2025 -- S 0347
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LC000617
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S T A T E O F R H O D E I S L A N D
IN GENERAL ASSEMBLY
JANUARY SESSION, A.D. 2025
____________
A N A C T
RELATING TO BUSINESSES AND PROFESSIONS -- BOARD OF MEDICAL LICENSURE
AND DISCIPLINE
Introduced By: Senators Urso, Murray, Lauria, Thompson, LaMountain, Appollonio,
DiMario, Valverde, DiPalma, and Quezada
Date Introduced: February 21, 2025
Referred To: Senate Health & Human Services
(General Treasurer)
It is enacted by the General Assembly as follows:
SECTION 1. Sections 5-37-1 and 5-37-16 of the General Laws in Chapter 5-37 entitled 1
"Board of Medical Licensure and Discipline" are hereby amended to read as follows: 2
5-37-1. Definitions. 3
As used in this chapter: 4
(1) “Board” means the Rhode Island board of medical licensure and discipline or any 5
committee or subcommittee thereof. 6
(2) “Chief administrative officer” means the administrator of the Rhode Island board of 7
medical licensure and discipline. 8
(3) “Department” means the Rhode Island department of health. 9
(4) “Director” means the director of the Rhode Island department of health. 10
(5) "ECFMG" means the Educational Commission for Foreign Medical Graduates. 11
(5)(6) “Healthcare facility” means any institutional health-service provider licensed 12
pursuant to the provisions of chapter 17 of title 23. 13
(6)(7) “Health-maintenance organization” means a public or private organization licensed 14
pursuant to the provisions of chapter 17 of title 23 or chapter 41 of title 27. 15
(8) "Internationally-trained physician" means a physician who has received a degree of 16
doctor of medicine or its equivalent from a legally chartered medical school outside the United 17
States recognized by the World Health Organization, who has been licensed or otherwise 18
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authorized to practice medicine in a country other than the United States, and who has practiced 1
medicine for at least one year 2
(7)(9) “Limited registrant” means a person holding a limited-registration certificate 3
pursuant to the provisions of this chapter. 4
(8)(10) “Medical malpractice” or “malpractice” means any tort, or breach of contract, 5
based on health care or professional services rendered or that should have been rendered, by a 6
physician, dentist, hospital, clinic, health-maintenance organization, or professional service 7
corporation providing healthcare services and organized under chapter 5.1 of title 7, to a patient or 8
the rendering of medically unnecessary services except at the informed request of the patient. 9
(9)(11) “Medical-practice group” means a single legal entity formed primarily for the 10
purpose of being a physician group practice in any organizational form recognized by the state in 11
which the group practice achieves its legal status, including, but not limited to, a partnership, 12
professional corporation, limited-liability company, limited-liability partnership, foundation, not-13
for-profit corporation, faculty practice plan, or similar association. 14
(10)(12) “Medical record” means a record of a patient’s medical information and treatment 15
history maintained by physicians and other medical personnel, which includes, but is not limited 16
to, information related to medical diagnosis, immunizations, allergies, x-rays, copies of laboratory 17
reports, records of prescriptions, and other technical information used in assessing the patient’s 18
health condition, whether such information is maintained in a paper or electronic format. 19
(11)(13) “Nonprofit medical-services corporation” or “nonprofit hospital-service 20
corporation” means any corporation organized pursuant to chapter 19 or chapter 20 of title 27 for 21
the purpose of establishing, maintaining, and operating a nonprofit medical-service plan. 22
(14) "Participating healthcare facility" means a federally-qualified health center, 23
community health center, hospital, or other healthcare facility approved by the board that provides 24
an assessment and evaluation program designed to develop, assess, and evaluate an internationally-25
trained physician's non-clinical skills, according to criteria developed or approved by the board; 26
provided, however, that the participating healthcare facility provides medical care in a Rhode Island 27
physician shortage area. 28
(12)(15)(i) “Peer-review board” means any committee of a state or local professional 29
association or society including a hospital association, or a committee of any licensed healthcare 30
facility, or the medical staff thereof, or any committee of a medical-care foundation or health-31
maintenance organization, or any committee of a professional-service corporation or nonprofit 32
corporation employing twenty (20) or more practicing professionals, organized for the purpose of 33
furnishing medical service, or any staff committee or consultant of a hospital-service or medical-34
