Tennessee refusing carribean students?

[isa]

I heard that Tennessee started to refuse to liscence students who didn't do ALL med school in their schools country of origin. Is this true? If it is, harder for any carib student to be liscenced in all 50 states, unless they do all their rotations on the islands.

[2cents]

can't say, but I wonder if this would apply to LCME students doing international rotations. That would be funny.

[CaliforniaEquality]

no matter which state, what new policy they will come up with, we should not just sit home and blame ourselves. we should contact politicians and get them involved!

[bhs2a]

That's crazy. I would like to know more. Is this for real??

[miasma]

this can't be real, right?

[ol' man]

At our clinicals meeting at SMU, we were told that TN now uses the CA list (what a cop-out on the board there; they could have at least used a list from some state that uses reason in their decisions). So, apparently there is something to this.

[miasma]

i just sent an email, i'll post the reply asap.

[CaliforniaEquality]

see, people, we can not let those idiots who are running the california board to ruin our life!

we need to send email complains, make phonecalls to california governor, senators, congressmen/women!

we must let our voice to be heard!

At our clinicals meeting at SMU, we were told that TN now uses the CA list (what a cop-out on the board there; they could have at least used a list from some state that uses reason in their decisions). So, apparently there is something to this.

[isa]

A friend of mine who is rotating in Atlanta told me that the GMC group said that.
I can't help but hope they were wrong:(

[Junito]

So I guess they have adopted the one of the recommendations of the FSMB...:shock:

[miasma]

So I guess they have adopted the one of the recommendations of the FSMB...:shock:
which recommendation is that? using the CA list?

[ol' man]

Well, that would suck. I thought the people in Tennessee were smart enough to think for themselves.

[miasma]

so are the CA approved schools ok? or do ALL four years have to be in the country of the school?

[IMG2006]

no matter which state, what new policy they will come up with, we should not just sit home and blame ourselves. we should contact politicians and get them involved!


I know that it is true. I know someone who was denied based on the fact that he did not do all of his rotations and course work in the same place.

YOU ARE RIGHT!!!! Start emailing, calling, faxing, and writing!! Let's get on it here people. Look at my post of what's going on in GA. If we just sit around and complain, we won't be able to go anywhere soon.

[bhs2a]

What if you were already practicing in TN? When they pass a new law do all of the people who were already practicing from the Caribbean have to leave?

[bhs2a]

Could anyone post the info of the people we should start calling and e-mailing. I am getting really pissed off at these ridiculous laws. I would think it would be better if we did our rotations in U.S. hospitals. Do they have something against Caribbean students?

[ol' man]

What if you were already practicing in TN? When they pass a new law do all of the people who were already practicing from the Caribbean have to leave?

Good question. Maybe TN will have to ask CA about that since they obviously think CA knows best? I cannot believe that a Southern state thinks that someone 3,000 miles away knows what is best for them.

[miasma]

so i'll ask again, are CA approved school ok? or does this new law require all 4 years to be in the location of the school? also, i have emailed the TN med board, waiting a reply.

[IMG2006]

so i'll ask again, are CA approved school ok? or does this new law require all 4 years to be in the location of the school? also, i have emailed the TN med board, waiting a reply.

Get off of your duff and write the board... Google Tennessee Medical Board, click on contact us, and get to it! If you don't like what they have to say, start to rally the troops.

[bhs2a]

In the future do you think things will continue to go downhill for Caribbean medical students? Will the outlook be better overtime? I am afraid that I get a degree from Saba and then can not practice say in 20 years. Could that happen??

Here is the information. Everyone do whatever you can. We have to stop these laws that are against us. Everyone should call on Monday. I think it would be awesome if 100's of calls came pouring at her all week next week.

Tennessee Board of Medical Examiners
Rosemarie Otto, Executive Director
425 5th Ave. North, 1st Floor, Cordell Hull Building
Nashville, TN 37247-1010

(615)532-3202
Fax (615) 253-4484
e-mail www.state.tn.us/health (http://www.state.tn.us/health)

[miasma]

i personally don't think caribb grads will ever be banned from practicing in the entire country, because the health care system would collapse without these schools supplying doctors, especially to the rural areas in primrary care. they need us more than they even know.

