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Panel approves temporary Maryland licenses for internationally trained physicians
Summary
The Health and Government Operations Committee approved House Bill 1199, creating a time-limited licensing pathway for physicians trained and licensed outside the U.S., with procedural amendments including a ‘‘domiciled in the state’’ requirement and a three‑year, nonrenewable license term.
The Health and Government Operations Committee on April 1 voted to approve House Bill 1199 as amended, a measure that creates a temporary licensing pathway for physicians licensed and trained outside the United States. The bill directs the Maryland Board of Physicians to begin issuing time-limited licenses under specified conditions and requires the Board to adopt regulations to implement the pathway.
The measure, sponsored by Delegate Hill, allows the Board of Physicians beginning 10/01/2027 to issue a license to a physician licensed in a country other than the United States, its territories, Puerto Rico or Canada if the applicant meets requirements set in the bill. The license may not exceed three years and may not be renewed. The board may revoke the license if the licensee practices outside the scope of the license, has their employment terminated, has been subject to disciplinary action or is no longer eligible for the license. The bill requires the Board to adopt regulations covering minimum qualifications, application fees, conditions applicable to licensees and a pathway to full licensure.
Committee amendments adopted in subcommittee and on the floor clarified several conditions. They require that applicants demonstrate that they practiced medicine for five of the seven years immediately preceding the application and that the board may determine that past discipline is disqualifying. Committee members also removed a fixed one‑year residency-in‑state requirement and replaced it with language that an applicant be domiciled in Maryland — eliminating a specified time-in-state minimum.
Supporters framed the bill as a way to recognize experienced physicians already living in Maryland and to expand clinical capacity without creating a short-term recruiting pathway for out-of-state clinicians. "This is not a recruitment tool," Delegate Hill said, adding the statute is aimed at physicians already resident in Maryland.
Committee members pressed for implementation details. Several asked whether the bill would harm U.S. medical graduates by using residency slots; Hill said the alternative pathway could free residency slots and benefit U.S. graduates. Members also asked about the number of eligible physicians already in Maryland; the sponsor said that number is "not specified" and staff did not have a figure at the hearing.
The bill sets several credential and testing requirements: the applicant must hold a medical degree recognized by the World Health Organization, complete at least two years of postgraduate training equivalent to an ACGME‑accredited residency, and satisfy examination and verification requirements such as ECFMG certification and passing scores on USMLE steps. The Board will define any additional coursework, supervision or conditions necessary during the temporary license term.
Committee members raised the bill's fiscal impact. Delegate Hill said the fiscal note remains a sizable special‑funds cost to the Board of Physicians but that Appropriations has approved the appropriation because the board is funded through fees rather than the general fund. "The fiscal note is still what it was ... but because the Board of Physicians raises fees to pay for all of its expenses and none of it comes out of the general fund, the Appropriations Committee approved it," Hill said.
After debate and two adopted amendments (one moved by Rosenberg), the committee voted to approve the bill as amended. Several members asked the Board to report back on implementation numbers; committee members agreed to request post‑implementation reporting and to continue technical work with the Board and stakeholder groups during rulemaking.
Votes and membership notes recorded during the roll call: when members were asked to indicate opposition, Delegates Kipke, Riley, Chisholm, Morgan and Hutchinson were recorded as objecting; Delegates Lopez and Shalika were excused. The committee moved the bill forward as amended.
