Pursuant to Rule 20(o) of the Rules of the Senate of Virginia, the Senate Committee on Education and Health referred the subject matters contained in Senate Bill 1006 of the 2023 General Assembly to the Department of Health Professions (“DHP") for study. The legislation sought to create an associate physician license and instructed various boards within DHP to collaborate to create regulations for this new practice group. This report includes background on SB1006, a review of the associate physician role and its history throughout the United States, causes of failure to match to a residency, and consideration of the need for associate physicians in Virginia.

SB1006 was passed by indefinitely with a unanimous vote in the Senate Committee on Education and Health during the 2023 General Assembly session. The bill was modeled after similar associate physician language used in other states.

The practitioner category of associate physician was created to address physician shortages by creating a license for medical school graduates who did not get placed into a residency. Every state and territory in the U.S. requires that an applicant complete a residency program prior to licensure as a physician, yet the number of residency spots has not kept pace with increasing medical school enrollments, leaving more graduates without residency spots upon graduation.(*1) Currently, there are eight states in the U.S. that provide an associate physician license, with most of these states limiting the amount of time a practitioner may hold the license. In most states, licensure as an associate physician is branded as a transitional license for people to hold and practice medicine until they get into a residency program.

States that have implemented associate physician licensure face unintended consequences that limit any potential effectiveness of the license type. Additionally, Virginia medical school programs do not see a need for associate physician licensure in the Commonwealth. Very few graduates from Virginia medical schools fail to match into a residency program in the first year after graduation. Thus, the schools do not feel state resources would be best spent by creating this pathway.
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(*1) The number of residency spots has not increased at pace with the increase in medical school enrollment, leaving thousands of students nationally without a residency match. Primary funding for post-graduate residency positions has remained stagnant since the 1990s, which is a key contributor to this gap.