[IMG2006]

What if you were already practicing in TN? When they pass a new law do all of the people who were already practicing from the Caribbean have to leave?

Almost certainly not. In the past, when states have changed, it only applies to initial licensure in that state. In fact, if you actually start to read the laws/rules, it will state something to the effect of, "on or after july 4th 1985....."

[bhs2a]

What are the odds of getting the law in TN back in our favor?

[golfman]

Has anyone heard back from the board? I am also from TN and interested to see what they have to say.

[miasma]

i've emailed. will probably get a response on monday.

[golfman]

I also just emailed them to let them know others are interested in the info. Hopefully wiil hear something tomorrow.

[gazpacho]

especially to the rural areas in primrary care
Caribbean doctors are found en masse in rural areas practicing primary care? This is news to me. Care to back this up?

[IMG2006]

What are the odds of getting the law in TN back in our favor?

Zero, unless we keep putting the fire to their feet. If everyone just keeps making this rule 20-45 minutes of every board meeting, then it will change. I'm seriously thinking of getting a lawyer. Maybe WE should all get a lawyer.
I'm starting to feel like a black man in 1950's Mississippi here.... seems like no matter how well I do, it's not good enough for some of these people. That isn't right. If we pass the boards and complete a residency, then we should have equal rights. It's not an unfair comparison. Ever see "Something the Lord Made" ? Hopkins made Vivian Thomas an official janitor, even though he was the co-founder of heart surgery. If he were an IMG they probably wouldn't have even let him in the door.

[AUCMD2006]

Caribbean doctors are found en masse in rural areas practicing primary care? This is news to me. Care to back this up?

not really 'caribbean docs' but foreign docs with visa issues. a ton of rural hospitals will sponsor visas so just drive in rural america and see the signs outside the medical offices, i was in middle michigan driving and saw dr. visha, khan, armedhi.... don't think many indian and arab families migrate to the midwest for the climate and tolerant liberal way of life eh?

[gazpacho]

not really 'caribbean docs' but foreign docs with visa issues. a ton of rural hospitals will sponsor visas so just drive in rural america and see the signs outside the medical offices, i was in middle michigan driving and saw dr. visha, khan, armedhi.... don't think many indian and arab families migrate to the midwest for the climate and tolerant liberal way of life eh?

Oh of course. But it is a mistake to say that Caribbean doctors will be "sorely missed" in rural areas in primary practice, because let's face it: the vast majority of Caribbean students are from large urban centers and clamor to head back there once they get that coveted independent license to practice.

[miasma]

so if this TN law was indeed true, then NO caribbean med school would be good for all 50 state then right (because of the 2 year island/2 year u.s curriculum)?

[Scott1981]

i still havent seen any proof on TN doing this.

im sick of the "i heard from my friend's girlfriend's brother inlaw."

[microphage]

i still havent seen any proof on TN doing this.

im sick of the "i heard from my friend's girlfriend's brother inlaw."

at least its better than "I heard it from the internet..."

[IMG2006]

so if this TN law was indeed true, then NO caribbean med school would be good for all 50 state then right (because of the 2 year island/2 year u.s curriculum)?


Not exactly. There are some 4 year schools there. UCE in DR is, Mexico has a few.

Also, just B/C TN is doing it doesn't mean that all 50 states are.

[IMG2006]

i still havent seen any proof on TN doing this.

im sick of the "i heard from my friend's girlfriend's brother inlaw."


I personally know an SMU grad who was denied in writing based on this issue alone. He was really upset about it and, so far, hasn't found any way around it.

[Scott1981]

I personally know an SMU grad who was denied in writing based on this issue alone. He was really upset about it and, so far, hasn't found any way around it.

so you have no proof.

you have "a friend." OMG...... spare me.

[IMG2006]

so you have no proof.

you have "a friend." OMG...... spare me.

Hold still..... I'll get you a DNA sample. Tell you what, go ahead and burn the application fee. Then you'll have ample proof. Of course, I'll want you to send me notarized copies in triplicate.

[IMG2006]

so you have no proof.

you have "a friend." OMG...... spare me.

On second thought... maybe he told me this to impress me. You could be right. Lots of people want to represent themselves as unfit for licensure.

