The bill amends RCW 18.71.051 and adds a new section to chapter 18.71 RCW to create preceptorship and hardship licensure pathways for graduates of medical schools located outside the U.S. and Canada. It authorizes the licensing commission to recognize Canadian medical school accreditation and the Canadian national medical licensure exam as equivalent to U.S. standards, to grant exceptional qualification waivers based on an applicant’s body of work and expert recommendations, and to waive statutory or rule requirements for internationally trained applicants who demonstrate hardship in providing required documents. The commission may require alternate demonstrations of competence (exams, specialty assessments, supervised practice, or other tools) but may not treat inability to complete Educational Commission on Foreign Medical Graduates (ECFMG) certification or examination failures as a hardship. The bill creates a preceptorship pathway that may waive the postgraduate training requirement in RCW 18.71.050(1)(b) and that, upon successful completion, grants full and unrestricted physician and surgeon licensure for practice, employment role definition, malpractice coverage, credentialing, and insurance billing (including Title 48 RCW plans), subject only to disciplinary action or standard practice-level credentialing or agreements. Pathway requirements include licensure under RCW 18.71.095(6) or a hardship waiver under RCW 18.71.051(3), at least four years (48 months) of full-time clinical practice acceptable to the commission, and a satisfactory rating in all categories by a supervising physician using a commission-approved clinical assessment evaluation. To apply for licensure through the pathway, applicants must submit documentation showing the 48 months of supervised full-time clinical practice, satisfactory clinical assessment evaluations, a supervising physician attestation, a written endorsement from the medical director if different, proof of board certification (the commission will accept only ABMS and AAGP certifications for this pathway), and any additional information the commission requires. The commission may also establish an abbreviated assessment program for exceptionally qualified international medical graduates and may adopt rules to implement the new section. The bill was read for the first time on 01/15/25 and referred to the Committee on Health Care & Wellness. The provided facts do not identify the full name of "the commission," do not include the full text of the referenced RCW provisions, do not expand acronyms ABMS or AAGP, and give no timelines for the commission’s rule making or implementation; nothing in the extracted facts indicates any changes to criminal penalties.

If enacted, this bill would give internationally trained physicians a new, practical route to full, unrestricted Washington physician licensure without completing U.S. postgraduate training by allowing a supervised preceptorship: four years of full‑time clinical practice under a supervising physician, satisfactory clinical evaluations, supervising attestations, and ABMS or AAGP board certification would let them apply for the same licensure, malpractice coverage, credentialing, and insurance billing rights as other licensees. The licensing body can also waive some documentary requirements for applicants facing genuine hardship, recognize Canadian accreditation and exams as equivalent, and set up abbreviated assessment options for exceptionally qualified applicants, but it cannot treat failure to complete ECFMG processes or exam failures as a hardship. The people most affected are internationally trained graduates, who gain a new practical option to practice and bill in Washington; supervising physicians and medical directors, who must commit to four years of full‑time supervision, complete evaluations and attestations, and take on related administrative and potential liability responsibilities; and the licensing agency, which must develop rules and application processes. The text leaves unclear which specific commission administers the program, how existing statutory cross‑references will be implemented, and the timing and procedural details for rulemaking, so some operational impacts and credentialing or insurance responses remain uncertain.