Bill Description: House Bill 418 would create an alternate licensing path for Idaho physicians that does not require entering a residency program.

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Does it increase barriers to entry into the market? Examples include occupational licensure, the minimum wage, and restrictions on home businesses. Conversely, does it remove barriers to entry into the market?

Under current Idaho law, going through a medical residency is essentially the only path by which a new physician can obtain full status as a licensed general practitioner. This barrier has contributed to the ongoing physician shortage and has pushed government to subsidize medical residency programs. 

House Bill 418 would amend Section 54-1867, Idaho Code, and create Section 54-1868, Idaho Code, to create another path to full licensure for recent medical school graduates, who would be known as assistant physicians. 

Under this law, an assistant physician would be defined as "a person who is within the first three (3) years of graduation from a medical school accredited or provisionally accredited by an entity recognized by the board and is a United States citizen or attended medical school in the United States." 

Rather than going through a traditional medical residency program, an assistant physician could gain eligibility to become a licensed general practitioner by completing "a total of thirty-six (36) months of cumulative, postgraduate, hands-on, full-time, active collaborative practice" and "at least fifty (50) hours of continuing medical education every year during the period of active collaborative practice."

During this 36-month period, an assistant physician would be required to "present a didactic training report every one hundred twenty (120) days to the collaborating physician."

An assistant physician would also be required to complete "step 3 of the United States medical licensing examination or the equivalent of such step of any board-approved medical licensing examination in three (3) or fewer attempts and within a seven (7) year period after completing steps 1 and 2 of the United States medical licensing examination."

While this is still a long and arduous path to licensure, it does reduce the barrier to market entry created by the existing shortage of available residency positions. 

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Does it increase government spending (for objectionable purposes) or debt? Conversely, does it decrease government spending or debt?

House Bill 418 would not directly reduce government spending, but it might do so indirectly. Currently, the Idaho State Board of Education (SBOE) is seeking to increase spending on residencies to $20.2 million per year — roughly a fourfold increase — for a total 385 residency slots by 2030.

Even if the board succeeds, this would only be a first step toward closing the physician shortage gap Idaho faces, and more spending would be all but inevitable. 

By creating an alternate licensing path, House Bill 418 would help alleviate the need for additional government subsidies for medical residency programs, at least relative to what would be required without the passage of this bill. 

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