Good morning, and thank you, Chair Wahab, Vice Chair Choi, and members of the committee, for the opportunity to testify today. My name is Lawson Mansell and I am a senior health policy analyst at the Niskanen Center, a non-partisan think tank based in Washington, DC. My colleagues and I have been providing expert technical assistance to legislators across the country working on licensing pathways for internationally trained doctors. I am here to testify in support of Assembly Bill 2386.
AB 2386 creates a pathway for internationally trained physicians and grants permanent licensure to the physicians currently in the Licensed Physicians from Mexico Program. Physicians would be sponsored by a licensed facility, complete a period of supervised practice, and then become eligible for full licensure.
This legislation is sorely needed, as experts predict that California will need an additional 10,500 primary care providers in the next 4 years to meet the demand for care.1 Rural communities, the Inland Empire, and the San Joaquin Valley bear the heaviest burden of this shortage.2
Still, California requires internationally-trained doctors to repeat their residency here before obtaining full licensure. This unnecessary duplication prevents qualified doctors from contributing to patient care. As a result, many trained doctors are forced into positions well below their expertise or unable to practice at all, instead working service jobs rather than using their extensive training and highly specialized skills to heal and cure.3
The existing Mexico program already shows this model works, allowing AB 2386 to build on a track record of demonstrated success. An independent UC Davis evaluation found that participating physicians integrated well into community health centers, expanded access to care, and improved patient trust.4 Twenty-seven states, including neighboring Oregon and Nevada, have adopted similar pathways in recent years, and AB 2386 reflects the lessons of those programs: clear eligibility, sponsorship, supervised practice, and a defined route to full licensure.
California is also in a unique position to implement this law with limited administrative burdens. The credentialing and oversight systems built for the existing Mexico pilot program are in place and the healthcare facilities that participated know how to integrate these physicians into their care teams. California patients, particularly those in underserved communities who have waited longest for access to a physician, will be better served if this legislation advances.
Thank you for your time and I welcome any questions.
- “Increasing Access to Primary Care Providers,” Let’s Get Healthy California, n.d. ↩︎
- Ibid. ↩︎
- Michael Nedelman, “Why refugee doctors become taxi drivers,” CNN, August 9, 2017.
Lucy Berrington, “The US Needs Foreign-Trained Physicians: Why Are We Making It So Tough for Them?,” Massachusetts Medical Society, November 8, 2019. ↩︎ - “Licensed Physicians from México Pilot Program: Final Report,” University of California, Davis
Center for Reducing Health Disparities, March 31, 2025 ↩︎