[miasma]

ok, ok, IMG2006, let's all calm down here. tell ya what: i've emailed the board already, they'll get back to me probably tomorrow, and i'll post the response. okay?

[IMG2006]

ok, ok, IMG2006, let's all calm down here. tell ya what: i've emailed the board already, they'll get back to me probably tomorrow, and i'll post the response. okay?

Hey we have a winner!!! ;) ;) My bad.

[DominusMedicus]

According to the application all you need is ECFMG certification to be considered.

http://www2.state.tn.us/health/Downloads/g4017051.pdf

That means there is no verification that TN is barring Caribbean grads.

[bhs2a]

If the board denied the "friend" for that reason wouldn't TN have to have it written down that they didn't accept people who didn't complete all their years in the same country. If this truly did happen then I think there could be a major lawsuit against them.
I really am starting to think this is **. Can't wait to see what they say. I also e-mailed them so that makes 3 of us.

[Scott1981]

img2006, your sarcasm doesnt impress me with the fact that you are going to an open forum and posting this rumor as a fact when you really dont have proof other than that of you "friend."

http://www2.state.tn.us/health/Downloads/g4017051.pdf

i think we have an alarmist on our hands. once again, find proof before immediately jumping into the rumor bandwagon. you are jumping to other forums claiming that tenn is out of the question for carib grads when all you have is what your "friend" told you.

so far, your friend's story doesnt add up because the proof is the offical tenn application. i know he is your friend, but he could be trying to cover up some flaws in his application (ie blue book rotations, etc) and doesnt want to admit it to you.

its ok to bring this circumstance up on vmd. however, its quite reckless of you to start jumping in many threads claiming that this is a 100 % fact about tenn and scaring the doo doo out of students from tenn.

once again, get some hard proof before posting recklessly.

here is an example of your immediete acceptance of the "new tenn law."

Wrong... I am about to graduate from SMU.

Kansas requires that your school be around for 15 years before you license there. 2012 is around the corner... I too can live without this one.

Indiana has banned SMU. I don't know why, but it happened when the school was in Belize.

Texas has not approved SMU

California disapproved SMU

Tennessee requires that all 4 years be in the same country... add that to the list

New Mexico uses the CA list.

................
There are also strict regulations on clerkships in about 20 states. This doesn't have to do with you school, but with where you do your clinicals. EVERY SINGLE ONE OF YOUR ROTATIONS NEEDS TO BE DONE IN AN ACGME TEACHING HOSPITAL IF YOU WANT LICENSURE OPTIONS!!!!!!!!!!! Write that down and take it to the bank. DO NOT LISTEN TO ANYONE ELSE ON THIS MATTER!!!!! DO YOUR OWN REASEARCH!!!!

like i said before, there is nothing wrong with bringing up your "friend's" situation. however, i would wait for that email from the tenn med board before posting stuff like above.

[IMG2006]

0880-2-.04 paragraph 3, section E


www.state.tn.us/sos/rules/0880/0880-02.pdf (http://www.state.tn.us/sos/rules/0880/0880-02.pdf)


The rule states that courses must be "continuous" and "centrally organized." The board is using this, at least in one case that I can vouch for, to mean in one country.

Let's hope we can punch some holes in this one.

[IMG2006]

I think section D might be an issue for many of us as well.

[AUCMD2006]

taking it out of context

i see "acceptable medical medical education courses and activities must be centrally organized, integrated, and controlled into a continuous program which was conducted, monitored and approved by the parent institution"

this means you need a medical administration office coordinating your education...how is that interpreted another way? it says centrally organized, NOT centrally located

[IMG2006]

taking it out of context

i see "acceptable medical medical education courses and activities must be centrally organized, integrated, and controlled into a continuous program which was conducted, monitored and approved by the parent institution"

this means you need a medical administration office coordinating your education...how is that interpreted another way? it says centrally organized, NOT centrally located


Hey brother... I'm on your side here. I think we should argue that point. Also, most schools do periodical site reviews... Shouldn't that count as centrally organized?

