An Act improving Healthcare delivery for underserved residents of the Commonwealth
Signed into Law November 20, 2024
Bill Summary
The Physician Pathway Act will mobilize the expertise of experienced internationally-trained physicians to address physician shortages in Massachusetts by creating a pathway to full licensure in exchange for at least 3 years of medical practice in an underserved community.
The Pathway – 3 steps to full licensure
The pathway will allow eligible internationally trained physicians (ITPs) to be issued a renewable 1-year limited license to practice medicine under the mentorship of a participating health center or hospital.
Upon successful completion, the ITP will be eligible for a renewable 2-year restricted license to practice in a shortage area or specialty.
The ITP will then be eligible to apply for a full unrestricted license to
practice medicine anywhere in the state.
The 1-year limited license and the 2-year restricted license are each
renewable once.
Mentorship Program: An alternative to residency
The PPA defines ITPs as physicians previously licensed or otherwise authorized to practice abroad, with a year or more of independent practice experience abroad.
The U.S. residency requirement for physician licensure is the most significant barrier to practice faced by ITPs, who must compete with recent medical school graduates for a residency match.
The PPA pathway substitutes a 1-year assessment and evaluation program at a participating health care facility, where the ITP would practice under the limited license.
The participating facility will develop and evaluate the ITP’s familiarity with non-clinical skills and standards appropriate for medical practice in Massachusetts.
Participating health care facility: a federally-qualified health center, community
health center, hospital, or other health center approved by the Board.
Step 1: Eligibility for Limited Licensure (1-2 years)
The 1-year limited license authorizes the ITP to practice medicine in a
participating health care facility approved by the Board.
To be eligible, an internationally-trained physician must have:
- Graduated from a legally-chartered medical school outside the U.S.
recognized by the World Health Organization - Been previously licensed or authorized to practice outside the U.S. and have
practiced independently for at least one year; - Obtained a valid ECFMG or other credential evaluation service approved by the
Massachusetts Board of Registration in Medicine; - Obtained a passing score on Step 1 and Step 2 CK of the USMLE; and
- been accepted into a program with a participating health care facility, with an
offer of full-time employment under the limited license.
Step 2: eligibility for a restricted license to practice in a Massachusetts physician shortage area
The 2-year restricted license authorizes the ITP to practice independently in a Massachusetts physician shortage area and specialty designated by the Board of Registration in Medicine.
To be eligible, an internationally-trained physician must have:
● Successfully completed the participating facility’s assessment and evaluation program
● Obtained a passing score on Step 3 of the USMLE
● Fulfilled any additional criteria that the Board may require (except postgraduate clinical training)
Once complete, the ITP will be eligible to apply for a full, unrestricted license to practice anywhere in Massachusetts.
What makes the PPA distinctive
● First bill filed in the nation to provide a pathway to full physician licensure by removing the residency requirement for experienced ITPs.
● Service requirement: requires participating ITPs to practice for at least 3 years in underserved communities before being eligible for full physician licensure.
● Not in a facility hosting a residency program: Participating facilities are federally-qualified health centers, community health centers, and other providers serving populations of greatest need.
● No repeat of clinical training: ITP would practice independently while being familiarized with Massachusetts and U.S. practice environment, increasing the facility’s capacity to take new patients and allowing it to bill for the physician’s work.
● No “lookback” period: Some states limit eligibility to ITPs who have practiced in their home country within a set prior time period. The PPA reflects the actual experience of ITPs in the U.S., who invest significant time preparing and taking the USMLEs, only to find out that residencies are unavailable to them.