California is facing a growing physician shortage, particularly in underserved regions where access to healthcare remains limited. Nearly 15 million residents live in areas lacking an adequate number of primary care doctors, often resulting in long wait times, difficulty finding providers accepting new patients, and lengthy travel for routine medical care.
To help address the issue, the California Senate is considering Assembly Bill 2386, known as the California Physician Expansion Act. The measure, authored by Assemblymember David Alvarez, recently passed the State Assembly and would establish a new pathway for internationally trained physicians to practice in underserved communities while completing requirements for full California licensure.
Under current law, most physicians educated outside the United States and Canada must repeat a full U.S. residency program before obtaining a medical license, even if they have already completed residency training and practiced independently in another country. AB 2386 would allow qualified international physicians to work under supervision at approved healthcare facilities and eventually earn full licensure by meeting established standards.
The proposal comes as California faces a significant healthcare workforce challenge. Experts estimate the state will need more than 10,500 additional primary care providers within the next four years to meet patient demand. The shortage is particularly severe in rural and economically disadvantaged regions. In Trinity County, for example, there is just one primary care physician for every 7,891 residents, compared with one physician for every 679 residents in Marin County.
Supporters of the legislation argue that internationally trained physicians could help close these gaps. Studies have shown that foreign-trained doctors are more likely to work in primary care settings and serve rural and lower-income communities than many U.S.-trained physicians.
California would not be alone in adopting such a policy. Twenty-seven states have already implemented similar licensure pathways for experienced physicians who completed postgraduate medical training and practiced abroad before relocating to the United States. Advocates say these programs recognize prior experience while helping states expand access to healthcare where it is needed most.
