HOUSE BILL NO. 102 am "An Act relating to the licensure of foreign medical graduates and to applications for a license to practice medicine; and providing for an effective date." This was the first hearing for this bill in the Senate Finance Committee. BEN MILLIGAN, Staff to Representative Bill Stoltze, the bill's sponsor, explained that this bill is an effort to address the shortage of doctors in the State as measured on a per capita basis, particularly in specialty fields. "In order to curb this shortage, it is important to recognize foreign medical school graduates." The current requirement is that doctors must complete a residency program in the United States (U.S.). This legislation would provide the Alaska State Medical Board the discretion to establish proof of competency and professional qualifications requirement in order to allow foreign medical school graduates to practice medicine in the State. Co-Chair Green noted that Members' packets include a one-page bill summary letter [copy on file] dated January 25, 2005 from the Alaska State Medical Association and addressed to Representative Stoltze. 9:20:00 AM Senator Olson spoke in "strong favor" of the bill. He shared that during his membership on the State Medical Board, this issue was a continuing "snag", as many "very good" foreign medical school graduates were unable to practice in the State. Co-Chair Wilken asked how Alaska compares to other states in this regard. 9:20:48 AM Mr. Milligan deferred to a forthcoming testifier, Jim Jordan, as he would be more qualified to address that question. GEORGE STEWART, MD, testified via teleconference from an offnet site to attest to the shortage of doctors in the State, specifically in specialty areas such as pulmonary critical care medicine in which he practices. While, ideally, there should be ten such practitioners, there are currently only eight and two of them, himself included, are 68 years old. This legislation would not "dumb down" acceptance for medical licensure in the State. Dr. Stewart cited two examples of very qualified foreign trained medical doctors who could not practice in the State due to their not meeting the State's U.S. training program requirement. This legislation would have allowed the Medical Board to review these doctors' qualifications and allowed the issuance of licenses to these doctors. The Board was disappointed that the current interpretation to existing requirements disallowed such action. In response to Co-Chair Wilken's question as to how Alaska's requirements compared to other states, he noted that most other states require 24-months of U.S. training. Alaska requires three years of training. 9:24:53 AM Co-Chair Green pointed out that a letter [copy on file] dated April 7, 2005, from Dr. Stewart and addressed to herself and Co-Chair Wilken included the examples presented by Dr. Stewart. JIM JORDAN, Executive Director, Alaska State Medical Association, noted that the aforementioned letter from the Association is indicative of the Association's support of the bill. He urged the committee to adopt the legislation as it would provide the Medical Board "the needed flexibility" that is required in regards to the qualification of foreign graduates. 9:25:48 AM Mr. Jordan added that a March third issue of the USA Today newspaper [copy not provided] cautioned that by the year 2020, the nation would experience a shortage of between 85,000 and 200,000 physicians. The State must be able to attract quality, well-trained physicians, including those who might not have been trained in the U.S. Mr. Jordan stated that some "very positive unintended consequences" could occur were this legislation adopted. Eighty different languages have been reportedly spoken in the Municipality of Anchorage school district. "That is reflective of the diverse ethnicity of our population." It is "very critical" when administering medical care "that the care that is provided be culturally competent". This bill would be an opportunity for some foreign nationals to provide such culturally competent care. They would also serve as teachers for the physicians in the community. 9:27:56 AM Co-Chair Wilken asked Mr. Jordan how the State's requirements compare with other states. 9:28:20 AM Mr. Jordan understood that numerous other states require fewer years of graduate level training programs. In addition, other states' medical boards are allowed "the latitude to adopt by regulation different standards that would provide for competency" of foreign trained medical doctors. Mr. Jordan noted that competency considerations could include licensure in another state for a period of time; English competency; specialty certifications or passage of a U.S. core clinical competency examination. "The key is to provide the discretion to the State Medical Board to adopt by regulation the standards" that would assure that the State has competent physicians. 9:29:38 AM Senator Olson questioned the reason that "such a good bill" had not been introduced before. 9:29:58 AM Mr. Jordan responded that, the fact that medical doctors such as Dr. Stewart, have stepped forward and provided "specific hard core examples" of need have furthered the cause. 9:30:30 AM RICK URION, Director, Division of Occupational Licensing, Department of Community and Economic Development testified in strong support of the bill. He acknowledged the comments of the testifiers and stated that providing the Board the needed discretion would be "a step in the right direction". "This is a good fix." 9:31:27 AM Co-Chair Wilken moved to report the bill from Committee with individual recommendations and accompanying fiscal note. There being no objection, HB 102am was REPORTED from Committee with zero Fiscal Note #1 dated February 2, 2005 from the Department of Commerce, Community and Economic Development. 9:32:04 AM