2005 California Business and Professions Code Sections 2100-2115 Article 5. Foreign Medical Graduates

2100.  The provisions of this article shall apply to all
applications of graduates of medical schools located outside the
United States or Canada.  Such applicants shall otherwise comply with
the provisions of this chapter, except where such provisions are in
conflict with or inconsistent with the provisions of this article.
2102.  Any applicant whose professional instruction was acquired in
a country other than the United States or Canada shall provide
evidence satisfactory to the division of compliance with the
following requirements to be issued a physician's and surgeon's
certificate:
   (a) Completion in a medical school or schools of a resident course
of professional instruction equivalent to that required by Section
2089 and issuance to the applicant of a document acceptable to the
division that shows final and successful completion of the course.
However, nothing in this section shall be construed to require the
division to evaluate for equivalency any coursework obtained at a
medical school disapproved by the division pursuant to this section.
   (b) Certification by the Educational Commission for Foreign
Medical Graduates, or its equivalent, as determined by the division.
This subdivision shall apply to all applicants who are subject to
this section and who have not taken and passed the written
examination specified in subdivision (d) prior to June 1, 1986.
   (c) Satisfactory completion of the postgraduate training required
under Section 2096.  An applicant shall be required to have
substantially completed the professional instruction required in
subdivision (a) and shall be required to make application to the
division and have passed steps 1 and 2 of the written examination
relating to biomedical and clinical sciences prior to commencing any
postgraduate training in this state.  In its discretion, the division
may authorize an applicant who is deficient in any education or
clinical instruction required by Sections 2089 and 2089.5 to make up
any deficiencies as a part of his or her postgraduate training
program, but that remedial training shall be in addition to the
postgraduate training required for licensure.
   (d) Pass the written examination as provided under Article 9
(commencing with Section 2170).  If an applicant has not
satisfactorily completed at least two years of approved postgraduate
training, the applicant shall also pass the clinical competency
written examination.  An applicant shall be required to meet the
requirements specified in subdivision (b) prior to being admitted to
the written examination required by this subdivision.
   Nothing in this section prohibits the division from disapproving
any foreign medical school or from denying an application if, in the
opinion of the division, the professional instruction provided by the
medical school or the instruction received by the applicant is not
equivalent to that required in Article 4 (commencing with Section
2080).
2103.  An applicant who is a citizen of the United States shall be
eligible for a physician's and surgeon's certificate if he or she has
completed the following requirements:
   (a) Official transcripts or other official evidence satisfactory
to the Division of Licensing of compliance with Section 2088.
   (b) Official evidence satisfactory to the division of completion
of a resident course or professional instruction equivalent to that
required in Section 2089 in a medical school located outside the
United States or Canada.  However, nothing in this section shall be
construed to require the division to evaluate for equivalency any
coursework obtained at a medical school disapproved by the division
pursuant to Article 4 (commencing with Section 2080).
   (c) Official evidence satisfactory to the division of completion
of all formal requirements of the medical school for graduation,
except the applicant shall not be required to have completed an
internship or social service or be admitted or licensed to practice
medicine in the country in which the professional instruction was
completed.
   (d) Attained a score satisfactory to an approved medical school on
a qualifying examination acceptable to the division.
   (e) Successful completion of one academic year of supervised
clinical training in a program approved by the division pursuant to
Section 2104.  The division shall also recognize as compliance with
this subdivision the successful completion of a one-year supervised
clinical medical internship operated by a medical school pursuant to
Chapter 85 of the Statutes of 1972 and as amended by Chapter 888 of
the Statutes of 1973 as the equivalent of the year of supervised
clinical training required by this section.
   (1) Training received in the academic year of supervised clinical
training approved pursuant to Section 2104 shall be considered as
part of the total academic curriculum for purposes of meeting the
requirements of Sections 2089 and 2089.5.
   (2) An applicant who has passed the basic science and English
language examinations required for certification by the Educational
Commission for Foreign Medical Graduates may present evidence of
those passing scores along with a certificate of completion of one
academic year of supervised clinical training in a program approved
by the division pursuant to Section 2104 in satisfaction of the
formal certification requirements of subdivision (b) of Section 2102.
   (f) Satisfactory completion of the postgraduate training required
under Section 2096.
   (g) Passed the written examination required for certification as a
physician and surgeon in this chapter.
2104.  The Division of Licensing shall approve programs of
supervised clinical training in hospitals for the purpose of
providing basic clinical training to students who are graduates of
foreign medical schools or have completed all the formal requirements
for graduation except for internship or social service and who
intend to apply for licensure as a physician and surgeon pursuant to
Section 2103.  Such programs shall be under the direction of approved
medical schools.
