ADEA State Update

States Develop New Paths for Medical School Students

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As states work to balance tight state budgets with an ever increasing demand for healthcare services, as a result of an aging baby-boomer population and implementation of the Affordable Care Act, more state legislatures are looking for new ways to address primary care professional shortages. Below is a brief summary of how two states, California and Missouri, are tackling the issue.


Gov. Jerry Brown (D-CA) signed A.B. 1838 into law on July 18. The new law allows accelerated medical school graduation (three years instead of four) in an effort to address the physician shortage in California. 

According to the bill sponsor, Assembly Member Susan Bonilla (D-CA), “California faces an extreme shortage of trained medical residents and physicians; and A.B. 1838 is an innovative step towards addressing this problem and meeting the needs of our communities, without diminishing the quality of patient care.”

In addition, “the new law could also help those medical school graduates rack up less debt during a shortened medical school track,” stated Assembly Member Bonilla in a recent press release.

The legislative analysis for A.B. 1838 states that New York University School of Medicine, Texas Tech University Health Sciences Center and Columbia University’s College of Physicians and Surgeons already have three-year programs for students who know which specialty they plan to enter and meet enhanced admissions requirements.

The University of California system has six of the nine medical schools in the state. Its medical centers provide specialty training for nearly half of the state’s medical residents. UC Davis School of Medicine has already begun its new accelerated program—it enrolled its first class of four accelerated students in June. 

A.B. 1838 will be effective January 2015.


Gov. Jay Nixon (D-MO) signed S.B. 716 into law on July 10. The new law establishes the role of an assistant physician. The law allows medical school graduates, who have completed their licensing exams but have not finished a residency, to practice immediately in medically underserved rural or urban areas. 

Under the new law, the Missouri Board of Registration for the Healing Arts is authorized to establish rules for establishing licensure and renewal procedures, supervision, fees, and collaborative practice agreements.[1] According to the Board website, the rule promulgation process is lengthy and as a result, “the Board does not anticipate the licensure of assistant physicians to begin until at least the summer or fall of 2015.”  

S.B. 716 will be effective August 28, 2014.

[1] According to the new law the assistant physician collaborative practice agreement is an agreement between a physician and an assistant physician detailing the services the assistant physician may perform, including the authority to administer or dispense drugs. No assistant physician may practice without an assistant physician collaborative practice agreement.

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