Physician Pathway Act News

The Physician Pathway Act has been signed into law!

The Physician Pathway Act (PPA) will mobilize the expertise of experienced internationally-trained physicians (ITPs) 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.

We are grateful to our bill sponsors, Senator Jason Lewis and Representatives Jack Lewis and Mindy Domb for believing in our vision for a brighter future.

Steps to Licensure

Eligible internationally-trained physicians (ITPs) can get a 1-year limited license to work under a mentor at an approved health center or hospital. After completing this year, they can obtain a 2-year restricted license to work in shortage areas or specialties. After these steps, they can apply for a full license to practice anywhere in Massachusetts. Both the 1-year and 2-year licenses can be renewed once

Mentorship Program Instead of Residency

In the US, doctors need to complete a residency program to get a medical license. This is a major challenge for internationally-trained physicians (ITPs) because they have to compete with new medical graduates for limited spots. The Physician Pathway Act (PPA) replaces the license requirement with mentorship.

The PPA pathway substitutes a 1-year assessment and evaluation program at a participating healthcare facility, where the ITP would practice under a 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 healthcare facilities would include a federally-qualified health center, community health center, hospital, or other healthcare facility approved by the Board of Registration in Medicine.

Eligibility for Limited Licensure (1-2 Years)

The 1-year limited license lets ITPs work in healthcare facilities in Massachusetts approved by the Board of Registration of Medicine. This license can be renewed once. To qualify, an ITP must:

Have graduated from a legally chartered medical school outside the US recognized by the World Health Organization
Have been licensed to practice medicine outside the US and have at least one year of independent practice
Have a valid certificate from the Educational Commission for Foreign Medical Graduates (ECFMG) or another board-approved credential service
Have passed Step 1 and Step 2 Clinical Knowledge (CK) of the United States Medical Licensing Examination (USMLE)
Be accepted into a mentorship program at an approved healthcare facility

Eligibility for a Restricted License

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. It is renewable one time. To be eligible, an internationally-trained physician must have:

1. Successfully completed the participating facility’s assessment and evaluation program
2. Obtained a passing score on Step 3 of the USMLE
3. Fulfilled any additional criteria that the Board may require (except postgraduate clinical training)

After 2 years of practice under the restricted license, the ITP will be eligible to apply for a full, unrestricted license to practice anywhere in Massachusetts.

Why is the PPA Important?

The 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.
No repeat of clinical training: ITP would practice independently while being familiarized with Massachusetts and US practice environments, 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 US, who invest significant time preparing and taking the USMLEs, only to find out that residencies are unavailable to them.

Implementation and Next Steps

Currently, there isn’t a specific timeline for when the PPA will start. Here’s what we know so far:

State Steps:

The Massachusetts Board of Registration in Medicine will create draft rules and ask for public feedback. These rules will list approved facilities and eligibility requirements. Under the new law, any new criteria CANNOT include postgraduate clinical training.
After finalizing these rules, the Board will post them on its website and start accepting applications.

Physician and Facility Steps:

Once the ITP has been accepted into a mentorship program at a participating healthcare facility, the ITP and the facility can apply together for the limited license.

What we don’t know

As this law is still new, we do not have all the information yet. Below are some of the things we do not know yet:

When the limited license application will be available – implementation could take as long as a year.
What additional eligibility criteria will be required by the Board of Registration in Medicine for the 1-year or 2-year license.
What the Board criteria will be for facilities to participate in the program.
The shortage areas or populations to be designated by the Board, as well as which facilities will accept ITPs.
The shortage specialties that will be designated by the Board, though primary care and psychiatry are favored by the PPA.
When employers and insurers will accept PPA licensees for employment.

Resources

Our resources will be under development as we learn more about the implementation of the law.

Resources for ITPs

Please check back soon for updated resources.

Resources for Employers and Facilities

Please check back soon for updated resources.

Stay Updated

Email Maddy Crudele at maddy@africanbn.org to be added to the PPA newsletter, or register below.

ABN and MIRA are long-standing advocates of the PPA. All reliable information and updates regarding the PPA will be shared through our websites and newsletters. Please use us as your first source for all accurate and timely information on the law.

Our Partners

Check out the PPA Information Session hosted by ABN and MIRA on December 16th, 2024, for the most recent information on the law and a Q&A.

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