AB 2398 California Assembly · 2025-2026 Regular Session

Graduate medical education capacity: report.

Summary

Existing law establishes the Department of Health Care Access and Information in the Health and Welfare Agency and requires the department to perform specified functions relating to, among other things, health policy and planning, health professions development, and health facility data. This bill would require the department to convene a workgroup to discuss graduate medical education capacity in California, with a focus on access to residency positions. The bill would require the workgroup to be composed of interested stakeholders, as specified. The bill would require the department, in consultation with the Medical Board of California, to prepare and submit a report to the appropriate committees of the Legislature on or before July 1, 2028, that includes, among other information, recommendations for increasing residency capacity in California, improving geographic and specialty distribution, and reducing barriers to entry, including for international medical graduates. The bill would repeal its provisions on January 1, 2030.

Issues: ✓ Healthcare

Bill status in committee 1 of 4 stages cleared

Introduction

Feb 2026

Committee Review

Floor Vote

Governor

Introduced Feb 20, 2026 Last action May 14, 2026

Maddy AI version diff · 3 comparisons

What changed between versions

04/13/26 - Amended Assembly → 04/22/26 - Amended Assembly · 6 edits · Apr 22, 2026

MODERATE

AB 2398 was substantially restructured to add an entirely new first section requiring HCAI to convene a workgroup on graduate medical education capacity and submit a report to the Legislature by July 1, 2028. The original Physician Graduate License Act provisions were retained but moved to a second section, and the pathway for physician graduates to apply for a full license after five years of supervised practice (which required passing Step 3) was removed. The bill now frames the license act as something the workgroup should evaluate for feasibility rather than an immediate standalone policy.

Scope change

The bill now has a dual scope: it both creates an immediate study mechanism (the HCAI workgroup on residency capacity) and retains the Physician Graduate License Act. The new GME article effectively makes the license act contingent on a policy review, as item (9) of the required report asks the workgroup to evaluate the feasibility and advisability of allowing non-residency graduates to practice under supervision.

SCOPE

A new Section 1 adds Article 6.1 (Section 2127) titled 'Graduate Medical Education,' requiring HCAI to convene a multi-stakeholder workgroup by January 1, 2028 to study residency capacity in California and submit a report to the Legislature by July 1, 2028. The article sunsets on January 1, 2030.

The bill's stated purpose changed from 'relating to healing arts' to 'relating to health workforce development,' and the legislative counsel digest was rewritten to lead with the GME workgroup requirement before describing the Physician Graduate License Act.

REQUIREMENT

The new GME workgroup must include representatives from the Medical Board, Osteopathic Board, California medical schools, teaching hospitals, physician professional organizations, student and resident groups, international medical graduate organizations, and consumer advocacy groups.

Section 2127.4 (renewal conditions) was restructured: 'positive evaluations from all sponsoring physicians' and 'no history of disciplinary action' were moved from the removed full-licensure pathway into the renewal requirements, meaning they now apply at every three-year renewal rather than only when seeking a full license.

TIMELINE

The GME report must be submitted no later than July 1, 2028, and the article repeals itself on January 1, 2030.

ELIGIBILITY

The provision allowing a physician graduate to apply for a full and unrestricted license after five years of supervised practice (requiring passage of Step 3 of the USMLE, positive evaluations, no disciplinary history, and meeting all other licensure requirements) was deleted entirely.

02/20/26 - Introduced → 04/13/26 - Amended Assembly · 6 edits · Apr 13, 2026

MODERATE

The amended version of AB 2398 adds several substantive provisions: it explicitly names the osteopathic licensing exam as an acceptable alternative, requires foreign medical graduates to hold ECFMG certification or equivalent, mandates the board establish transparent criteria for recognizing international medical schools, adds supervision ratio and on-site supervision requirements, requires the board to define permissible and prohibited clinical activities by regulation, and most significantly declares that a physician graduate is considered a full-scope physician for purposes of medical practice.

Scope change

The bill's scope was expanded in two ways: (1) it now explicitly covers osteopathic graduates by naming their licensing exam, and (2) it establishes that physician graduates are legally considered full-scope physicians for medical practice purposes, which could affect how they are treated under other statutes and regulations governing physician practice.

ELIGIBILITY

New requirement (g): applicants who graduated from a medical school outside the United States must possess a valid ECFMG certificate or demonstrate equivalent qualifications as determined by the board.

The examination requirement now explicitly names Levels 1 and 2 of the Comprehensive Osteopathic Medical Licensing Examination of the United States as an acceptable alternative to USMLE Steps 1 and 2, rather than just referencing 'an equivalent examination.'

REQUIREMENT

The board must now establish, by regulation, clear and transparent criteria for recognizing international medical schools, including accreditation standards, curriculum requirements, clinical training components, and verification through recognized international accrediting bodies.

Three new supervision standards added: minimum ratios for supervising physicians to physician graduates, requirements for on-site supervision, and documentation and reporting requirements to ensure compliance with supervision standards.

SCOPE

New section 2127.3(d) requires the board to define, by regulation, permissible and prohibited clinical activities for physician graduates, including limitations based on training, experience, and practice setting.

DEFINITION

New section 2127.7 declares that a physician graduate licensed under this article is considered a full-scope physician for purposes of medical practice, provided they practice in accordance with the article. This clarifies their legal status relative to other healthcare providers.

Floor votes

How they voted

No floor votes recorded yet.

Full legislative history

Actions timeline

Total actions

Key actions

Committee

Amendments

May 14, 2026

Lower · Passed

In committee: Held under submission.

lower

May 13, 2026

Committee

In committee: Set, first hearing. Referred to APPR. suspense file.

lower

May 6, 2026

Lower · Passed

In committee: Hearing postponed by committee.

lower

Apr 23, 2026

Committee

Re-referred to Com. on APPR.

lower

Apr 22, 2026

Lower · Passed

Read second time and amended.

lower

Apr 21, 2026

Introduced

From committee: Amend, and do pass as amended and re-refer to Com. on APPR. (Ayes 17. Noes 0.) (April 21).

lower

Apr 14, 2026

Committee

Re-referred to Com. on B. & P.

lower

Apr 13, 2026

Introduced

From committee chair, with author's amendments: Amend, and re-refer to Com. on B. & P. Read second time and amended.

lower

Mar 9, 2026

Committee

Referred to Com. on B. & P.

lower

Feb 21, 2026

Lower · Passed

From printer. May be heard in committee March 23.

lower

1 primary · 0 co-sponsors