2100-2115

BUSINESS AND PROFESSIONS CODE
SECTION 2100-2115




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.  An applicant whose professional instruction was acquired in a
country other than the United States or Canada shall provide
evidence satisfactory to the board 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
board that shows final and successful completion of the course.
However, nothing in this section shall be construed to require the
board to evaluate for equivalency any coursework obtained at a
medical school disapproved by the board pursuant to this section.
   (b) Certification by the Educational Commission for Foreign
Medical Graduates, or its equivalent, as determined by the board.
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 subdivision (b) of 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 board 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 board 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) Passage of the written examination as provided under Article 9
(commencing with Section 2170). 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.
   (e)  Nothing in this section prohibits the board from disapproving
a foreign medical school or from denying an application if, in the
opinion of the board, 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) Submitted official evidence satisfactory to the board 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 board to evaluate for
equivalency any coursework obtained at a medical school disapproved
by the board pursuant to Article 4 (commencing with Section 2080).
   (b) Submitted official evidence satisfactory to the board 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.
   (c) Attained a score satisfactory to an approved medical school on
a qualifying examination acceptable to the board.
   (d) Successfully completed one academic year of supervised
clinical training in a program approved by the board pursuant to
Section 2104. The board 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 board pursuant to Section 2104 in satisfaction of the formal
certification requirements of subdivision (b) of Section 2102.
   (e) Satisfactorily completed the postgraduate training required
under Section 2096.
   (f) Passed the written examination required for certification as a
physician and surgeon under 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 board 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 board 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 board 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
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 or division 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, supervised by the
staff of the medical school's medical center, and known for these
purposes as a "visiting fellow." The visiting fellow shall wear a
visible name tag containing the title "visiting fellow" when he or
she provides clinical services.
   (b) (1) Application for approval shall be made on a form
prescribed by the division and shall be accompanied by a fee fixed by
the division in an amount necessary to recover the actual
application processing costs of the program. The application shall
show that the person does not immediately qualify for a physician's
and surgeon's certificate under this chapter and that the person has
completed at least three years of postgraduate basic residency
requirements. The application shall include a written statement of
the recruitment procedures followed by the medical school before
offering the appointment to the applicant.
   (2) Approval shall be granted only for appointment to one medical
school, and no physician shall be granted more than one approval for
the same period of time.
   (3) Approval may be granted for a maximum of three years and shall
be renewed annually. The medical school shall submit a request for
renewal on a form prescribed by the division, which shall be
accompanied by a renewal fee fixed by the division in a amount
necessary to recover the actual application processing costs of the
program.
   (c) Except to the extent authorized by this section, the visiting
fellow may not engage in the practice of medicine. Neither the
visiting fellow nor the medical school may assess any charge for the
medical services provided by the visiting fellow, and the visiting
fellow may not receive any other compensation therefor.
   (d) 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.
   (e) The division shall notify both the visiting fellow and the
dean of the appointing medical school of any complaint made about the
visiting fellow.
   The division may terminate its approval of an appointment for any
act that would be grounds for discipline if done by a licensee. The
division shall provide both the visiting fellow and the dean of the
medical school with a written notice of termination including the
basis for that termination. The visiting fellow may, within 30 days
after the date of the notice of termination, file a written appeal to
the division. The appeal shall include any documentation the
visiting fellow wishes to present to the division.
   (f) 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 and recognized by the division
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. A
certificate of registration does not authorize a registrant to admit
patients to a nursing or a skilled or assisted living facility unless
that facility is formally affiliated with the sponsoring medical
school. A clinical fellowship shall not be submitted as a faculty
service appointment.
   (b) Application for a certificate of registration shall be made on
a form prescribed by the division and shall be accompanied by a
registration fee fixed by the division in a amount necessary to
recover the actual application processing costs of the program. To
qualify for the certificate, an applicant shall submit all of the
following:
   (1) 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, 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.
   (3) If the applicant is a graduate of an approved medical school
in the United States or Canada, documentary evidence that he or she
has completed a resident course of professional instruction as
required in Section 2089.
   (4) Written certification by the head of the department in which
the applicant is to be appointed of all of the following:
   (A) The applicant will be under his or her direction.
   (B) The applicant will not be permitted to practice medicine
unless incident to and a necessary part of his or her duties as
approved by the division in subdivision (a).
   (C) The applicant will be accountable to the medical school's
department chair or division chief for the specialty in which the
applicant will practice.
   (D) The applicant will be proctored in the same manner as other
new faculty members, including, as appropriate, review by the medical
staff of the school's medical center.
   (E) The applicant will not be appointed to a supervisory position
at the level of a medical school department chair or division chief.
   (5) Demonstration by the dean of the medical school that the
applicant has the requisite qualifications to assume the position to
which he or she is to be appointed and that shall include a written
statement of the recruitment procedures followed by the medical
school before offering the faculty position to the applicant.
   (c) A certificate of registration shall be issued only for a
faculty position at one approved medical school, and no person shall
be issued more than one certificate of registration for the same
period of time.
   (d) (1) A certificate of registration is valid for one year from
its date of issuance and may be renewed twice.
   A request for renewal shall be submitted on a form prescribed by
the division and shall be accompanied by a renewal fee fixed by the
division in an amount necessary to recover the actual application
processing costs of the program.
   (2) The dean of the medical school may request renewal of the
registration by submitting a plan at the beginning of the third year
of the registrant's appointment demonstrating the registrant's
continued progress toward licensure and, if the registrant is a
graduate of a medical school other than in the United States or
Canada, that the registrant has been issued a certificate by the
Educational Commission for Foreign Medical Graduates. The division
may, in its discretion, extend the registration for a two-year period
to facilitate the registrant's completion of the licensure process.
   (e) 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 clinical 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.
   (f) Except to the extent authorized by this section, the
registrant shall not engage in the practice of medicine, bill
individually for medical services provided by the registrant, or
receive compensation therefor, unless he or she is issued a physician'
s and surgeon's certificate.
   (g) When providing clinical services, the registrant shall wear a
visible name tag containing the title "visiting professor" or
"visiting faculty member," as appropriate, and the institution at
which the services are provided shall obtain a signed statement from
each patient to whom the registrant provides services acknowledging
that the patient understands that the services are provided by a
person who does not hold a physician's and surgeon's certificate but
who is qualified to participate in a special program as a visiting
professor or faculty member.
   (h) The division shall notify both the registrant and the dean of
the medical school of a complaint made about the registrant. The
division may terminate a registration for any act that would be
grounds for discipline if done by a licensee. The division shall
provide both the registrant and the dean of the medical school with
written notice of the termination and the basis for that termination.
The registrant may, within 30 days after the date of the notice of
termination, file a written appeal to the division. The appeal shall
include any documentation the registrant wishes to present to the
division.


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.