2104.5.  The board, in consultation with various medical schools
located in California, the Office of Statewide Health Planning and
Development, and executive directors and medical directors of
nonprofit community health centers, hospital administrators, and
medical directors with experience hiring graduates of the Fifth
Pathway Program or foreign medical school graduates shall study
methods to reactivate the Fifth Pathway Program in medical schools
located in this state.  The executive directors and medical directors
of nonprofit community health centers, the hospital administrators,
and the medical directors should serve or work with underserved
populations or in facilities located in medically underserved
communities or in health professional shortage areas.  The board
shall submit a report to the Legislature on or before July 1, 2003,
that shall include options for the Legislature to consider in order
to facilitate the establishment of one or more Fifth Pathway Programs
in medical schools located in California.  The study shall focus on
whether the Fifth Pathway Program can address the needs of areas
where a shortage of providers exists, communities with a non-English
speaking population in need of medical providers who speak their
native language and understand their culture, and whether it can
provide greater provider stability in these communities.
2105.  No hospital licensed by this state, or operated by the state
or a political subdivision thereof, or which receives state financial
assistance, directly or indirectly, shall require an individual who
at the time of his or her enrollment in a medical school outside the
United States is a citizen of the United States, to satisfy any
requirements other than those contained in subdivisions (a), (b),
(c), (d), and (e) of Section 2103 prior to commencing the
postgraduate training required by subdivision (f) which are not
required for graduates of approved medical schools located in the
United States or Canada.
2107.  (a) The Legislature intends that the Division of Licensing
shall have the authority to substitute postgraduate education and
training to remedy deficiencies in an applicant's medical school
education and training.  The Legislature further intends that
applicants who substantially completed their clinical training shall
be granted that substitute credit if their postgraduate education
took place in an accredited program.
   (b) To meet the requirements for licensure set forth in Sections
2089 and 2089.5, the Division of Licensing may require an applicant
under this article to successfully complete additional education and
training.  In determining the content and duration of the required
additional education and training, the division shall consider the
applicant's medical education and performance on standardized
national examinations, and may substitute approved postgraduate
training in lieu of specified undergraduate requirements.
Postgraduate training substituted for undergraduate training shall be
in addition to the year of postgraduate training required by
Sections 2102 and 2103.
2111.  (a) Physicians who are not citizens but who meet the
requirements of subdivision (b), are legally admitted to the United
States, and who seek postgraduate study in an approved medical school
may, after receipt of an appointment from the dean of the California
medical school and application to and approval by the Division of
Licensing, be permitted to participate in the professional activities
of the department in the medical school to which they are appointed.
  The physician shall be under the direction of the head of the
department to which he or she is appointed, and shall be known for
these purposes as a "Section 2111 guest physician."
   (b) (1) Application for approval shall be made on a form
prescribed by the division.  The application shall show that the
person does not immediately qualify for a physician and surgeon
certificate under this chapter and that the person has completed at
least three years of postgraduate basic residency requirements.
   (2) Approval shall be granted for a maximum of three years and
shall be renewed annually.  Renewal shall be granted subject to the
discretion of the division.  Notwithstanding the limitations in this
subdivision on the length of the approval, a Section 2111 guest
physician may apply for, and the division may in its discretion
grant, not more than two extensions of that approval.  An extension
may be granted only if the dean of the California medical school has
provided justification that the extension is necessary and the person
holds a certificate issued by the Educational Commission for Foreign
Medical Graduates.
   (c) Except to the extent authorized by this section, the visiting
physician may not engage in the practice of medicine, bill for his or
her medical services, or otherwise receive compensation therefor.
The time spent under appointment in a medical school pursuant to this
section may not be used to meet the requirements for licensure under
Section 2102.
   (d) Nothing in this section shall preclude any United States
citizen who has received his or her medical degree from a medical
school located in a foreign country from participating in any program
established pursuant to this section.
2112.  (a) Physicians who are not citizens but are legally admitted
to the United States and who seek postgraduate study, may, after
application to and approval by the Division of Licensing, be
permitted to participate in a fellowship program in a specialty or
subspecialty field, providing the fellowship program is given in a
hospital in this state which is approved by the Joint Committee on
Accreditation of Hospitals and providing the service is satisfactory
to the division.  Such physicians shall at all times be under the
direction and supervision of a licensed, board-certified physician
and surgeon who is recognized as a clearly outstanding specialist in
the field in which the foreign fellow is to be trained.  The
supervisor, as part of the application process, shall submit his or
her curriculum vitae and a protocol of the fellowship program to be
completed by the foreign fellow.  Approval of the program and
supervisor is for a period of one year, but may be renewed annually
upon application to and approval by the division.  The approval may
not be renewed more than four times.  The division may determine a
fee, based on the cost of operating this program, which shall be paid
by the applicant at the time the application is filed.
   (b) Except to the extent authorized by this section, no such
visiting physician may engage in the practice of medicine or receive
compensation therefor.  The time spent under appointment in a medical
school pursuant to this section may not be used to meet the
requirements for licensure under Section 2101 or 2102.
   (c) Nothing in this section shall preclude any United States
citizen who has received his or her medical degree from a medical
school located in a foreign country from participating in any program
established pursuant to this section.
2113.  (a) Any person who does not immediately qualify for a
physician's and surgeon's certificate under this chapter and who is
offered by the dean of an approved medical school in this state a
full-time faculty position may, after application to and approval by
the Division of Licensing, be granted a certificate of registration
to engage in the practice of medicine only to the extent that the
practice is incident to and a necessary part of his or her duties as
approved by the division in connection with the faculty position.
