Were physicians licensed in California or New York entitled to a Washington medical license without examination?

Plain-English summary

The Washington AG said a physician licensed in another state was not entitled to a Washington license without examination merely because the other state had a reciprocity statute. The amended Washington law used “may” rather than the former “shall,” leaving the decision to the licensing director. An applicant also had to prove that the other state’s standards, eligibility rules, and examination were at least equal to Washington’s.

The official opinion states: “Whether or not the holder of a license to practice medicine from another state is to be licensed without examination in this state as a matter of reciprocal legislation lies within the discretion of the director of the department of licenses.” (source).

Currency note

This opinion was issued in 1958. Subsequent statutory amendments, court decisions, or later AG opinions may have changed the analysis. Treat this page as historical context, not current legal advice. Verify current law before relying on any specific rule, deadline, or remedy mentioned here.

Common questions

Q: Did a California or New York license ensure approval?
A: No. The director had discretion after considering statutory requirements.

Q: What did the applicant need to show?
A: Equivalent standards, eligibility requirements, and examinations, plus the other statutory conditions.

Q: What changed in the law?
A: The AG said the amendment changed mandatory “shall” to discretionary “may.”

Background and statutory framework

A state representative asked about physicians licensed in New York and California. The AG examined the amended RCW 18.71.090 and left factual comparison of the states’ licensing regimes to the director rather than deciding the individual applications.

Source

• Landing page: https://www.atg.wa.gov/ago-opinions/licenses-physicians-and-surgeons-reciprocity-medicine-surgery-and-osteopathy-physicians

Original opinion text

Attorney General John J. O'Connell

LICENSES ‑- PHYSICIANS AND SURGEONS ‑- RECIPROCITY --MEDICINE, SURGERY, AND OSTEOPATHY ‑- PHYSICIANS AND SURGERY

Whether or not the holder of a license to practice medicine from another state is to be licensed without examination in this state as a matter of reciprocal legislation lies within the discretion of the director of the department of licenses.

January 14, 1958

Honorable Mark Litchman, Jr.
State Representative, 45th District
13706 Second Avenue Northeast
Seattle 55, Washington Cite as: AGO 57-58 No. 147

Dear Sir:

By letter, previously acknowledged, you requested an opinion of this office interpreting § 5, chapter 60, Laws of 1957. We paraphrase your question as follows:

Are physicians who are licensed to practice medicine and surgery in New York and California eligible to receive such a license in this state without examination under the reciprocity provision of our laws, cited above?

We answer your question as follows:

Whether or not the holder of a license to practice medicine granted by another state is to be licensed without examination in this state as a matter of reciprocal legislation lies within the discretion of the director of the department of licenses.

[[Orig. Op. Page 2]]

ANALYSIS

Section 5, chapter 60, Laws of 1957, which amended RCW 18.71.090, reads as follows:

"Any applicant who has been examined and licensed under the laws of another state, which through a reciprocity provision in its laws, similarly accredits the holders of certificates from the proper authorities of this state to the full privileges of practice within its borders may, in the discretion of the director, be granted a license without examination on the payment of a fee of twenty-five dollars to the state treasurer:Provided, That he has not previously failed to pass an examination held in this state. He must file with the director a copy of his license certified by the proper authorities of the issuing state to be a full, true copy thereof, and must show that the standards, eligibility requirements and examinations of that state are at least equal in all respects to those of this state." (Emphasis supplied.)

Initially, it is necessary that the applicant must be seeking recognition on the basis of a license issued as a result of an examination by a state which offers such reciprocal privileges to properly licensed physicians of this state. Both California and New York have reciprocity provisions in their laws. (See § 2118, Article 2 and Article 11, Vol. 1, Business and Professions, Deering's California Codes; and § 6509, Article 131, Title VIII, Chapter 16 (Education), Consolidated Laws of New York.)

Thereafter this section states that the applicant ". . . may, in the discretion of the director, be granted a license . . ."

