Senate advances licensing pathway for internationally trained physicians despite Medical Board safety concerns

Assemblymember Alvarez presented AB 23 86 to create a permanent pathway and a provisional licensure route for qualified internationally trained physicians, building on the existing Physicians From Mexico program and extending to other countries for candidates with sufficient postgraduate experience or accredited training.

Supporters told the committee the change would expand access to care in medically underserved areas, noting California faces thousands fewer physicians than needed. Dr. Elias Shapiro, a community physician and international medical graduate, said the bill ‘‘is not a shortcut’’ but a structured pathway with supervised practice and competency‑based evaluations. Lawson Mansell of the Niskanen Center said 27 states have adopted similar pathways and that enabling experienced internationally trained physicians to practice in California could reduce access gaps.

The Medical Board of California opposed the bill in its current form. Aaron Bone told the committee that the bill erodes normative licensing safeguards — such as 36 months of postgraduate accredited training — and removed the board’s authority to verify the quality of overseas training in recent amendments. The board asked that USMLE and ECFMG certification requirements be restored for the pathway and for authority to approve sponsoring entities or training equivalence to be returned to the board.

Committee members and witnesses debated supervision, credential verification, and whether the bill should impose caps or preserve the board’s approval authority for sponsoring entities. Several members urged continued stakeholder negotiations; others said the state needs more physicians now. The committee voted to advance AB 23 86 to Senate Appropriations with recorded roll call (7–2), and the author said he will continue to work with the Medical Board and physician groups on amendments.

What happens next: AB 23 86 will be considered by the Senate Appropriations Committee; proponents and the Medical Board signaled a willingness to continue technical talks about verification, supervision and preserving patient safety safeguards.