Substitute Senate Bill 5,118 would revise Washington’s limited-license pathway for international medical graduates (CE license), removing the separate time-limited clinical-experience license, easing some requirements for the nomination-based license, and extending renewal potential, the House Health Care & Wellness Committee heard March 14.

The bill would eliminate one existing license type, remove the one-year Washington residency requirement for the nomination-based license, require completion of USMLE steps 1 and 2 (rather than all three steps) to qualify, and authorize up to three renewals if the applicant has applied for a residency before the third renewal. The Washington Medical Commission would gain explicit authority to waive statutory or rule requirements for applicants demonstrating hardship and to require alternate demonstrations of competence.

Senator Javier Valdez, the bill’s prime Senate sponsor, described the measure as an extension of a 2019 pilot to expand physician access in rural and underserved areas. ‘‘Over 40 doctors have now been serving in Washington State as part of this program, and over 35,000 patients have been served,’’ Valdez said. The Washington Medical Commission’s deputy executive director Micah Matthews and program case manager Fatima Merza testified the license has produced substantial placement in long-term care and rural settings, reporting that ‘‘about 60 percent of them are in long term care practicing geriatrics’’ and that the WMC has issued ‘‘over 40’’ such licenses since 2021.

Several practicing physicians who used the CE license testified remotely about clinical impact and urged extension or a permanent pathway. Dr. Oksana Nestarenko said the license allowed her to serve roughly 900 patients in post-acute care settings and urged an extension to avoid losing clinicians. Dr. Caleb Chu and Dr. Nerissa Mercado described serving hundreds of elderly and medically complex patients in post-acute and long-term care using the CE license and urged extension and movement toward a permanent full-licensure pathway.

Stakeholders including the Washington State Medical Association and the International Medical Graduates Academy also supported the bill, noting that other states have adopted similar policies and warning that the time-limited nature of the license is prompting some physicians to leave for states with more stable pathways.

Committee members asked for more data on practice areas and retention; sponsor and WMC witnesses said they would follow up with detailed placement and specialty breakdowns. The committee did not take final action on the bill during the hearing.