(1) The department, with the recommendation of the board, may issue a provisional license for no longer than three years to an internationally trained physician if the physician and the participating health care entity submit evidence that the physician:

(a) Meets the definition of an internationally trained physician as defined in section 38-2065;

(b) Has a valid certification issued by the Educational Commission for Foreign Medical Graduates;

(c) Has achieved a passing score on step 1 and step 2 of the licensing examination;

(d) Has entered into an agreement with a participating health care entity for full-time employment under the supervision of a licensed physician. Such agreement shall provide that the participating health care entity shall conduct an initial formative needs assessment, develop an individualized learning and supervision plan, and assess and evaluate the physician's familiarity with the standards appropriate for medical practice in the state, consistent with assessment and evaluation criteria established in rules and regulations adopted and promulgated by the department, with the recommendation of the board, and designed to address all general competencies;

(e) Is either a United States citizen or is legally authorized to work by the federal government pursuant to 8 C.F.R. 274a.12, as such regulation existed on January 1, 2026; and

(f) Has satisfied other criteria as required by the board which shall not include a medical education residency program as a prerequisite.

(2) An internationally trained physician practicing under a provisional license shall be allowed to renew such physician's provisional license for one three-year period. No physician practicing under a provisional license shall be allowed to hold a provisional license for more than six years.

(3)(a) Within six months after a physician commences practice under a provisional license, the participating health care entity shall: (i) Conduct an initial formative needs assessment of the internationally trained physician's competence in the general competencies, including a review of the physician's prior graduate medical education and practice experience using a process approved by the department, with the recommendation of the board; and (ii) submit an individualized learning and supervision plan to the department for the physician that is informed by the initial formative needs assessment and addresses all general competencies for the physician's intended scope of practice. A copy of such plan shall be provided to the board.

(b) The initial formative needs assessment shall be used to identify areas of strength and areas in which additional support is needed and shall not be used to deny issuance of a provisional license to a physician who otherwise meets the requirements of subsection (1) of this section.

(4)(a) The assessment and evaluation program utilized by a participating health care entity for a physician practicing under a provisional license shall include, but not be limited to: (i) Standardized assessments of medical knowledge; (ii) direct observation of the physician's clinical skills; (iii) multi-source feedback from physicians and other health care team members and, when feasible, patients; and (iv) periodic audits of medical records for which the physician is responsible.

(b) The assessment and evaluation program shall ensure that the physician engages in a sufficient volume and breadth of cases to permit meaningful assessment across the general competencies for the physician's intended scope of practice.

(5) An internationally trained physician practicing under a provisional license shall be supervised and employed by a participating health care entity. All practice under a provisional license shall initially occur under supervision by a supervisor who meets the requirements described in subdivision (a) of this subsection. The level of supervision may be adjusted over time based on documented competence demonstrated through the assessment and evaluation program, in accordance with standards and supervision levels established in rules and regulations adopted and promulgated by the department, with the recommendation of the board. A participating health care entity shall:

(a) Employ one or more supervisors to supervise internationally trained physicians. A supervisor shall (i) be licensed to practice medicine in the state in good standing, and (ii) possess all necessary institutional privileges;

(b) Carry medical malpractice insurance covering such physician during the period of time the physician practices under the provisional license; and

(c) Complete all required assessment and evaluation program criteria.

(6) The department, with the recommendation of the board, may adopt and promulgate rules and regulations to carry out this section, including, but not limited to, criteria for participating health care entities and supervisors, requirements for assessment and evaluation programs, supervision levels, and required forms for initial formative needs assessments and individualized learning and supervision plans.