The Texas Senate passed a committee substitute to House Bill 2038 on Monday to create additional licensing pathways for internationally trained physicians and other physicians who meet standards set by the Texas Medical Board.

Senator Sparks, sponsor of the committee substitute, said the bill responds to an expected physician shortfall and creates pathways for trained international physicians to provide care in underserved communities without taking U.S.-funded graduate medical education (GME) residency slots. The bill gives the Texas Medical Board discretion to assess whether a foreign residency is equivalent to U.S. residency and tightens provisional licensing standards, including U.S. Medical Licensing Examination requirements and U.S. equivalency filters.

Senators pressed the sponsor on quality controls and GME slot preservation. Senator Kolkhorst said additional language and floor amendments were added to ensure residency equivalence reviews and to align with the Texas Medical Board's recommendations. Supporters said the measure provides flexibility while protecting quality standards; a floor amendment recommended by the Texas Medical Board and accepted on the floor clarified the board's role in setting equivalency and filtering applicants.

The committee substitute was adopted and the Senate recorded a final passage vote of 30 ayes and 1 nay in the transcript excerpts. Sponsors said the change will free up GME slots because internationally trained physicians who qualify will practice without occupying U.S.-funded residency positions.