S.F. 439 Section 1. NEW SECTION . 148I.1 Definitions. 1 For the purposes of this chapter: 2 1. “Board” means the board of medicine established pursuant 3 to chapter 147. 4 2. “Health care facility” means all of the following: 5 a. A facility as defined in section 514J.102. 6 b. A facility licensed pursuant to chapter 135B. 7 c. A facility licensed pursuant to chapter 135C. 8 3. “International medical graduate” means an individual who 9 meets all of the following requirements: 10 a. Has a medical doctorate or substantially similar degree 11 issued by an international medical program in good standing. 12 b. Is in good standing with the medical licensing or 13 regulatory institution of the individual’s resident country. 14 c. Has completed a residency or substantially similar 15 post-graduate medical training in the individual’s resident 16 country or has practiced as a medical professional performing 17 medicine and surgery or osteopathic medicine and surgery for 18 at least two years. 19 d. Possesses basic fluency in the English language. 20 4. “International medical program” means a medical school, 21 residency program, medical internship program, or entity that 22 provides physicians with a medical education or training 23 outside of the United States that is substantially similar to 24 the practice of medicine and surgery or osteopathic medicine 25 and surgery in Iowa. 26 Sec. 2. NEW SECTION . 148I.2 Licensure of international 27 medical graduates. 28 1. The board shall a grant a license to practice medicine 29 and surgery or osteopathic medicine and surgery in this state 30 to an international medical graduate who is a resident of and 31 licensed to practice in any of the following countries: 32 a. Australia. 33 b. Canada. 34 c. Hong Kong. 35 -1- LSB 1866XS (4) 90 ss/rh 1/ 5

S.F. 439 d. Ireland. 1 e. Israel. 2 f. New Zealand. 3 g. Singapore. 4 h. South Africa. 5 i. Switzerland. 6 j. The United Kingdom. 7 k. Additional countries as determined by the board by rule. 8 2. An international medical graduate holding a medical 9 degree from an international medical program accredited 10 pursuant to section 148I.3 shall be granted a license to 11 practice medicine and surgery or osteopathic medicine and 12 surgery in this state without meeting additional training or 13 residency requirements. However, the board shall not grant a 14 license pursuant to this subsection to an international medical 15 graduate who does not possess a federal immigration status 16 allowing the international medical graduate to practice as a 17 physician in the United States. 18 Sec. 3. NEW SECTION . 148I.3 Accreditation of international 19 medical programs. 20 1. The board shall adopt rules pursuant to chapter 17A 21 to allow an international medical program to apply for 22 accreditation with the board. 23 2. The board shall grant an application pursuant to 24 subsection 1 within one hundred twenty days of receiving the 25 application unless the board finds by clear and compelling 26 evidence that a majority of the international medical program’s 27 graduates are not likely to provide medical services that 28 satisfy this state’s medical safety, competence, or conduct 29 standards. An international medical program may appeal a 30 denial pursuant to this subsection in a court of competent 31 jurisdiction within one hundred twenty days of the denial. 32 3. The board shall grant accreditation pursuant to this 33 section, to an international medical program that has granted 34 a medical degree to five international medical graduates who 35 -2- LSB 1866XS (4) 90 ss/rh 2/ 5

S.F. 439 later received a permanent license to practice medicine and 1 surgery or osteopathic medicine and surgery pursuant to section 2 148I.4, subsection 1, paragraph “b” . 3 4. The board shall post a complete list of accredited 4 international medical programs on the internet site of the 5 board. 6 Sec. 4. NEW SECTION . 148I.4 International medical graduates 7 —— provisional licenses. 8 1. a. The board shall grant a provisional license to 9 practice medicine and surgery or osteopathic medicine and 10 surgery in this state to an international medical graduate 11 with an offer for employment as a physician at a health care 12 facility in this state. However, the board shall not grant a 13 license pursuant to this subsection to an international medical 14 graduate who does not possess a federal immigration status 15 allowing the international medical graduate to practice as a 16 physician in the United States. 17 b. A provisional license granted pursuant to paragraph “a” 18 shall be converted to a full license to practice medicine and 19 surgery or osteopathic medicine and surgery after one year 20 unless the license has been revoked pursuant to subsection 2 21 or surrendered by the licensee. 22 2. The board may revoke a provisional license granted 23 pursuant to subsection 1, paragraph “a” , if the board finds by 24 clear and compelling evidence that the licensee has violated 25 a provision of section 148.6. A licensee may appeal a 26 revocation pursuant to this subsection in a court of competent 27 jurisdiction within one hundred twenty days of the revocation. 28 Sec. 5. EFFECTIVE DATE. This Act takes effect January 1, 29 2024. 30 EXPLANATION 31 The inclusion of this explanation does not constitute agreement with 32 the explanation’s substance by the members of the general assembly. 33 This bill relates to the licensure of international 34 medical graduates in Iowa. The bill defines “international 35 -3- LSB 1866XS (4) 90 ss/rh 3/ 5

S.F. 439 medical graduate” as a person who holds a medical doctorate or 1 substantially similar degree issued by an international medical 2 program, is in good standing with the medical regulatory body 3 of the person’s country of residence, has completed a residency 4 or similar post-graduate education program, and has a basic 5 fluency in English. The bill defines “international medical 6 program” as a medical training program or entity that provides 7 physicians with a medical education or training outside of the 8 United States that is substantially similar to the practice of 9 medicine and surgery or osteopathic medicine and surgery in 10 Iowa. 11 The bill requires the board of medicine to grant a license 12 to practice medicine and surgery or osteopathic medicine 13 and surgery to an international medical graduate who is a 14 resident of and licensed to practice in a country listed in 15 the bill. An international medical graduate holding a medical 16 degree from an international medical program shall be allowed 17 to practice medicine and surgery or osteopathic medicine 18 and surgery in Iowa without meeting additional training or 19 residency requirements, provided that the person has a federal 20 immigration status allowing the person to practice as a 21 physician in the United States. The bill allows the board of 22 medicine to expand the list by rule. 23 The bill requires the board of medicine to adopt rules 24 to allow an international medical program to apply for 25 accreditation by the board. The board shall grant an 26 application within 120 days of receiving an application 27 unless the board finds by clear and compelling evidence that 28 a majority of the international medical program’s graduates 29 are not likely to provide medical services that satisfy this 30 state’s medical safety, competence, or conduct standards. A 31 denial of accreditation may be appealed to a court of competent 32 jurisdiction. An international medical program that produces 33 five graduates who later receive full licenses pursuant to this 34 provision shall become an accredited international medical 35 -4- LSB 1866XS (4) 90 ss/rh 4/ 5

S.F. 439 program. 1 The bill requires the board of medicine to issue a 2 provisional license to practice medicine and surgery or 3 osteopathic medicine and surgery in Iowa to an international 4 medical graduate who has an offer for employment as a physician 5 with a health care facility in this state, defined in the 6 bill. The board may revoke a provisional license if the board 7 finds by clear and compelling evidence that the licensee has 8 engaged in conduct for which a licensee in medicine and surgery 9 or osteopathic medicine and surgery may be disciplined. If 10 a provisional license is not revoked or surrendered, the 11 provisional license shall be converted to a full license after 12 one year. 13 The bill takes effect January 1, 2024. 14 -5- LSB 1866XS (4) 90 ss/rh 5/ 5