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Bridge Year Graduate

Overview

  • The Physician Workforce Act of 2023 established a mechanism for limited, supervised practice by graduates of accredited medical schools who applied to, but were not accepted into, a residency training program for the first year following medical school graduation ("bridge year graduate physicians"). International Medical School graduates do not meet the qualification requirements of a bridge year graduate physician permit at this time.
  • Bridge Year Graduate Physician Permit Administrative Rules set forth the requirements for the bridge year graduate physician permit.
  • This permit does not confer any future right to a license to practice medicine in Alabama.

PLEASE NOTE: There are no refunds or transfers of application fees to persons who complete the application but do not qualify for this permit.  Review the below information and Board Rules carefully before applying.

Qualifications for a Bridge Year Graduate Physician Permit

  • Graduation from a medical school accredited by the Liaison Committee on Medical Education or the Commission on Osteopathic College Accreditation.
  • Achieved a passing score on one of these licensing examinations:
    • Steps 1 and 2 of the United States Medical Licensing Examination (USMLE),
    • Comprehensive Osteopathic Medical Licensing Examination (COMLEX), or
    • Licentiate of the Medical Council of Canada Examination (LMCCE).
  • Applied to, but was not accepted into a postgraduate or residency training program accredited by the Accreditation Council for Graduate Medical Education (ACGME), American Osteopathic Association (AOA), Accreditation Committee of the Royal College of Physicians and Surgeons of Canada (ACRCPSC), or the College of Family Physicians of Canada (CFPC) for the first year following medical school graduation. 
  • The Board, in its discretion, may waive the one-year requirement for applicants who are otherwise eligible and meet all other requirements and are no more than two years post medical school graduation. The waiver request must be submitted with the application.

Qualifications of the Supervising Physician

  • Possess a current, unrestricted license to practice medicine in Alabama; and
  • Have satisfied one of the following:
    • Practiced medicine for at least three years, excluding any practice in a postgraduate training program, or
    • Practiced medicine for at least one year and is certified by one or more of the specialty boards recognized by the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA), or
    • Practiced medicine for at least one year and the bridge year graduate physician's practice site is limited solely to a general acute care, critical access, or specialized hospital licensed as such by the Alabama Department of Public Health.
  • The Board, in its discretion, may waive these practice requirements.
  • The Board may decline to consider an application where the physician is under investigation by the Board.

Application for a Bridge Year Graduate Physician Permit

  • Submit Board approved applications and any other information or documentation as deemed necessary.
  • Pay to the Board in advance the required application fee of $200.00. This fee is nonrefundable once payment is received by the Board.
  • Submit to a criminal history background check (must submit complete set of fingerprints and pay directly to the Board a nonrefundable/nontransferable criminal background check fee of $65.00).

Forms/Required Documents

Permit Renewal

  • A permit to practice as a bridge year graduate physician is valid for one year and may be renewed for no more than one additional one-year period.
  • An application for renewal must be received by the Board before the expiration date of the permit and be accompanied by a renewal fee of $100.00.
  • The renewal application must also be accompanied by the supervising physician's report as required by Board rules and the supervising physician's certification that any approved covering physician continues to agree to serve in that capacity.

Other Provisions

  • A bridge year graduate physician or supervising physician may terminate the supervisory relationship at any time, for any reason; the Board must be notified in writing within ten days of the effective date of the termination.
  • If, at the time of termination, there is time left remaining in the permit year, a new supervising physician may be submitted for approval to supervise the bridge year graduate physician for the remainder of the permit.
  • Grounds for denial or discipline of a bridge year graduate physician permit are stated in Board Rule 540-X-27-.11.
  • The Board may assess administrative fines not to exceed $10,000 for each violation of the statutes and rules governing the bridge year graduate physician permit.

Functions and Activities of Bridge Year Graduate Physicians

  • There shall be at all times a direct, continuing, and close supervisory relationship between the bridge year graduate physician and the supervising physician.   
  • The bridge year graduate physician shall provide medical services within their education, training, and experience that are delegated by the supervising physician, including, but not limited to:
    • Obtaining patient histories and performing physical examinations
    • Ordering and/or performing diagnostic and therapeutic procedures
    • Formulating a working diagnosis
    • Developing and implementing a treatment plan
    • Monitoring the effectiveness of therapeutic interventions
    • Offering counseling and education to meet patient needs
    • Making appropriate referrals
    • Administering any legend drug which they are authorized to prescribe
  • A bridge year graduate physician may write admission orders for inpatients and nursing home patients as directed by the supervising physician and subsequent orders in accordance with established guidelines and institutional policies.
  • A bridge year graduate physician may not provide any pain management services, practice within any practice which advertises or holds itself out to the public as a provider of pain management services, or practice under the supervision of a physician who solely provides pain management services.

Requirements for Supervised Practice

  • Physician supervision requires, at all times, a direct, continuing, and close supervisory relationship between a bridge year graduate physician and the supervising physician.
  • There shall be no independent, unsupervised practice by bridge year graduate physicians.
  • The supervising physician shall, at a minimum, provide on-site supervision.
  • See Board Rule 540-X-27-.14 for further detail about requirements for supervised practice.

Limitations Upon Utilization of Bridge Year Graduate Physicians

  • A supervising physician may supervise no more than two bridge year graduate physicians at any given time.
  • A bridge year graduate physician cannot be supervised by more than one Board-approved supervising physician, not including any covering physicians, at any given time.

Prescriptions and Medication Orders

See Board Rule 540-X-27-.16. A bridge year graduate physician permitee may write prescriptions for those legend/non-controlled medications contained in the approved formulary.  No bridge year graduate physician is authorized to order, distribute, administer, or prescribe controlled substances.

Covering Physicians for Bridge Year Graduate Physicians

  • When the supervising physician is not readily available to respond to patients' medical needs, the bridge year graduate physician is not authorized to perform any act or render any treatments unless a covering physician as defined in Board Rule 540-X-27-.17 is immediately available on site to supervise the bridge year graduate physician.
  • The covering physician must affirm in writing that they are familiar with the current rules regarding bridge year graduate physicians and the job description filed by the supervising physician, and that they approve the drug type, dosage, quantity and number of refills of legend drugs which the bridge year graduate physician is authorized to prescribe.
  • The covering physician must meet the same qualifications as the supervising physician.

Report by Supervising Physician

  • At the end of the initial bridge year, the supervising physician must submit a report to the Board that includes the information set forth in Board Rule 540-X-27-.18 regarding the scope and breadth of the practice of the bridge year graduate physician and their ability to complete the medical services delegated.
  • The report must include a statement as to whether the bridge year graduate physician would be recommended for a residency position upon reapplication.