The legislature may be in summer recess, but CAFP advocacy staff remains actively engaged on our sponsored bills and other high-priority legislation. One bill we are particularly focused on opposing is AB 2386 (Alvarez), a proposal that threatens longstanding physician education and licensure standards.
What is AB 2386?
Known as the Licensed Physicians from Mexico Program and California Physician Expansion Act, AB 2386 would establish a new provisional licensing pathway for internationally trained physicians. The bill would allow these physicians to practice in a clinic under a supervising physician for three years with a provisional license. Upon successful completion of these three years, they would qualify for a California Physician’s and Surgeon’s License, without completing an ACGME-accredited residency program. The bill also allows certain physicians from the Licensed Physicians from Mexico Program to qualify for a California license. While proponents of the bill claim that it will help to address the primary care physician shortage, this approach fundamentally misunderstands the source of our state’s workforce challenges.
Residency: A Foundation, Not a Hurdle
CAFP recognizes the urgency of addressing the primary care physician shortage. Family physicians see firsthand how workforce gaps, long waits, inadequate access to primary care can harm patients and communities. However, the solution is not to lower training standards.
Residency is far more than an accumulation of supervised clinical hours. It is a rigorous, nationally accredited framework designed to cultivate and test clinical judgement, procedural skill, and decision-making abilities. Through continuous supervision, standardized competency-based assessment, and exposure to diverse healthcare settings, residency ensures that every physician is prepared for the complex, independent reality of physician practice. By creating a parallel track that bypasses this essential training, AB 2386 risks creating a two-tiered system that devalues the consistent standards our patients expect and deserve.
Addressing the Real Workforce Challenges
The primary care physician shortage is a systemic issue that requires structural solutions, not licensure shortcuts. The shortage stems from inadequate reimbursement, rising practice costs, administrative burdens, and financial incentives that drive physicians into higher-paying specialty care, not from California's physician licensure standards. Lasting solutions require investing in proven workforce strategies that recruit, train, and retain physicians in the communities that need them most.
Long term solutions to our workforce shortages require evidence-based strategies:
CAFP’s Position
CAFP is formally opposed to AB 2386. Our advocacy includes written position letters and directly engaging with the bill’s author, legislative staff, and the Governor’s office to emphasize that licensing policy is not merely an administrative question, but a patient safety imperative. We must continue to welcome and value internationally trained physicians, but we must do so by integrating them into pathways supported by rigorous clinical training, transparency, and clear accountability.
We Need Your Voice
The bill is currently sitting in the Senate Appropriations Committee as legislators consider next steps. CAFP advocacy staff will continue to advocate for an evidence-based workforce pipeline that preserves the integrity of our physician training system.
CAFP needs your voice. Don't assume someone else will speak for physicians. Contact your Legislator today and urge them to vote NO on AB 2386.
