Bill Text: CA SB1410 | 2009-2010 | Regular Session | Enrolled
Bill Title: Medicine: licensure examinations.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Vetoed) 2010-09-29 - In Senate. To unfinished business. (Veto) [SB1410 Detail]
Download: California-2009-SB1410-Enrolled.html
BILL NUMBER: SB 1410 ENROLLED
BILL TEXT
PASSED THE SENATE AUGUST 25, 2010
PASSED THE ASSEMBLY AUGUST 19, 2010
AMENDED IN ASSEMBLY JUNE 23, 2010
AMENDED IN SENATE MAY 19, 2010
INTRODUCED BY Senator Cedillo
FEBRUARY 19, 2010
An act to amend Section 2177 of, and to add Sections 2177.5 and
2177.7 to, the Business and Professions Code, relating to medicine.
LEGISLATIVE COUNSEL'S DIGEST
SB 1410, Cedillo. Medicine: licensure examinations.
Existing law, the Medical Practice Act, requires the Medical Board
of California to issue a physician's and surgeon's certificate to a
qualified applicant. Under the act, an applicant for a physician's
and surgeon's certificate is required to include specified
information with his or her application and to obtain a passing score
on an entire examination or on each part of an examination. Existing
law authorizes applicants to take the written examinations conducted
or accepted by the board in separate parts, and requires the board
to adopt by resolution the passing score for each examination or each
part of an examination. Existing law requires an applicant to obtain
a passing score on Step III of the United States Medical Licensing
Examination within not more than 4 attempts of taking that part of
the examination.
This bill would delete the prohibition on taking Step III of the
United States Medical Licensing Examination more than 4 times. The
bill would also require the board to accept as a passing score from
an applicant the passing score that was adopted by the board and in
effect on the date the applicant registered for that examination or
part of the examination. The bill would further require the board to
act by passing a resolution every time it adopts a passing score for
an entire examination or for each part of an examination that is
required for certification, subject to specified requirements and in
conformity with the court's holding in Marquez v. Medical Board of
California (2010) 182 Cal.App.4th 548.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature finds and declares all of the
following:
(a) Under Section 2177 of the Business and Professions Code, an
applicant who is seeking a physician's and surgeon's certificate in
California must obtain a passing score on Step III of the United
States Medical Licensing Examination (USMLE) within not more than
four attempts in order to be eligible for a certificate. The
examination has three steps. However, only Step III has a limit on
the number of times that an applicant may attempt to pass the step.
(b) The USMLE is administered by the Federation of State Medical
Boards (FSMB), a national nonprofit entity. Periodically, the FSMB
recommends passing scores to the various state medical boards. It is
left to the discretion of each state board to determine whether to
adopt the recommended score. Historically, the Medical Board of
California (MBC) has not had a formal procedure regarding adoption of
the FSMB recommended passing score.
(c) When an applicant registers for the USMLE, he or she has an
eligibility period of three months in which to take the examination.
Multiple examination dates are available within the three-month
period. The lack of a formal adoption process within the MBC,
combined with a three-month window to take the examination after
registration, has created some confusion as the MBC may increase the
accepted passing score at any time without public record, input, or
notification to applicants who have already registered for the
examination.
(d) Furthermore, prior to the enactment of Chapter 843 of the
Statutes of 2006 (AB 1796), California did not limit the number of
times an applicant may take any part of the USMLE. Under the new law,
which places an arbitrary limit of attempts on Step III of the
examination, highly qualified and much needed physicians and surgeons
are being denied a license to practice medicine in California. Their
only option is to move to another state, become licensed and
practice there, and return four years later.
(e) Failing to pass the USMLE under an arbitrary cap on the number
of attempts does not translate into a lack of competency in
providing high-quality medical care. Furthermore, existing law does
not take into consideration learning disabilities, a history of poor
performance on standardized tests, hardships, or other variables that
may impede the ability of an individual to pass the examination,
essentially discriminating against certain applicants.
