An easy way to expand California’s physician workforce | Opinion
Across California, patients are waiting weeks and sometimes months to see a primary care doctor. Conditions that should be caught early are being caught late; chronic illnesses go unmanaged; preventive care is delayed; and families are left navigating a system that is already stretched far too thin.
That is why Assembly Bill 2386, introduced by Assemblymember David Alvarez, D-Chula Vista, is so important. The bill builds a real, durable pathway for qualified, internationally trained physicians to practice in California.
I know how important this bill is from personal experience: I came to California from Mexico, where I trained as a physician. Furthermore, I have spent my career working to expand access to care in underserved communities. When patients can speak directly with their doctor and when they feel understood and respected, it changes outcomes.
AB 2386 tackles two pieces of the puzzle at once: First, it turns California’s existing Licensed Physicians from Mexico Program into a true career pathway. Today, that program issues only nonrenewable three-year licenses, which means physicians must leave the state just as they are building trust with their patients.
Under AB 2386, physicians who are vetted, supervised and clinically proven could earn a full, unrestricted California license after completing the three-year term in good standing and securing continued employment, including at a federally qualified health center.
Second, the bill creates a new Provisional License for Qualified International Physicians, known as the California Physician Expansion Act. This program is broader than the Mexican pilot, as it would allow any qualified physician who holds a full, unrestricted medical license in another country to practice in California under a board-approved sponsoring entity. The provisional license would last three years, renewable once, with a possible one-time extension.
After at least three years of supervised practice in good standing, these physicians could convert to a full, unrestricted California license.
AB 2386 maintains rigorous clinical, licensing and language standards. It is not about cutting corners, it’s about removing unnecessary barriers that keep qualified, fully credentialed physicians from caring for the patients who need them most.
California is projected to be short more than 4,000 physicians by 2032. The state already has 661 federally designated primary care shortage areas — more than any other state in the country. And roughly 11 million Californians, nearly a third of the state, live in an area without enough primary care providers.
But we do not need to start from scratch to solve the problem. There are hundreds of experienced, internationally trained physicians already living in California, ready to serve. Many were educated in Mexico, Colombia and other Spanish-speaking countries. They bring clinical expertise and the cultural and linguistic understanding essential to caring for diverse communities.
In a state where Latinos make up roughly 40% of the population but only 6% of licensed physicians, that fluency is not a luxury — it is the difference between an earlier diagnosis and a missed one.
Other states have already moved in this direction: Florida, Illinois, Tennessee and Wisconsin are building licensure pathways for qualified internationally trained physicians. But California, despite having the greatest need, has been slower to adapt.
We already know the underlying approach works here. The original Mexican Physician Pilot Program demonstrated that internationally trained physicians can deliver high-quality care on par with U.S.-trained doctors.
AB 2386 takes the lessons of the pilot and turns them into a lasting solution. It is a careful, accountable expansion of California’s physician workforce, with the safeguards Californians expect and the urgency the moment demands.
Dr. Ilan Shapiro is senior vice president, chief health correspondent and medical affairs officer at AltaMed Health Services, where he leads external health communications, advocacy and community engagement.