relative to the licensing of physicians who graduated from medical schools outside of the United States or Canada.

The provisional license system was eliminated entirely. The introduced bill allowed international physicians to receive a temporary provisional license and convert to a full unrestricted license after 2 years in good standing. The amended bill instead provides a single direct licensure pathway with no provisional stage.

The amended version adds an amendment to existing RSA 329:12, reorganizing it to explicitly state it applies to licensees who graduated from medical schools located in the United States or Canada, and removing the bracketed alternative pathway that previously allowed foreign graduates recognized by UNWHO/ECFMG to qualify under that section.

The bill title changed from 'licensing of international physicians' to 'licensing of physicians who graduated from medical schools outside of the United States or Canada,' narrowing the focus to a specific educational background rather than a broad category of 'international physicians.'

The requirement that licensees (or provisional licensees) only practice at health care providers with an ACGME-accredited residency program was removed. The amended version only requires an offer of employment at any health care provider operating in the state.

The English fluency requirement was made more specific. The introduced bill required only 'basic fluency in the English language.' The amended bill requires a passing score on the occupational English test for medicine or another equivalent examination approved by the board.

The introduced bill required either completion of a residency OR 5 years of practice as a physician. The amended bill requires BOTH: (1) completion of a residency, at least 2 years of postgraduate training, or substantially similar training accredited by the equivalent body in the licensing country, AND (2) at least 5 years of practice performing physician duties in the licensing country.

The introduced bill's specific revocation provisions (allowing the office to revoke a provisional license based on clear and convincing evidence of violations) and the 30-day appeal window were removed, as they tied to the now-eliminated provisional license system.