to:
a) review the report submitted and the data collected, including application outcomes,
complaint records, geographic distribution and conversion rates to full licensure; and
b) determine whether provisional licensure should be continued, modified or
discontinued. (Sec. 1)
20. Requires the review process for the HHS Committees to consider whether the licensing
framework:
a) supports public health and safety;
b) maintains professional standards; and
c) effectively addresses workforce needs in Arizona. (Sec. 1)
Miscellaneous
21. Forbids the AMB or BOEMS from accepting applications for provisional medical licensure
by January 1, 2034. (Sec. 1)
22. Defines the following terms:
a) board;
b) health care provider;
c) international medical licensee;
d) international medical program;
e) physician; and
f) provisional licensee. (Sec. 1)
23. Exempts the AMB and BOEMS from rulemaking requirements for one year after the
effective date. (Sec. 2)
24. Contains an effective date of January 1, 2026. (Sec. 3)