New Law Allows International Medical Graduates to Bypass US Residency
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https://www.medscape.com/viewarticle/993693?src=FYE
Pediatric nephrologist Bryan Carmody, MD, recalls working alongside an extremely experienced neonatologist during his residency. She had managed a neonatal intensive care unit in her home country of Lithuania, but because she wanted to practice in the United States, it took years of repeat training before she was eligible for a medical license.
"She was very accomplished, and she was wonderful to have as a co-resident at the time," Carmody said told Medscape Medical News.
The neonatologist now practices at a US academic medical center, but to obtain that position, she had to complete 3 years of pediatric residency and 3 years of fellowship in the US, Carmody said.
Such training for international medical graduates (IMGs) is a routine part of obtaining a US medical license, but a new Tennessee law bypasses these requirements and creates a quicker pathway for IMGs to secure medical licenses in the US.
The American Medical Association (AMA) took similar measures at its recent annual meeting, making it easier for IMGs to gain licensure. Because the pandemic and Russia's invasion of Ukraine disrupted the process by which some IMGs had their licenses verified, the AMA is now encouraging state licensing boards and other credentialing institutions to accept certification from the Educational Commission for Foreign Medical Graduates as verification, rather than requiring documents directly from international medical schools.
When it comes to Tennessee's new law, signed by Gov. Bill Lee in April, experienced IMGs who have received medical training abroad can skip US residency requirements and obtain a temporary license to practice medicine in Tennessee if they meet certain qualifications.
The international doctors must demonstrate competency, as determined by the state medical board. In addition, they must have completed a 3-year postgraduate training program in the graduate's licensing country or otherwise have practiced as a medical professional in which they performed the duties of a physician for at least 3 of the past 5 years outside the US, according to the new law.
Upon completion of the program, IMGs will be able to practice general medicine in Tennessee, not a specialty. Requirements for specialty certification would have to be met through the specialties' respective boards.
Interesting, and probably a good idea.
At our small place, there was a group of "surgical assistants." Their job was to be the first assistant in surgery - they would tie knots, hold retractors, even give advice to the surgeon.
Almost all of them were actually physicians from overseas (Pakistan, Philippines, India) who could not get a job practicing medicine in the US because of restrictive laws. I don't know the circumstances of why they left their native countries. At least two were general surgeons, one was a pulmonologist (took him a while to learn the ropes of surgery, of course). Sometimes, you could tell that they had better technique and judgment than the surgeon responsible for the case.
It always bothered me that these smart and capable people were denied a career in medicine other than being an "assistant."
Up here it is not the law that is impeding foreign trained doctors from practicing but rather the medical profession itself through its national licensing association and the various provincial organizations that act as local regulators of the profession.
For example:
https://www.cbc.ca/news/politics/canadian-doctor-struggle-to-get-licensed-1.6890254
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One problem is that there is, in medicine, no standard or good way to judge competence.
As far as surgeons go, is the faster surgeon the better surgeon? Is the one who gets sued more often inferior? What about those online ratings? I've worked with great surgeons in private practice and shitty surgeons in academia.
I agree that there needs to be a minimum standard of education and training, but beyond that, how do you judge.
On a more micro level, for me to have moved north of the Cheddar Curtain would have involved getting a new license. Many states require a written examination before you can get a license in that state. I, most certainly, fail any such examination. Nevertheless, I used to be pretty competent.
How do you judge?
@George-K said in New Law Allows International Medical Graduates to Bypass US Residency:
One problem is that there is, in medicine, no standard or good way to judge competence.
As far as surgeons go, is the faster surgeon the better surgeon? Is the one who gets sued more often inferior? What about those online ratings? I've worked with great surgeons in private practice and shitty surgeons in academia.
I agree that there needs to be a minimum standard of education and training, but beyond that, how do you judge.
On a more micro level, for me to have moved north of the Cheddar Curtain would have involved getting a new license. Many states require a written examination before you can get a license in that state. I, most certainly, fail any such examination. Nevertheless, I used to be pretty competent.
How do you judge?
A national standard or test with full reciprocity between states.
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"Now look here, you Baltic gas passer... " - Mik, 6/14/08
The saying, "Lite is just one damn thing after another," is a gross understatement. The damn things overlap.
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@George-K said in New Law Allows International Medical Graduates to Bypass US Residency:
Related.
About bloody time. We get a lot of GPs coming here from South Africa. They seem to be the only ones interested in working in rural hospitals or rural practices. Quite a few in urban centres are Emergency doctors.
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This is awesome news. I understand Jolly’s concern but it isn’t unique to medicine and other fields manage to do okay weeding out the unqualified through interviews or probationary periods.
@Jon said in New Law Allows International Medical Graduates to Bypass US Residency:
This is awesome news. I understand Jolly’s concern but it isn’t unique to medicine and other fields manage to do okay weeding out the unqualified through interviews or probationary periods.
Jolly has worked with a shitload of them. Syrian, Brazilian, Jamaican, Vietnamese, Indian, Indian, Indian, UK, Venezualan, Panamanian, Honduran, Turkish, Columbian and a smattering of others. Some good, some mediocre and some I wouldn't have wanted treating my Sheltie.
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@Jon said in New Law Allows International Medical Graduates to Bypass US Residency:
This is awesome news. I understand Jolly’s concern but it isn’t unique to medicine and other fields manage to do okay weeding out the unqualified through interviews or probationary periods.
Jolly has worked with a shitload of them. Syrian, Brazilian, Jamaican, Vietnamese, Indian, Indian, Indian, UK, Venezualan, Panamanian, Honduran, Turkish, Columbian and a smattering of others. Some good, some mediocre and some I wouldn't have wanted treating my Sheltie.
@Jolly said in New Law Allows International Medical Graduates to Bypass US Residency:
Some good, some mediocre and some I wouldn't have wanted treating my Sheltie.
Same with American-trained docs, including at the "U" - one of which I called out, years ago, LOL.
"Now look here, you Baltic gas passer... " - Mik, 6/14/08
The saying, "Lite is just one damn thing after another," is a gross understatement. The damn things overlap.
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@Jolly said in New Law Allows International Medical Graduates to Bypass US Residency:
Some good, some mediocre and some I wouldn't have wanted treating my Sheltie.
Same with American-trained docs, including at the "U" - one of which I called out, years ago, LOL.
@George-K said in New Law Allows International Medical Graduates to Bypass US Residency:
@Jolly said in New Law Allows International Medical Graduates to Bypass US Residency:
Some good, some mediocre and some I wouldn't have wanted treating my Sheltie.
Same with American-trained docs, including at the "U" - one of which I called out, years ago, LOL.
Yup. Would be ideal if there were some sort of "international accreditation" for medical schools.