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service corporation, the function of which, or one of the functions of which, is to evaluate and 1
improve the quality of health care rendered by providers of healthcare services or to determine that 2
healthcare services rendered were professionally indicated or were performed in compliance with 3
the applicable standard of care or that the cost of health care rendered was considered reasonable 4
by the providers of professional healthcare services in the area and shall include a committee 5
functioning as a utilization-review committee under the provisions of 42 U.S.C. § 1395 et seq. 6
(Medicare law) or as a professional-standards review organization or statewide professional-7
standards review council under the provisions of 42 U.S.C. § 1301 et seq. (professional-standards 8
review organizations) or a similar committee or a committee of similar purpose, to evaluate or 9
review the diagnosis or treatment of the performance or rendition of medical or hospital services 10
that are performed under public medical programs of either state or federal design. 11
(ii) “Peer-review board” also means the board of trustees or board of directors of a state or 12
local professional association or society, a licensed healthcare facility, a medical-care foundation, 13
a health-maintenance organization, and a hospital-service or medical-service corporation only 14
when such board of trustees or board of directors is reviewing the proceedings, records, or 15
recommendations of a peer-review board of the above enumerated organizations. 16
(13)(16) “Person” means any individual, partnership, firm, corporation, association, trust 17
or estate, state or political subdivision, or instrumentality of a state. 18
(14)(17) “Physician” means a person with a license to practice allopathic or osteopathic 19
medicine in this state under the provisions of this chapter. 20
(15)(18) “Practice of medicine” includes the practice of allopathic and osteopathic 21
medicine. Any person is regarded as practicing medicine within the meaning of this chapter who 22
holds himself or herself out as being able to diagnose, treat, operate, or prescribe for any person ill 23
or alleged to be ill with disease, pain, injury, deformity, or abnormal physical or mental condition, 24
or who either professes to heal, offer, or undertake, by any means or method, to diagnose, treat, 25
operate, or prescribe for any person for disease, pain, injury, deformity, or physical or mental 26
condition. In addition, one who attaches the title, M.D., physician, surgeon, D.O., osteopathic 27
physician, and surgeon, or any other similar word or words or abbreviation to his or her name 28
indicating that he or she is engaged in the treatment or diagnosis of the diseases, injuries, or 29
conditions of persons, shall be held to be engaged in the practice of medicine. 30
(19) "Rhode Island physician shortage area" means a geographic region or population in 31
the state experiencing a shortage of physicians, especially primary care physicians or psychiatrists, 32
relative to population and need, as determined by the board. 33
(20) "USMLE" means United States Medical Licensure and Exam which consists of three 34
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(3) steps: 1
(i) Step 1 of the USMLE requires an assessment of the examinee’s understanding of and 2
ability to apply important concepts of the basic sciences to the practice of medicine, with special 3
emphasis on principles and mechanisms underlying health disease, and modes of therapy; 4
(ii) Step 2 of the USMLE requires an assessment of the examinee’s ability to apply 5
knowledge, skills, and understanding of clinical science essentials for the provision of patient care 6
under supervision, with an emphasis on health promotion and disease prevention; 7
(iii) Step 3 of the USMLE requires an assessment of the examinee’s ability to apply medical 8
knowledge and understanding of biomedical and clinical science essential for the unsupervised 9
practice of medicine, with the emphasis on patient management in ambulatory settings. 10
5-37-16. Limited registrations. 11
(a) An applicant for limited registration under this chapter who furnishes the board with 12
satisfactory proof that the applicant is eighteen (18) years of age or older and of good moral 13
character; that the applicant has graduated from a legally chartered medical school or school of 14
osteopathic medicine having power to grant degrees in allopathic or osteopathic medicine; and that 15
the applicant has been appointed an intern, resident, fellow, or medical officer in a hospital or other 16
institution maintained by the state, or by a city or town, or in a hospital or clinic that is incorporated 17
under the laws of this state, or in a clinic that is affiliated with a hospital licensed by the department 18