The fundamental object in construing a statute is to determine the intent of the legislature. Graffell v. Honeysuckle, 30 Wn. (2d) 390; Public Hospital District v. Taxpayers, 44 Wn. (2d) 623. The intent of the legislature is primarily deduced from what it said in the statute itself. Graffell v. Honeysuckle, supra;Hatzenbuhler v. Harrison, 49 Wn. (2d) 691. Thus, in construing an act of legislation, it is unnecessary to go further than the words themselves when the meaning is clear. Public Hospital District v. Taxpayers, supra. It is apparent that the legislature intended to vest the power to issue a license to practice medicine in this state in the director of the department of licenses where the application falls within the reciprocity provision.

[[Orig. Op. Page 3]]

InSeattle v. Reed, 6 Wn. (2d) 186, 188, the court stated that:

". . . In determining the legislative intent, the court will take into consideration previous legislation upon the statutory subject . . ." (See alsoGraffell v. Honeysuckle, supra.)

Prior to amendment by § 5, chapter 60, Laws of 1957, the reciprocity provision regarding physicians and surgeons was found in § 11, chapter 134, Laws of 1919 (see RCW 18.71.090), which reads as follows:

"Applicants for a certificate, who have been examined and licensed by a state board of medical examiners of another state, which through a reciprocity provision in its law, similarly accredit the holders of certificates from the board of medical examiners of this state to the full privileges of practice within its boundaries, on payment of a fee of $25.00 to the board, and on filing with the secretary of the board a copy of such license certified by the president or secretary of the state board of medical examiners issuing the same to be a full, true copy thereof, and showing also that the standard of requirements adopted by such state board of medical examiners as provided by the law of such state is equal to that provided for by the provisions of this act,shall without further examinations receive a certificate to practice medicine and surgery in this state: Provided, that such applicant has not previously failed at an examination held by the board of medical examiners of this state." (Emphasis supplied.)

Prior to amendment it was mandatory, if certain statutory requirements were met, that the director of the department of licenses issue a license to practice medicine in this state where the application came under the reciprocity provision due to the use of the imperative verb "shall". See AGO 55-57 No. 202. The explicit amendment of RCW 18.71.090 in 1957 with a change from the word "shall" to the permissive words "may, in the discretion of the director . . ." clearly indicates a legislative intent to make the issuance of licenses under this reciprocity provision directory rather than mandatory with that power resting in the sound discretion of the director. (SeeSeattle v. Reed, supra, and Graffell v. Honeysuckle, supra.)

In exercising the discretion vested by § 5, chapter 60, Laws of 1957, the director is to be guided by the requirements set out in that section. Under the recent amendment of the reciprocity provision, the applicant, among other requirements, ". . . must show that the standards, eligibility requirements and examinations of that state are at least equal in all respects to those of this state." Thus, from [[Orig. Op. Page 4]] the clear wording of § 5, chapter 60, Laws of 1957, the legislature intended that the applicant bear the burden of showing not only that the standards and eligibility requirements of the state in which he was licensed through examination are equal to ours, but that the examinations of the two states are equal in all respects.

It appears unnecessary for this office to compare the standards, eligibility requirements and examinations of California and New York with those of this state. Comparing statutes to determine whether or not the standards, eligibility requirements and examinations are equal requires a determination of fact since statutes of different states cannot be expected to be identical. Such factual determinations are to be made by the director of the department of licenses, as previously discussed.

In considering this act of the legislature, we have not considered any question as to its constitutionality, since only a court of competent jurisdiction is empowered to rule thereon. It has been the policy of this office since 1891 to presume that statutes are constitutional until judicially declared otherwise. (See the following opinions of the attorney general: Opinion to the Chief, Washington State Patrol, dated July 31, 1928 [[1927-28 OAG 867]]; opinion to the prosecuting attorney of Pacific County, dated July 17, 1945 [[1945-46 OAG 269]]; and opinion to the Honorable Victor A. Meyers, Secretary of State, dated February 6, 1957 [[AGO 57-58 No. 13]].)

We trust that the foregoing will be helpful to you.

Very truly yours,

JOHN J. O'CONNELL
Attorney General

ERNEST M. FURNIA
Assistant Attorney General