This bill amends RCW 18.71.051 and creates a new section in chapter 18.71 RCW to establish a "clinical experience graduate pilot program" that creates a procedural pathway to physician licensure for international medical graduates. It adds an exceptional qualification waiver allowing the Washington medical commission to waive specified requirements by rule for applicants with an acceptable body of work and expert recommendations, and authorizes the commission to adopt rules to establish a primary care license for applicants who complete the pilot. These are regulatory and licensing changes, not criminal provisions. The new pilot program requires the commission to administer eligibility and training standards. To qualify, applicants must hold a clinical experience license issued on or before July 1, 2026, have completed two years of continuous supervised clinical practice under that license, have no active disciplinary action or significant disciplinary history as determined by the commission, obtain satisfactory clinical assessment evaluations from their supervising physician, and secure required attestations and endorsements by the supervising physician and medical director. The bill directs the commission to engage the American Board of Medical Specialties about possible board certification processes for participants. To obtain full, unrestricted primary care licensure through this pathway, participants must complete two additional years of supervised practice, meet the clinical experience license program requirements, pass USMLE Step 3, and complete a commission-approved clinical competency assessment. Eligible practice sites for the program include hospitals, federally qualified health centers, government entities, qualifying private practices or physician employment groups, and commission-approved mental and behavioral health facilities. The commission must report annually to the Legislature by November 1, 2027, and each November 1 through 2035 on program data, practice patterns, disciplinary actions, and recommendations for expansion; the pilot section expires June 30, 2035. The provided text does not define key terms such as "clinical experience license," "supervising physician," "medical director," or the content and approval criteria for the required clinical assessments, nor does it specify how the commission will determine "significant disciplinary history" or the details of its engagement with the American Board of Medical Specialties. The amendment also contains deletions and changes to RCW 18.71.051 whose full implications cannot be determined from the excerpt alone.

If enacted, the bill creates a temporary pilot that gives international medical graduates already working under a specific "clinical experience" license a clear route to become fully licensed primary care physicians in Washington after additional supervised practice and passing USMLE Step 3 and a commission-approved competency assessment. Practically, this will likely expand the pool of eligible primary care doctors in hospitals, community health centers, certain large private practices, government sites, and approved behavioral health facilities by letting qualifying international graduates complete a defined supervised pathway instead of meeting some traditional requirements. Participants must already have the clinical experience license by July 1, 2026 and complete two years of supervised practice to enter the pilot, then two more years plus the listed assessments to qualify for full licensure. The Washington Medical Commission will take on new responsibilities to create and run the pilot, adopt rules for a new primary care license, report yearly to the legislature through 2035, and consult with the American Board of Medical Specialties about board certification options. That will create administrative costs and work for the commission and new duties for supervising physicians and practice sites, which must provide evaluations, attestations, and endorsements for participants. The law leaves key terms and some implementation details undefined (for example what the clinical experience license requires, how "supervising physician" is qualified, and what a "clinical competency assessment" must include), so how burdens and costs are allocated in practice and how quickly participants can progress will depend on rules the commission adopts.