GuamBill No. 206-38 (COR)38th Guam Legislature (2025-2026)legislatureWALLET

AN ACT TO ADD A NEW § 12202 (c), AMEND § 12205 (c), § 12206 AND ADD A NEW 12206.1 AND § 12207 (a) (5) TO ARTICLE 2, CHAPTER 12, TITLE 10, GUAM CODE ANNOTATED, RELATIVE TO BUILDING A MORE DIVERSE AND SUSTAINABLE HEALTHCARE WORKFORCE ON GUAM BY EXPANDING LICENSURE PATHWAYS FOR FOREIGN MEDICAL GRADUATES AND ESTABLISHING A LOCAL CONRAD 30 J-1 PHYSICIAN WAIVER PROGRAM.

Sponsored By: Telo T. Taitague (Republican)

Signed by Governor

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Bill Overview

Analyzed Economic Effects

6 provisions identified: 1 benefits, 1 costs, 4 mixed.

Foreign-trained doctors gain a Guam licensing path

The law creates a full-license path for eligible doctors trained outside the United States or Canada. Its foreign-graduate definition covers medicine, osteopathy, and podiatry degrees that qualify graduates to practice where earned. Applicants generally need 36 months of approved postgraduate training; the Board can accept foreign training equivalent to U.S. standards. They must meet exam, credential verification, medical certification, immigration, and competency standards, and show English or Chamorro proficiency. They also need three years of independent specialty practice after training, a Guam job offer, and clinical practice within five years before applying. The Board can waive or change the recent-practice rule for good cause and continued competency. The specialty-practice, job-offer, and recent-practice requirements do not apply to licenses under §§ 12206.2 through 12206.7.

Foreign-trained doctors gain another licensing route

Eligible foreign-trained doctors can seek a Guam license through endorsement, which recognizes qualifying credentials rather than requiring Guam's usual exam. Applicants still must meet other licensing requirements and hold the required medical certification. They also need a licensing exam the Board accepts as comparable to the U.S. Medical Licensing Examination or equivalent. The Board controls exam acceptance and license approval. Applicants whose last qualifying exam was more than ten years ago can face an additional Board-approved test.

Foreign-trained doctors gain time-limited public-facility licenses

Eligible internationally trained doctors can get an interim license for up to four years at approved Guam-funded health facilities. Interim practice requires Board-approved supervision, evaluations, and reports; applicants with a clinical-practice gap of at least 24 consecutive months need a Board-approved U.S. physical reentry program. After at least three years, doctors can qualify for a permanent limited license through assessments, facility approval, good standing, and USMLE Step 3 within three attempts. That license permits full clinical autonomy only at approved Guam-funded facilities and cannot become an unrestricted license. One extension of up to two years is allowed, with both licenses together capped at six years; country-specific exceptions require case-by-case approval. Employers must submit the job offer and attest that qualified local workers are unavailable and hiring will not harm comparable workers' wages or conditions. The first 18 months prioritize Guam Memorial Hospital and the Health Professional Licensing Office; other Guam-funded facilities can apply afterward. Ending qualifying employment suspends or inactivates the license; unauthorized outside practice can bring fines up to $500 per offense and license revocation. The Board can immediately suspend a doctor who poses an imminent patient-safety risk.

Some doctors face supervised licensing periods

The Board can require supervised practice for doctors whose postgraduate training was outside an ACGME-accredited program. This provisional license lasts up to 12 months and can be renewed once for good cause. Practice is limited to approved settings and a Board-approved supervision plan and scope. An unrestricted license requires documented competency evaluations, three years of independent specialty practice, and clinical practice within five years before applying. The Board can waive or change the recent-practice rule for good cause and continued competency. These requirements do not apply to applicants or licenses under §§ 12206.2 through 12206.7.

Military doctors gain free volunteer licenses

Eligible military-credentialed doctors can get a volunteer medical license at no charge for two years. They need an out-of-state license in good standing, military credential verification, and command approval. Practice is limited to specified public health facilities, community health centers, and clinics or outreach services mainly serving low-income patients. Doctors cannot receive direct or indirect payment for care provided to indigent patients. Renewal, continuing education, registration, and Board discipline rules still apply.

Guam establishes doctor waiver program oversight

Guam's Department of Public Health and Social Services administers the federal Conrad 30 J-1 Physician Waiver Program. It must follow federal law, regulations, and U.S. Department of State guidance; this does not grant any doctor a waiver. The Department must report waiver applications received, recommended, and approved, plus compliance issues, to the Guam Legislature each year. Separately, the medical Board must adopt licensing and competency rules and coordinate with public health officials to collect implementation data. By December each year, the Board must report applicant and license counts, training countries, disciplinary actions, specialties, and practice locations to Guam's executive and legislative leaders.

Sponsors & Cosponsors

Sponsor

Telo T. Taitague
Republican • legislature

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 0 • No: 0

legislature vote • 3/27/2026

Floor Vote