Maybe what they are getting at is having the home office in one state, the ** courses in another country and the CS in another state(s). Nothing about that sounds very central, though it's not AT ALL uncommon for US schools to do things in a fairly simialr manner. I don't know.

Anyway, that's what they cited on my friend when they blocked him. He's licensed in GA, which requires 100% ACGME clerkships, so I know that wasn't a factor. In any case, it's a crap rule that is specifically designed to target us, while leaving the board some wiggle room if they like.

Georgia does something like this lingo-twist with the ACGME req. They state in the rules that each clerkship has to be in an ACGME hospital, but when it comes to the application, they require a GME stamp. It's a fine line, but one that can certainly matter in a lot of cases. People get burned on that one all the time when they rotate through a teaching hosp with a doctor, but the GME office doesn't hold a record on them. You were there, it just wasn't official.

Another sticky point for us here is section D. Is there any foreign school with admission standards equal to or exceeding those of LCME schools? Maybe in Europe?

This really throws me off base, TN was one of the places I REALLY wanted to be.

Anyway... I'm just shy of having rocks thrown at me for this one, so wait for your emails to come back. I hope they have loosened up on this one.

[AUCMD2006]

-yea i guess they can use the office, **, CS as an issue..good point

-as for rotating through a hospital with a doctor, rules are very clear on that one. you can not just rotate with a doctor, it has to be through that program so its not a fine line..if you are rotating with a private doctor you aren't rotating through the program so why would they have a record of you? i know for a fact that any hospital you rotate through needs malpractice insurance, immunizations, tb test, some a recent criminal record and b/c you have direct contact with pts they keep your record onfile for malpractice purposes for 7 years usually...

-admin standards, the ones with staffords are accredited by a brittisk body i beleive that deems them to have standards equivalent to the lcme. i don't know about the rest

anyway hopefully they aren't doing this....i just looked at a residency site in ten

[Junito]

The Recommendations I was referring to was that of the FSMB:

Recommendations: 1. The FSMB should monitor closely efforts underway in various quarters to establish approval or accreditation mechanisms for international medical schools and provide support for these initiatives if appropriate. 2. State medical boards should review closely all statutes and regulations concerning medical licensure to ensure that no fundamental inconsistencies exist between any approval processes involving international medical schools and the requirements applicable to graduates of US medical schools. For example, statutory or regulatory language that allows for the creation of a branch campus from an international school within the state’s borders is likely to be inconsistent with (perhaps even contradictory to) the language most states have requiring that graduates of US allopathic medical schools only be considered for licensure if their schools are accredited by the LCME. 3. Clinical clerkships for students enrolled in any medical school program should be conducted a. in the same country as the host nation where the medical school is located physically, or b. when conducted in another country outside of where the medical school is located, a written affiliation agreement exists between the medical school program and the teaching hospital where the clerkship occurs, and the clerkship has comparable standards to those conducted by LCME-or AOA-accredited medical school programs, or c. within the context of a teaching hospital that features programs approved by the ACGME or the AOA, and with a written affiliation agreement between the medical school program and the teaching hospital within which the clerkships occur.

That is crazy!

http://www.fsmb.org/grpol_policydocs.html

[DominusMedicus]

The Recommendations I was referring to was that of the FSMB:



That is crazy!

http://www.fsmb.org/grpol_policydocs.html

No it's not. Read parts b). and c).

b. when conducted in another country outside of where the medical school is located, a written affiliation agreement exists between the medical school program and the teaching hospital where the clerkship occurs, and the clerkship has comparable standards to those conducted by LCME-or AOA-accredited medical school programs, or c. within the context of a teaching hospital that features programs approved by the ACGME or the AOA, and with a written affiliation agreement between the medical school program and the teaching hospital within which the clerkships occur.

[Scott1981]

well, its definitely grounds for a legal challenge if this was the only thing reason that your friend was denied.

is this a new law? if it isnt, what makes your friend any different than the many other caribbean grads practicing in tenn?

one thing that may be the "X factor". i highly doubt the board would have thorough information about the basic sciences and clinical rotations along with the inner workings of the school unless they did a site visit. is the tenn board reading the cali site visit and stretching their own wording of their law just to deny the smu grad? the reason for this is because 880 2 .04 is a real vague law that doesnt sound like it was designed for this, and im still having a problem interpreting that law this way.