(f) Twenty-seven states in the United States and two territories
have more lenient policies regarding the USMLE, which may include
having no cap or allowing for more attempts than California. Those
states and territories include AL, AZ, CO, CT, DE, FL, GU, HI, IA,
IL, KS, MA, MI, MN, MS, MT, NM, NV, NJ, NY, NC, ND, OH, OK, PA, TN,
VA, VI, and WY. In fact, AZ, CO, CT, DE, GU, HI, IA, KS, MA, MI, MN,
MS, MT, NJ, NY, NC, ND, OH, PA, TN, VI, VA, and WY have no limit on
the number of times an applicant may take the examination.
(g) Lastly, even though Assembly Bill 1796 was signed by the
Governor, he expressed concerns with the measure. The Governor issued
a signing message stating that Assembly Bill 1796 failed to provide
the appropriate exceptions to the requirement that physicians and
surgeons applying for licensure pass Step III of the USMLE within
four attempts, and that Assembly Bill 1796 may have unintended
consequences. The Governor requested that the MBC address his
concerns. Subsequently, the MBC requested that language be added to
Section 2177 of the Business and Professions Code that would
cross-reference Section 2135.5 of the Business and Professions Code
to exempt from the four-attempt limitation an applicant who holds an
unlimited and restricted license as a physician and surgeon in
another state and who has held that license continuously for a
minimum of four years prior to the date of application. This
amendment was added by Chapter 588 of the Statutes of 2007 (SB 1048),
which was an omnibus bill for the Senate Committee on Business and
Professions.
(h) The inclusion of those changes by Senate Bill 1048 has proven
to be an inadequate approach to addressing the need for flexibility
and consideration of other factors that may contribute to an
individual failing to pass Step III of the USMLE within four
attempts. It is now viewed by the Legislature as unreasonable to
require an individual to leave the state, go through all the steps
necessary to obtain licensure in another state, and then return to
California after four years to obtain a license to practice medicine.
(i) It is further unreasonable for the MBC to change the passing
score for an examination once an applicant has registered for that
examination without any formal procedure or notification to the
applicant.
SEC. 2. Section 2177 of the Business and Professions Code is
amended to read:
2177. (a) A passing score is required for an entire examination
or for each part of an examination, as established by resolution of
the board.
(b) Applicants may elect to take the written examinations
conducted or accepted by the board in separate parts.
(c) An applicant shall have obtained a passing score on Step III
of the United States Medical Licensing Examination in order to be
eligible for a physician's and surgeon's certificate.
SEC. 3. Section 2177.5 is added to the Business and Professions
Code, to read:
2177.5. Notwithstanding subdivision (a) of Section 2177, the
board shall accept as a passing score on an examination or part of an
examination from an applicant the passing score that was adopted by
the board and in effect on the date the applicant registered for that
examination or part of the examination.
SEC. 4. Section 2177.7 is added to the Business and Professions
Code, to read:
2177.7. (a) Pursuant to Sections 2177 and 2184, the board shall
adopt a resolution every time the board adopts a passing score for an
entire examination or for each part of an examination that is
required for certification under this article.
(b) The resolution required pursuant to subdivision (a) shall be
adopted or readopted at a public meeting of the board, and subject to
public input and an affirmative vote of a majority of board members
present at the meeting constituting at least a quorum.
(c) The board shall not delegate to any other entity, whether by
contract or resolution, the responsibility to adopt the passing score
described in this section. If the board adopts the recommended
passing score of another entity as its passing score for an
examination or any part of an examination and that entity
subsequently changes that recommended passing score, the board's
passing score shall not be changed unless the board readopts that
recommended passing score, or adopts some other score, by resolution
pursuant to this section.
(d) The passing score to be adopted pursuant to this section shall
be stated as a numerical score and shall not be stated as a
percentage of correct answers.
SEC. 5. (a) It is the intent of the Legislature in enacting
Section 4 of this act that the Medical Board of California comply
with the court's holding in Marquez v. Medical Board of California
(2010) 182 Cal.App.4th 548.
(b) Sections 2177 and 2184 of the Business and Professions Code
unambiguously require the Medical Board of California to establish a
passing score for Step III of the United States Medical Licensing
Examination and to do so by resolution.
(c) The board shall adopt a passing score by means of a formal,
memorialized public vote. This single, unambiguous statutory
requirement is intended to keep the board accountable to the
Legislature, the medical professions, medical license applicants, and
the public, and to prevent the board from delegating this
responsibility to anyone else.
