California will need an additional 10,500 primary care providers in the next four years to meet patient demand, according to testimony delivered June 22, 2026, by Lawson Mansell, a senior health policy analyst at the Niskanen Center before state legislators. The testimony supports Assembly Bill 2386, which would create a pathway for internationally trained physicians to earn full licensure in California without repeating their entire residency training. The bill would also grant permanent licensure to doctors currently participating in the state's temporary Licensed Physicians from Mexico Program.
Rural communities, the Inland Empire, and the San Joaquin Valley face the heaviest burden of the physician shortage, according to the testimony. Right now, California requires internationally-trained doctors to repeat their residency before they can get full licensure, even if they've already completed years of medical training abroad. As a result, many trained doctors work in positions well below their expertise or can't practice at all—some end up driving taxis or working service jobs instead of treating patients. Twenty-seven states, including neighboring Oregon and Nevada, have adopted similar pathways in recent years to bring foreign-trained physicians into their healthcare systems.
The testimony points to an independent UC Davis evaluation that found participating physicians in the existing Mexico pilot program "integrated well into community health centers, expanded access to care, and improved patient trust." According to Mansell, AB 2386 reflects lessons from programs across the country with "clear eligibility, sponsorship, supervised practice, and a defined route to full licensure." Under the proposed law, physicians would be sponsored by a licensed healthcare facility, complete a period of supervised practice, and then become eligible for full licensure.
The testimony argues that California is uniquely positioned to implement the law with limited administrative headaches because the infrastructure already exists. The credentialing and oversight systems built for the existing Mexico pilot program are in place, and the healthcare facilities that participated already know how to integrate these physicians into their care teams. This means the state wouldn't need to build new bureaucratic systems from scratch—it can expand what's already working. The supervised practice model lets doctors prove their skills under professional oversight before earning full licensure, balancing patient safety with the urgent need for more providers.
Mansell told the committee that California patients, particularly those in underserved communities who have waited longest for access to a physician, will be better served if the legislation advances. With the state facing a shortage of more than 10,000 primary care doctors in just four years, the bill offers a practical solution that's already been tested and proven effective. The question now is whether California will join the 27 states that have already opened their doors to qualified doctors trained abroad.