LICENSES ‑- RECIPROCITY ‑- MEDICINE AND SURGERY ‑- EQUALITY
1. To qualify for a license as a physician and surgeon, under reciprocity, it is not required that the reciprocity laws of the other state grant an identical or equal right to licensees of this state, but only that such state grant a similar right.
2. The equality required by RCW 18.71.090 refers to the standard of requirements of the law and not to equality of reciprocity.
3. The director may not, by administrative regulation or otherwise, add to the requirements of a statute.
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February 8, 1956
Honorable J. N. Ryder
6811 55th Avenue N.E.
Seattle, Washington Cite as: AGO 55-57 No. 202
Honorable Richard Ruoff
818 Republic Building
By letters previously acknowledged you have each requested an opinion on a similar state of facts as follows:
"A" is a physician of good moral character, is a graduate of and holds a diploma from a medical school accredited under the laws of the state of California but not approved and accredited under the laws of the state of Washington. He has been examined and licensed and admitted to the practice of medicine and surgery under the laws of the state of California. He has never failed an examination held by the board of medical examiners held by the state of Washington and is willing to take any examination required by our laws.
[[Orig. Op. Page 2]]
On this state of facts you submit two questions:
1. Can "A" qualify to take the examination required by RCW 18.71.050 and RCW 18.71.070?
The answer to this question is no.
2. Can "A" qualify for a license to practice medicine and surgery under the reciprocity law of the state of Washington, RCW 18.71.090?
The answer to this question is yes.
There are but two methods by which an applicant for a license to practice medicine and surgery in this state may obtain such a license: One is by passing the examinations provided by law, the other is under the reciprocity provisions of our law. The two methods are separate and distinct, and to qualify under one the applicant does not need to meet the requirements of the other.
1. "A" is not eligible to take the examination in this state for the reason that the medical school from which he was graduated is not accredited and approved as required under the provisions of RCW 18.71.050.
2. RCW 18.71.090 (§ 11, chapter 134, Laws of 1919), the reciprocity statute, as it appears in the session laws, reads as follows:
"Applicants for a certificate, who have beenexamined 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 [[Orig. Op. Page 3]] 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.)
To qualify under this section "A" must show (1) that he has been examined and licensed by the board of medical examiners of the state of California; (2) that California similarly accredits the holder of a license from this state; (3) that the standard of requirements of California is equal to that provided by the laws of Washington; (4) that he is prepared to pay the fee of twenty-five dollars; (5) that he has never failed an examination in this state.
When these five requirements are met, the applicant "shall, without further examinations, receive a certificate to practice medicine and surgery in this state." This quoted language of the statute is mandatory.
The laws of both states require that the applicant must furnish proof of good moral character. The law of Washington, RCW 18.71.070, requires that the applicant must pass an examination in twelve fundamental subjects, shall answer ten questions in each subject, and must obtain a grade of not less than sixty percent in each subject. Sections 2286 and 2288 of Deering's Business and professional Code of California provide that the applicant shall be examined in sixteen fundamental subjects (including the twelve required in the state of Washington), and must answer ten questions in each subject and shall obtain a general average of seventy-five per cent and not less than sixty per cent in any two subjects.
Thus it appears that if there is any difference, the standard of requirements of California is higher than that of Washington.
The reciprocity laws of California are embodied in several sections of the California code, and requirements as to reciprocity are substantially the same as ours, but contain an additional requirement to the effect that the applicant [[Orig. Op. Page 4]] for reciprocity in California shall present a diploma from a school approved under the California law. Our law, RCW 18.71.090, contains no such requirement and in this respect the reciprocity laws of the two states are not exactly equal. But this does not, in our opinion, affect the application of the laws. Our law does not call for equality except as to the standards of skill and learning. The granting of reciprocity is a privilege rather than a right, and equality as used in our statute has no application to any privilege involved.
On its face, it thus appears that the California practitioner may be given an advantage. The answer to such an objection is that our law does not require that the reciprocity provisions involved be equal but only that they besimilar.
Moreover, the primary purpose of our license laws is not to confer upon the licensees protection against competition from the practitioners of other states. Rather, its primary purpose is to protect the public against the activities of poorly trained and incompetent practitioners. It is common knowledge that for many years past, practitioners of medicine and surgery, qualified by examination and licensed under the laws of California, have been granted reciprocity certificates by the state of Washington. It is our understanding that this privilege has been granted only in those cases where the California applicant produced proof that he had graduated from a medical school approved and accredited under our law. Our reciprocity law does not contain such a requirement.
It is further our opinion that such a requirement cannot be added administratively. We must follow the statutes as they were written by the legislature.
It is our opinion that reciprocity in any case could be granted to a California practitioner only upon the accepted basis that the standard of requirements of the California law is the equal of ours. When we admit this equality of standard we need only to determine that the applicant has been "examined and licensed" under the laws of California, and this being established, it is mandatory that the certificate be issued to the applicant.
We trust the foregoing analysis will prove helpful in the solution of your problem.
Very truly yours,
ROY C. FOX
Assistant Attorney General