Last year TN passed a new law that fast-tracked the licensing of IMGs without requiring US residency training.
This week the TN Medical Board voted not to comply with the law which they felt would force them to violate their medical ethics
After much back and forth, the board voted not to create an application form for IMGs to use, and defied their legislative mandate. It approved posting an explanation of its policy on its website with an FAQ, which simply says, “At this time, the Board does not have an application.”
The Medical Board cited issues with the verification of experience a foreign doctor might claim as well as an inability to complete criminal and malpractice background checks on foreign applicants.
I think the whole idea just to bring doctors from all over the world without residency in the US is ridiculous. US citizens fight to get to medical schools and residency and need to pass numerous exams, and we will just simplify process for foreign doctors… It is not a field that cannot attract students. It is a field artificially limited. Open up medical schools, reduce tuition. You will have oversupply of good American doctors in no time.
As the parent of a medical school applicant with very high grades and MCAT scores who was shut out from 19 schools last year, I concur that we don’t need to make it easier for foreign doctors to take spots from aspiring U.S. doctors.
But a significant majority of US trained doctors do NOT want to practice in the areas where there are shortages/medical deserts. Rural, urban/poor, Tribal communities… how to help those people who have needs right now/this year while we figure out the long term solution??? Tell women to give themselves Pap smears, teach them how to diagnose their own melanomas?
Every young doctor I know says that. And every med student and prospective med student. And other than the ones who participate in the federal loan program (so they HAVE to serve there) ends up elsewhere. I get the reality- massive amounts of debt, and the most efficient way to pay those off is in high paying specialties in more affluent areas. And yes- a doctor working at Cedars Sinai or Cleveland Clinic is going to see a diverse patient roster for sure. But it’s not the same as working in a remote clinic where you are the only physician for miles and miles, diagnosing everything from impetigo to MRSA to MS in a single day.
We have really created a mess in our medical systems and incentives. My physician cousins in Europe have many complaints about their systems (most notably how long it takes to get a referral to either the right specialist or to get a costly diagnostic procedure approved) but by and large they choose where to practice based on the lifestyle they want (urban, rural, something in between) and since they are paid as civil servants, the link between specialty, compensation, location, etc. isn’t that meaningful.
Allow nurse practitioners full practice rights in those underserved areas. If the doctors don’t want to go there it seems like an extremely reasonable solution to help those populations.
Certain countries send well trained doctors. Some not. I suspect that in certain 3rd world countries, admissions to med school are bought with bribes. We already know that there has been compromise of the boards administered abroad. Licensing of FMGs without having completed a full formal residency here was always a bad idea.
As someone who lives in an underserved rural area, I believe I deserve access to doctors who have undergone years of specialized medical training just like everyone else. We aren’t second class citizens. The answer is to open up way, way more medical school slots (instead of artificially capping the numbers). The answer is not to shrug and say those living in rural areas can have NPs instead of MDs.
As someone who has been a practicing NP for 15 years it is disheartening to hear that. As this is not the thread for a debate on MD vs NP, I’ll just stop here. Someone posted asking for a short term solution, I provided one.
We already have NPs here. My primary care is an NP (and wonderful). The first 8 months of my pregnancy I was only seen by NPs. My child’s pediatrician is an NP. This is not a knock against NPs. But NPs do not have the same medical training as MDs, and I wish we had more doctors in our area.
I hear your frustration. I just wish that you wouldn’t have taken my post of suggesting NP’s to practice in the area as implying underserved populations are second-class. I currently provide care to underserved populations. I don’t believe they feel the care I provide is “second-rate.”
While I agree with what you are saying, shouldn’t there be a way for well-trained foreign doctors to get licensed to practice here without it taking an inordinate amount of time and money? A friend of mine came here from Russia where he was a pediatrician but gave up on practicing in the US due to the hurdles & cost. Instead he pivoted and got certified in database administration and turned that into a great career - he is an absolutely brilliant guy but is still (after many years) a little disappointed he had to give up his medical career.
Let us drop formal Soviet Union for a second. Do you think that training in Japan, Kenya and Philippines will be the same? Not even trying to compare to the US. I would say no…
Then should US be involved in current training practices all around the world? No way.
But I love doctors who were educated initially not in the US but went through residency here. They are amazing and open minded and usually have different approaches.
So I am an md and have trained with and trained imgs. Generally, the medical training in other countries is comparable to the us. 5-6 year courses and post graduate training. Most who come to the us are not new grads but have been in practice for many years. There is an incredible doctor shortage in the US and it is being filled by newly minted physician extenders who have online degrees. Residency spaces are limited and those with us medical degrees can go unmatched, some for years. Seems that allowing imgs to practice is an easy win for patients.