1.1 	A bill for an act
1.2 	relating to health occupations; changing a medical practice licensing provision 
1.3 	for United States or Canadian medical school graduates; modifying the time 
1.4 	period in which applicants applying for a license to practice medicine must 
1.5 	take and pass the United States Medical Licensing Examination; permitting 
1.6 	certain foreign medical school graduates to use a credentials verification service;
1.7 	amending Minnesota Statutes 2006, sections 147.02, subdivision 1, by adding a 
1.8 	subdivision; 147.037, subdivision 1.
1.9 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.10 	Section 1. Minnesota Statutes 2006, section 147.02, subdivision 1, is amended to read:
1.11 		Subdivision 1.United States or Canadian medical school graduates. The board 
1.12 	shall issue a license to practice medicine to a person not currently licensed in another state 
1.13 	or Canada and who meets the requirements in paragraphs (a) to  (i).
1.14 	(a) An applicant for a license shall file a written application on forms provided by 
1.15 	the board, showing to the board's satisfaction that the applicant is of good moral character 
1.16 	and satisfies the requirements of this section.
1.17 	(b) The applicant shall present evidence satisfactory to the board of being a graduate 
1.18 	of a medical or osteopathic school located in the United States, its territories or Canada, 
1.19 	and approved by the board based upon its faculty, curriculum, facilities, accreditation by a 
1.20 	recognized national accrediting organization approved by the board, and other relevant 
1.21 	data, or is currently enrolled in the final year of study at the school.
1.22 	(c) The applicant must have passed an examination as described in clause (1) or (2).
1.23 	(1) The applicant must have passed a comprehensive examination for initial licensure 
1.24 	prepared and graded by the National Board of Medical Examiners, the Federation of 
1.25 	State Medical Boards, the National Board of Medical Examiners, the Medical Council of 
2.1 	Canada, or the appropriate state board that the board determines acceptable. The board 
2.2 	shall by rule determine what constitutes a passing score in the examination.
2.3 	(2) The applicant taking the United States Medical Licensing Examination (USMLE) 
2.4 	must have passed steps one, two, and three within a seven-year period. This seven-year 
2.5 	period begins when the applicant first passes either step one or two, as applicable. 
2.6 	Applicants actively enrolled in or graduated from accredited MD/PhD, MD/JD, MD/MBA, 
2.7 	or MD/MPH dual degree programs or osteopathic equivalents must have passed each of 
2.8 	steps one, two, and three within three attempts in seven years plus the time taken to obtain 
2.9 	the non-MD degree or ten years, whichever occurs first. Step three must be passed within 
2.10 	five years of passing step two, or before the end of residency training. The applicant must 
2.11 	pass each of steps one, two, and three with passing scores as recommended by the USMLE 
2.12 	program within three attempts. The applicant taking combinations of Federation of State 
2.13 	Medical Boards, National Board of Medical Examiners, and USMLE may be accepted 
2.14 	only if the combination is approved by the board as comparable to existing comparable 
2.15 	examination sequences and all examinations are completed prior to the year 2000.
2.16 	(d) The applicant shall present evidence satisfactory to the board of the completion 
2.17 	of one year of graduate, clinical medical training in a program accredited by a national 
2.18 	accrediting organization approved by the board or other graduate training approved 
2.19 	in advance by the board as meeting standards similar to those of a national accrediting 
2.20 	organization.
2.21 	(e) The applicant shall make arrangements with the executive director to appear in 
2.22 	person before the board or its designated representative to show that the applicant satisfies 
2.23 	the requirements of this section. The board may establish as internal operating procedures 
2.24 	the procedures or requirements for the applicant's personal presentation.
2.25 	(f) The applicant shall pay a fee established by the board by rule. The fee may not be 
2.26 	refunded. Upon application or notice of license renewal, the board must provide notice 
2.27 	to the applicant and to the person whose license is scheduled to be issued or renewed of 
2.28 	any additional fees, surcharges, or other costs which the person is obligated to pay as a 
2.29 	condition of licensure. The notice must:
2.30 	(1) state the dollar amount of the additional costs; and
2.31 	(2) clearly identify to the applicant the payment schedule of additional costs.
2.32 	(g) The applicant must not be under license suspension or revocation by the 
2.33 	licensing board of the state or jurisdiction in which the conduct that caused the suspension 
2.34 	or revocation occurred.
2.35 	(h) The applicant must not have engaged in conduct warranting disciplinary action 
2.36 	against a licensee, or have been subject to disciplinary action other than as specified in 
3.1 	paragraph (g). If the applicant does not satisfy the requirements stated in this paragraph, 
3.2 	the board may issue a license only on the applicant's showing that the public will be 
3.3 	protected through issuance of a license with conditions and limitations the board considers 
3.4 	appropriate.
3.5 	(i) If the examination in paragraph (c) was passed more than ten years ago, the 
3.6 	applicant must either:
3.7 	(1) pass the special purpose examination of the Federation of State Medical Boards 
3.8 	with a score of 75 or better within three attempts; or
3.9 	(2) have a current certification by a specialty board of the American Board of 
3.10 	Medical Specialties, of the American Osteopathic Association Bureau of Professional 
3.11 	Education, the Royal College of Physicians and Surgeons of Canada, or of the College 
3.12 	of Family Physicians of Canada.

