Committee hears bipartisan support for provisional licensing, grants for internationally trained health professionals

Lawmakers, licensing officials and internationally trained health-care professionals testified on Feb. 27 in support of Senate Bill 476, a measure that would create provisional licensing pathways for internationally trained health professionals and a grant program to support credentialing and workforce reentry.

The bill’s dash-1 amendment would require licensing boards to publish guidance for internationally educated applicants, require culturally responsive training for board staff, establish a provisional-license pathway for internationally trained physicians with supervision requirements, and create a grant program through the Oregon Department of Human Services to help internationally educated professionals pay fees and access reentry services. Committee staff and several witnesses framed the bill as a workforce and equity proposal that could help reduce “brain waste” — the underutilization of highly skilled immigrants.

Why it matters: supporters said the measure would address workforce shortages across health professions by allowing qualified, experienced international professionals already living in Oregon to reenter their fields under supervision rather than being forced to pursue full repeat training. Witnesses cited economic analyses showing lost earnings and tax revenue when skilled immigrants cannot work in their trained professions.

What supporters said

Sen. Casey Jama, who introduced the bill, described a long-term effort to create pathways for internationally trained professionals and called the proposal a workforce development priority. Rep. Mari Watanabe cited a Migration Policy Institute–commissioned study showing thousands of highly skilled immigrants in Oregon who are underemployed and estimated the state loses significant earnings and tax revenue as a result.

Nicole Krishnaswamy, executive director of the Oregon Medical Board, testified in support of the dash-1 amendment and pointed to national movements toward consistent licensing pathways. She said the amendment’s eligibility criteria would include an assessment that applicants have completed equivalent education and residency training, ECFMG certification and a license in good standing from another jurisdiction. Krishnaswamy also said the amendment maintains the board’s authority to set detailed requirements by rule and noted that the board and a national advisory commission are working on competency assessment models.

Mike Zimmer of World Education Services said 11 states have adopted IMG (international medical graduate) pathways since 2022 and that similar legislation is pending in many other states. He called the measure a means to both use existing workforce capacity and address shortages without requiring reuse of scarce residency positions.

Internationally trained clinicians described barriers to reentering practice. A number of testifiers — physicians, pharmacists and others — said they have clinical experience, have passed parts of the U.S. Medical Licensing Examination (USMLE) or are preparing for exams and lack opportunities to obtain supervised U.S. clinical experience or financial support to complete credentialing steps.

Clarifying details from testimony

- The dash-1 amendment requires provisional supervised practice and contemplates supervision periods used in other states; witnesses said supervision periods vary nationally from about two to five years and that the bill envisions a four-year provisional period.

- The amendment calls for biannual reporting by the Oregon Medical Board with application, approval, denial and disciplinary statistics for the provisional licensing pathway.

- The bill’s pilot professions discussed by sponsors include certified nursing assistant, LPN, RN, physician, pharmacist, dentist and dental hygienist, behavioral-health workers and certain school-based roles.

Questions and implementation concerns

Witnesses and committee members discussed practical implementation issues, including how the board will evaluate international postgraduate training, how provisional licensees would interact with hospital credentialing and insurance panels, and visa and immigration considerations for nonresident applicants. Nicole Krishnaswamy said the board will need time and rulemaking to develop competency-assessment tools and supervisory standards and noted an effective date of Jan. 2027 would allow lead time for those preparations.

Ending

Supporters urged the committee to advance the measure as a workforce and equity reform. The committee closed the public hearing but did not record a committee vote during the session; sponsors and agency staff recommended additional rulemaking and reporting steps if the bill advances.