of health, or in an outpatient clinic operated by the state, may, upon the payment as set forth in § 19
23-1-54, be registered by the board as a hospital medical officer for any time that the board may 20
prescribe. This limited registration shall entitle the applicant to practice medicine in the hospital or 21
other institution designated on his or her certificate of limited registration, or outside this hospital 22
or other institution for the treatment, under the supervision of one of its medical officers who is a 23
licensed physician, of persons accepted by it as patients, or in any hospital, institution, clinic, or 24
program affiliated for training purposes with the hospital, institution, or clinic designated on this 25
certificate, which affiliation is approved by the board, and in any case under regulations established 26
by the hospital, institution, or clinic; provided, that each hospital, institution, or clinic annually 27
submits to the board a list of affiliated hospitals, institutions, clinics, or programs providing training 28
programs that comply with the terms of this section. Limited registration under this section may be 29
revoked at any time by the board. 30
(b) Notwithstanding the other provisions of subsection (a) of this section, an 31
internationally-trained physician who has been licensed or otherwise authorized to practice 32
medicine in a country other than the United States shall be eligible to apply for a limited license to 33
practice medicine for a renewable one-year term after satisfying the criteria in subsection (c) of this 34
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section; provided, however, that such limited registration shall provide a pathway for the issuance 1
of a full unrestricted license to practice medicine in accordance with, and upon satisfaction of, the 2
criteria in subsection (f) of this section. 3
(c) The board shall issue a limited license to an applicant if the participating facility and 4
the applicant submit evidence acceptable to the board that the applicant: 5
(1) Is an internationally-trained physician; 6
(2) Has a valid certificate issued by the Educational Commission for Foreign Medical 7
Graduates or other credential evaluation service approved by the board; provided, however, that 8
the board may waive such certification at its discretion where the applicant is unable to obtain the 9
required documentation from a non-cooperating country; 10
(3) Has achieved a passing score on both of Steps 1 and 2 (Clinical Knowledge) of the 11
United States Medical Licensing Examination; 12
(4) Has entered into an agreement with the participating healthcare facility providing that 13
the facility shall develop, assess and evaluate the applicant's familiarity with nonclinical skills 14
standards appropriate for medical practice in Rhode Island, according to the assessment and 15
evaluation criteria developed or approved by the board; 16
(5) Will enter a full-time employment relationship with that participating healthcare facility 17
after the board issues a limited license pursuant to this subsection; and 18
(6) Has satisfied other criteria that the board may require for issuance of a restricted license 19
pursuant to this section. 20
(d) The one-year limited license may be renewed once, for a total two (2) year term of 21
limited registration. 22
(e) To be eligible for a renewable two (2) year restricted license to practice medicine only 23
in a Rhode Island physician shortage area designated by the board, an internationally trained 24
physician shall provide the board with proof of the following: 25
(1) Successful completion of the participating facility’s assessment and evaluation 26
program; 27
(2) A passing score on Step 3 of the USMLE; and 28
(3) The license shall authorize the holder to practice independently in a primary care 29
specialty, psychiatry, or other specialty approved by the board. 30
(f) After a minimum of two (2) years of restricted practice, the internationally trained 31
physician shall be eligible to apply for a full, unrestricted license to practice medicine. 32
(b)(g) The director may promulgate any rules and regulations that he or she the director 33
deems necessary to carry out the provisions of this chapter. 34
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SECTION 2. This act shall take effect upon passage. 1
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EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
A N A C T
RELATING TO BUSINESSES AND PROFESSIONS -- BOARD OF MEDICAL LICENSURE
AND DISCIPLINE
***
This act would allow internationally trained physicians to practice at healthcare facilities 1
in rural and underserved communities and would provide a mentorship alternative to the residency 2
requirement. This act would also create pathways to licensure and allow them to apply for a full, 3
unrestricted license to practice medicine. 4
This act would take effect upon passage. 5
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