3.13 	Sec. 2. Minnesota Statutes 2006, section 147.02, is amended by adding a subdivision 
3.14 	to read:
3.15 		Subd. 1b.Examination extension; medical reasons. The board may grant an 
3.16 	extension to the time period and to the number of attempts permitted to pass the United 
3.17 	States Medical Licensing Examination (USMLE) as specified in subdivision 1, paragraph 
3.18 	(c), clause (2), if an applicant has been diagnosed with a medical illness during the process 
3.19 	of taking the USMLE but before passage of all steps, or fails to pass a step within three 
3.20 	attempts due to the applicant's medical illness. Proof of the medical illness must be 
3.21 	submitted to the board on forms and according to the timelines of the board.

3.22 	EFFECTIVE DATE. This section is effective the day following final enactment.

3.23 	Sec. 3. Minnesota Statutes 2006, section 147.037, subdivision 1, is amended to read:
3.24 		Subdivision 1.Requirements. The board shall issue a license to practice medicine 
3.25 	to any person who satisfies the requirements in paragraphs (a) to (g).
3.26 	(a) The applicant shall satisfy all the requirements established in section 147.02, 
3.27 	subdivision 1, paragraphs (a), (e), (f), (g), and (h). 
3.28 	(b) The applicant shall present evidence satisfactory to the board that the applicant 
3.29 	is a graduate of a medical or osteopathic school approved by the board as equivalent 
3.30 	to accredited United States or Canadian schools based upon its faculty, curriculum, 
3.31 	facilities, accreditation, or other relevant data. If the applicant is a graduate of a medical 
3.32 	or osteopathic program that is not accredited by the Liaison Committee for Medical 
3.33 	Education or the American Osteopathic Association, the applicant must may use the 
3.34 	Federation of State Medical Boards' Federation Credentials Verification Service (FCVS) 
4.1 	or its successor. If the applicant uses this service as required allowed under this paragraph, 
4.2 	the physician application fee may be less than $200 but must not exceed the cost of 
4.3 	administering this paragraph.
4.4 	(c) The applicant shall present evidence satisfactory to the board that the applicant 
4.5 	has been awarded a certificate by the Educational Council for Foreign Medical Graduates, 
4.6 	and the applicant has a working ability in the English language sufficient to communicate 
4.7 	with patients and physicians and to engage in the practice of medicine.
4.8 	(d) The applicant shall present evidence satisfactory to the board of the completion 
4.9 	of two years of graduate, clinical medical training in a program located in the United 
4.10 	States, its territories, or Canada and accredited by a national accrediting organization 
4.11 	approved by the board. This requirement does not apply:
4.12 	(1) to an applicant who is admitted as a permanent immigrant to the United States on 
4.13 	or before October 1, 1991, as a person of exceptional ability in the sciences according to 
4.14 	Code of Federal Regulations, title 20, section 656.22(d);
4.15 	(2) to an applicant holding a valid license to practice medicine in another country 
4.16 	and issued a permanent immigrant visa after October 1, 1991, as a person of extraordinary 
4.17 	ability in the field of science or as an outstanding professor or researcher according to 
4.18 	Code of Federal Regulations, title 8, section 204.5(h) and (i), or a temporary nonimmigrant 
4.19 	visa as a person of extraordinary ability in the field of science according to Code of 
4.20 	Federal Regulations, title 8, section 214.2(o),
4.21 	provided that a person under clause (1) or (2) is admitted pursuant to rules of the United 
4.22 	States Department of Labor; or
4.23 	(3) to an applicant who is licensed in another state, has practiced five years without 
4.24 	disciplinary action in the United States, its territories, or Canada, has completed one year 
4.25 	of the graduate, clinical medical training required by this paragraph, and has passed the 
4.26 	Special Purpose Examination of the Federation of State Medical Boards within three 
4.27 	attempts in the 24 months before licensing.
4.28 	(e) The applicant must:
4.29 	(1) have passed an examination prepared and graded by the Federation of State 
4.30 	Medical Boards, the United States Medical Licensing Examination program in accordance 
4.31 	with section 147.02, subdivision 1, paragraph (c), clause (2), or the Medical Council 
4.32 	of Canada; and 
4.33 	(2) have a current license from the equivalent licensing agency in another state or 
4.34 	country and, if the examination in clause (1) was passed more than ten years ago, either:
4.35 	(i) pass the Special Purpose Examination of the Federation of State Medical Boards 
4.36 	with a score of 75 or better within three attempts; or
5.1 	(ii) have a current certification by a specialty board of the American Board of 
5.2 	Medical Specialties, of the American Osteopathic Association Bureau of Professional 
5.3 	Education, of the Royal College of Physicians and Surgeons of Canada, or of the College 
5.4 	of Family Physicians of Canada.
5.5 	(f) The applicant must not be under license suspension or revocation by the licensing 
5.6 	board of the state or jurisdiction in which the conduct that caused the suspension or 
5.7 	revocation occurred.
5.8 	(g) The applicant must not have engaged in conduct warranting disciplinary action 
5.9 	against a licensee, or have been subject to disciplinary action other than as specified in 
5.10 	paragraph (f). If an applicant does not satisfy the requirements stated in this paragraph, 
5.11 	the board may issue a license only on the applicant's showing that the public will be 
5.12 	protected through issuance of a license with conditions or limitations the board considers 
5.13 	appropriate.

5.14 	EFFECTIVE DATE. This section is effective the day following final enactment.