HB 598 creates a new limited licensure pathway for internationally trained physicians to practice medicine in Maryland under specified conditions, beginning January 1, 2028. The bill authorizes the State Board of Physicians to issue a limited license to certain physicians educated and trained outside the United States, its territories, Puerto Rico, and Canada, provided they meet requirements related to medical education, postgraduate training, prior practice experience, English proficiency, moral character, exam performance, and good standing with foreign licensing authorities. The limited license is time-limited to three years, may not be renewed, and is intended to lead toward full licensure if the physician later satisfies additional board requirements.
The bill also revises existing rules for physicians licensed in another jurisdiction who are practicing in Maryland without a Maryland license in certain training or teaching settings, tightening the disciplinary-history standard by allowing some prior discipline if it has been satisfied and corrected to the Board’s satisfaction. In addition, it removes references to Puerto Rico from several osteopathic education provisions and repeals the existing § 14-308 while replacing it with a much more detailed new section governing internationally trained physicians. The Board must adopt regulations on qualifications, fees, conditions of practice, and a pathway to full licensure, and must report to the legislature on implementation readiness before the program begins.
The bill’s impact on state law is significant because it adds a new statutory framework in the Health Occupations Article for foreign-trained physicians, including definitions for community sponsors, facilities, and a state standard of care assessment. It also creates a supervised practice model that can require employment at approved facilities or affiliation with approved community sponsors, with restrictions such as no solo practice and no supervision of physician assistants, residents, or medical students for certain license holders. The measure also directs Maryland medical schools and related entities to help develop the assessment tool and requires the Board to consult with MedChi on implementation.
Overall sentiment appears favorable, as reflected by the committee report and House action adopting the bill, with no recorded opposing votes or transcripted debate in the provided materials. The bill’s structure suggests a policy goal of expanding the physician workforce while maintaining oversight and patient-safety safeguards. The absence of recorded floor or committee testimony in the provided context limits insight into detailed public debate, but the favorable action indicates broad legislative support.
The main points of contention likely concern how much flexibility to give internationally trained physicians versus how much supervision and testing should be required before independent practice. Potential concerns include patient safety, verification of foreign credentials and disciplinary history, the adequacy of the state standard of care assessment, and whether the pathway is too restrictive or too permissive. The bill also creates administrative burdens for the Board and participating facilities, which may be a point of concern for implementation.
HB 598 repeals the existing physician licensure provision at § 14-308 and replaces it with a new, detailed licensing pathway in the Health Occupations Article for internationally trained physicians. It also amends related provisions governing out-of-state physicians practicing in Maryland, osteopathic education references, and board authority over licensure standards, regulations, and enforcement. The bill expands the Board’s regulatory role, creates new definitions and supervision requirements, and establishes reporting and implementation deadlines for the Board and designated medical institutions.
The available legislative history indicates generally favorable sentiment toward the bill. The House adopted the committee-reported version, and the Senate Finance Committee later reported the bill favorably with amendments. No vote breakdown or committee transcript is provided, so there is no evidence in the record supplied here of organized opposition or divided sentiment, though the bill’s detailed supervision and credentialing requirements suggest an effort to balance workforce expansion with patient-safety concerns.
Likely areas of contention include the standards for foreign medical education and postgraduate training, the use and design of the state standard of care assessment, and the extent of supervision required before a physician can move toward full licensure. Stakeholders concerned with workforce shortages may favor the bill’s new pathway, while patient-safety advocates or licensing regulators may focus on verifying discipline history, malpractice history, and competence. Facilities and the Board may also be concerned about the administrative and oversight responsibilities created by the bill.