[AUCMD2006]

its not 'crazy'. it is what some states require already and is why we are told we can not set up any cores ourseleves unless we get an affiliation agreement.

this also prevents anyone from just setting things up with any doctor friend, family, etc and cruising through a clerkship and protects people who would have set up the rotation and get 'burned' later as teh other post stated. so exactly what is bad or different than what is being done now?

[IMG2006]

[quote=Scott1981]well, its definitely grounds for a legal challenge if this was the only thing reason that your friend was denied.

is this a new law? if it isnt, what makes your friend any different than the many other caribbean grads practicing in tenn?

one thing that may be the "X factor".quote]

Not sure about the timing on this one... I know that as of about 5-6 years ago, IMG residents from the hospital I worked in during college COULD license in TN. In fact, it was easier than GA at the time. Many of these guys were Carib grads. We can check the minutes and see.

I think is is intentionally vague because of the X-factor, if you want to know the truth. Scary to say, but I think they want the option of thumbs downing you based on whatever they like.

As for who's already there, it seems that states don't take your license away when the law changes, they just block the new ones. I'm not sure what has happened, but mostly I think all of us are just much more "on the radar" than we have been in the past with the recent boom in new schools. I doubt there has been any sort of problem with the current IMGs there or even with those who have applied for licensure. It's just a panic button being pushed.....

What all these boards seem to forget is that the only people who will be applying for a license have passed the boards and completed a residency. That's a reasonably fine filter though which idiots and or nutters would not pass.

[Junito]

No it's not. Read parts b). and c).

I was referring to the Tennessee MB just looking at part A and ignoring b & c.

[miasma]

still waiting for a response from TN med board guys...

[rdecastro]

The Recommendations I was referring to was that of the FSMB:



That is crazy!

http://www.fsmb.org/grpol_policydocs.html

Why? That a written agreement between the school and the hospital, for a clerkship?

Whats so bad about that?

[golfman]

I just heard back form the TN Board of Medical Examiners. Here is what she said:
On February 6, 2006 a new rule became effective requiring all International Medical School Graduates must show proof that "The school's admission standards must meet or exceed those of medical schools accredited by the Liaison Committee on Medical Education (LCME)." Hope this answers your question.

Marsha Arnold, Unit Manager
Board of Medical Examiners


From this info I conclude that the info on here has been blown out of proportion. Carribean grads have the same opportunity to practice in TN as US grads as long as our schools meet the standards of the LCME.

Hope that clears up some of the confusion.

Lee

[bhs2a]

What exactly are the standards of the LCME. What if the school doesn't require the mcat or physics? (like Saba) I feel like these are dumb questions but I just want to be sure there aren't any loopholes.

[miasma]

yeah, i got the same response as golfman. so it looks as if we're ok. but i emailed back just to clarify.

[golfman]

the LCME doesn't refer to undergrad admission standards but refers to what you do during Med School. Saba I know meets these standards.

[Aviv Imanuel]

What exactly are the standards of the LCME. What if the school doesn't require the mcat or physics? (like Saba) I feel like these are dumb questions but I just want to be sure there aren't any loopholes.

Last time I checked ALL LCME schools required the MCAT and as long as I have been involved in this, Organic 1/2 Physics 1/2 gEN cHEM 1/2...etc.

If SABA does not require MCAT or physics then their admissions requirements DO NOT meet, not to mention does not exceed those of medical schools accredited by the Liaison Committee on Medical Education (LCME). I guess their students are out of the party after the new rule came into effect.

[2cents]

Neither University of Ottawa, nor MacMaster require MCAT; both are LCME schools

[miasma]

Last time I checked ALL LCME schools required the MCAT and as long as I have been involved in this, Organic 1/2 Physics 1/2 gEN cHEM 1/2...etc.

If SABA does not require MCAT or physics then their admissions requirements DO NOT meet, not to mention does not exceed those of medical schools accredited by the Liaison Committee on Medical Education (LCME). I guess their students are out of the party after the new rule came into effect.
i think this is inaccurate. i'm from canada, and the new med school (lcme accredited) Northern Ontario School of Medicine, has no mcat requirement, and no pre -req courses. if you doubt me, check their website.

