SB 5185 Washington Senate · 2025-2026 Regular Session

Establishing preceptorship and hardship pathways to medical practice for international medical graduates.

SB 5185 proposes a new pathway for international medical graduates (IMGs) to obtain full medical licensure in Washington without completing standard U.S. postgraduate training. It establishes a "preceptorship pathway" requiring 48 months of supervised clinical practice under a licensed physician, followed by evaluations and board certification (ABMS or AAGP), to qualify for unrestricted licensure. The bill also creates hardship waivers for IMGs facing refugee status, persecution, or other documented barriers preventing standard documentation, excluding inability to pass ECFMG exams. This directly affects IMGs seeking to practice in Washington and the Washington Medical Commission, which would implement the new rules. The bill is currently pending in the Senate Health & Long-Term Care Committee.

Issues: ✓ Healthcare ✓ Immigration

Bill status signed all 5 stages cleared

Introduction

Jan 2026

Committee Review

Mar 2026

Senate Passage

Mar 2026

House Passage

Mar 2026

Signed into Law

Mar 2026

Introduced Jan 12, 2026 Signed Mar 23, 2026

Maddy AI version diff · 2 comparisons

What changed between versions

Substitute Bill → Substitute Passed Legislature · 4 edits

MODERATE

The bill adds formal certification of enrollment details and modifies eligibility criteria for a medical pilot program. Key changes include expanding the program to international medical graduates, requiring in-person patient care for certain physician groups, and correcting a terminology error regarding the examination council.

Scope change

The bill's scope was expanded to include international medical graduates in the clinical experience graduate pilot program, while tightening requirements for private practices to ensure they provide in-person care.

ENFORCEMENT

Added a formal certificate of enrollment section to document the bill's passage by the Senate and House with specific vote counts and dates.

ELIGIBILITY

Changed the pilot program eligibility from 'medical graduate' to 'international medical graduate' to broaden participation.

REQUIREMENT

Updated the definition of eligible private practices to explicitly require that physicians deliver 'in-person' patient care.

TECHNICAL

Corrected a text error changing 'educational council' to 'educational commission' in the examination requirements.

Floor votes · Senate Mar 9, 2026 · House Mar 3, 2026

How they voted

43–8

Passed

Total votes 51

Mar 9, 2026

D Democratic31

31 Yea

100% Yea

R Republican20

12 Yea 8 Nay

60% Yea

Vote distribution

All Yea All Nay Mixed No data

Full legislative history

Actions timeline

Total actions

Key actions

Committee

Mar 23, 2026

Signed into law

Governor signed.

executive

Mar 11, 2026

Lower · Passed

Speaker signed.

lower

Mar 10, 2026

Upper · Passed

President signed.

upper

Mar 9, 2026

Upper · Passed

Passed final passage; yeas, 41; nays, 8; absent, 0; excused, 0.

upper

Mar 9, 2026

Upper · Passed

Senate concurred in House amendments.

upper

Mar 3, 2026

Lower · Passed

Committee amendment(s) adopted with no other amendments.

lower

Mar 3, 2026

House · Passed

House Vote: pass (91-4-5)

house

Feb 25, 2026

Committee

Referred to Rules 2 Review.

lower

Feb 24, 2026

Lower · Passed

HCW - Majority; do pass with amendment(s).

lower

Feb 24, 2026

Lower · Passed

Executive action taken in the House Committee on Health Care & Wellness at 1:30 PM.

lower

Feb 20, 2026

Lower · Passed

Public hearing in the House Committee on Health Care & Wellness at 8:00 AM.

lower

Jan 30, 2026

Upper · Passed

Minority; without recommendation.

upper

Jan 30, 2026

Upper · Passed

Executive action taken in the Senate Committee on Health & Long-Term Care at 8:00 AM.

upper

Jan 27, 2026

Upper · Passed

Public hearing in the Senate Committee on Health & Long-Term Care at 10:30 AM.

upper

Jan 12, 2026

Introduced

By resolution, reintroduced and retained in present status.

upper

Feb 18, 2025

Upper · Passed

Executive session scheduled, but no action was taken in the Senate Committee on Health & Long-Term Care at 10:30 AM.

upper

Feb 14, 2025

Upper · Passed

Executive session scheduled, but no action was taken in the Senate Committee on Health & Long-Term Care at 8:00 AM.

upper

Jan 31, 2025

Upper · Passed

Public hearing in the Senate Committee on Health & Long-Term Care at 8:00 AM.

upper

1 primary · 13 co-sponsors