   (b) To qualify for the certificate an applicant shall meet all the
following requirements:
   (1) Furnish documentary evidence satisfactory to the division that
the applicant is a United States citizen or is legally admitted to
the United States.
   (2) If the applicant is a graduate of a medical school other than
in the United States or Canada, furnish documentary evidence
satisfactory to the division that he or she has been licensed to
practice medicine and surgery for not less than four years in another
state or country whose requirements for licensure are satisfactory
to the division, or has been engaged in the practice of medicine in
the United States for at least four years in approved facilities, or
has completed a combination of that licensure and training.
   If the applicant is a graduate of an approved medical school in
the United States or Canada, furnish documentary evidence that he or
she has completed a resident course of professional instruction as
required in Section 2089.
   (3) The head of the department in which the applicant is to be
appointed shall certify in writing to the division that the applicant
will be under his or her direction and will not be permitted to
practice medicine unless incident to and a necessary part of the
applicant's duties as approved by the division in subdivision (a).
   (4) Submit an application on a form prescribed by the division.
   (5) The dean of the medical school shall demonstrate that the
applicant has the requisite qualifications to assume the position to
which he or she is to be appointed.
   (c) A certificate of registration is valid for one year after its
issuance.  During this period the division may require the registrant
to take the written examination required for issuance of a physician'
s and surgeon's certificate.  If the registrant is required to take
the written examination and does not pass, the certificate of
registration shall nevertheless be effective for the one-year period
issued and if the effective period of the certificate will lapse
before the examination may be retaken, the certificate of
registration may be renewed, subject to the discretion of the
division, for a period not to exceed one additional year.
   If the registrant is not required to take the written examination
in order to be issued a certificate of registration or has passed
that examination, the certificate of registration may be renewed
annually at the discretion of the division for a total period of five
years from the date of issuance of the original certificate,
provided, however, that the division, may in its discretion refuse to
renew a certificate of registration if the registrant is a graduate
of a medical school other than in the United States or Canada and has
not, within two years after registration, been issued a certificate
by the Educational Commission for Foreign Medical Graduates.  The
division may condition any renewal on passing the written examination
as described in this subdivision.
   (d) If the registrant is a graduate of a medical school other than
in the United States or Canada, he or she shall meet the
requirements of Section 2102 or 2135, as appropriate, in order to
obtain a physician's and surgeon's certificate.  Notwithstanding any
other provision of law, the division may accept practice in an
appointment pursuant to this section as qualifying time to meet the
postgraduate training requirements in Section 2102, and may, in its
discretion, waive the examination and the Educational Commission for
Foreign Medical Graduates certification requirements specified in
Section 2102 in the event the registrant applies for a physician's
and surgeon's certificate.  As a condition to waiving any examination
or the Educational Commission for Foreign Medical Graduates
certification requirement, the division in its discretion, may
require an applicant to pass the clinical competency examination
referred to in subdivision (d) of Section 2135.  The division shall
not waive any examination for an applicant who has not completed at
least one year in the faculty position.
   (e) Except to the extent authorized by this section, the
registrant shall not engage in the practice of medicine or receive
compensation therefor, unless he or she is issued a physician's and
surgeon's certificate.
2115.  (a) Physicians who are not citizens but are legally admitted
to the United States and who seek postgraduate study may, after
application to and approval by the Division of Licensing, be
permitted to participate in a fellowship program in a specialty or
subspecialty field, providing the fellowship program is given in a
clinic or hospital in a medically underserved area of this state that
is licensed by the State Department of Health Services or is exempt
from licensure pursuant to subdivision (b) or (c) of Section 1206 of
the Health and Safety Code, and providing service is satisfactory to
the division.  These physicians shall at all times be under the
direction and supervision of a licensed, board certified physician
and surgeon who has an appointment with a medical school in
California and is a specialist in the field in which the fellow is to
be trained.  The supervisor, as part of the application process,
shall submit his or her curriculum vitae and a protocol of the
fellowship program to be completed by the foreign fellow.  Approval
of the program and supervisor is for a period of one year, but may be
renewed annually upon application to and approval by the division.
The approval may not be renewed more than four times.  The division
may determine a fee, based on the cost of operating this program,
which shall be paid by the applicant at the time the application is
filed.
   (b) Except to the extent authorized by this section, no visiting
physician may engage in the practice of medicine or receive
compensation therefor.  The time spent under appointment in a clinic
pursuant to this section may not be used to meet the requirements for
licensure under Section 2102.
   (c) Nothing in this section shall preclude any United States
citizen who has received his or her medical degree from a medical
school located in a foreign country from participating in any program
established pursuant to this section.
   (d) For purposes of this section, a medically underserved area
means a federally designated Medically Underserved Area, a federally
designated Health Professional Shortage Area, and any other  clinic
or hospital determined by the board to be medically underserved.
Clinics or hospitals determined by the board pursuant to this
subdivision shall be reported to the Office of Statewide Health
Planning and Development.