[miasma]

whoa, 2cents, you posted the same time as me! lol

[bhs2a]

You guys are so on the ball and I'm glad that everyone is working together nicely to get all of this figured out.
Everyone pat themselves on the back.

[golfman]

So anyone have another take on this? As far as I can tell Saba students are ok.

[Scott1981]

so the question is, what exactly happened to that SMU student that IMG2006 was talking about. did TN unofficially disapprove SMU? or was there other issues to his/her application?

[2cents]

Untill this person comes here and air his dirty laundry this is all wild conjecture; and not at all grounded in fact. I suggest no one lose any sleep on speculation.

[solideliquid]

so the question is, what exactly happened to that SMU student that IMG2006 was talking about. did TN unofficially disapprove SMU? or was there other issues to his/her application?

Most likely the case was as you said, there were problems with the indiviual and their choice of clinical rotations. Five years ago SMU was still in its infancy, and that being the case the clinical rotations were often located far and wide apart from each other, and they may have been in small hospitals or offices that no longer exist.

Just my .02

[Miklos]

Last time I checked ALL LCME schools required the MCAT and as long as I have been involved in this, Organic 1/2 Physics 1/2 gEN cHEM 1/2...etc.

If SABA does not require MCAT or physics then their admissions requirements DO NOT meet, not to mention does not exceed those of medical schools accredited by the Liaison Committee on Medical Education (LCME). I guess their students are out of the party after the new rule came into effect.
It has been a very long time since I checked, but when I checked there were several prominent LCME schools in the US (in addition apparently to the Canadian schools listed above) that specifically did not require the MCAT.

[Scott1981]

Most likely the case was as you said, there were problems with the indiviual and their choice of clinical rotations. Five years ago SMU was still in its infancy, and that being the case the clinical rotations were often located far and wide apart from each other, and they may have been in small hospitals or offices that no longer exist.

Just my .02

its a shame that this speculation went on as long as it did. i dont want a medal or anything (:lol:), but i said that there were probably issues with the application (rotations, etc) some days ago as soon as i read about the TN "issue"

[IMG2006]

so the question is, what exactly happened to that SMU student that IMG2006 was talking about. did TN unofficially disapprove SMU? or was there other issues to his/her application?


It was the person... There wasn't anything said about the school. Hope on the horizon?

[IMG2006]

Most likely the case was as you said, there were problems with the indiviual and their choice of clinical rotations. Five years ago SMU was still in its infancy, and that being the case the clinical rotations were often located far and wide apart from each other, and they may have been in small hospitals or offices that no longer exist.

Just my .02


SMU rotation sites at this time:

Bethany Hospital, Chicago, IL
Bethesda Medical Center, W. Palm Beach, FL
Case Western Reserve, Cleveland, OH
Children’s Mercy Hospital, Liberty, MO
Christ Hope Children’s Hospital, Oak Lawn, IL
Cook County Hospital, Chicago, IL
Deaconess Hospital, Spokane, WA
Duke University School of Medicine, Durham, NC
Flagler Hospital, St. Augustine, FL
Florida Hospital Celebration, Celebration, FL
Florida Hospital, Kissimmee, FL
Grant/Riverside Methodist Hospital, Columbus, OH
Harvard Medical College, Boston, MA
Howard University Hospital, Washington, D.C.
Huntsville Hospital, Huntsville, AL
Iowa Methodist Medical Center, Des Moines, IA
Johns Hopkins University School of Medicine, Baltimore, MD
Kootenai Medical Center, Coeur dAlene, IA
Lincoln Family Practice Program, Lincoln, NE
Louis A. Weiss Memorial, Chicago, IL
Memorial Medical Center, Las Cruces, NM
Memorial Sloan Kettering Cancer Center, New York, NY
Mercy Hospital, Chicago, IL
Mercy Hospital, Des Moines IA
Methodist/Childrens Hospital, Omaha, NE
Methodist Hospital Medical Center, Omaha, NE
Morehouse School of Medicine, Atlanta, GA
Mount Sinai School of Medicine – New York, NY
Nassau University Medical Center, East Meadow, NY
Newport Hospital – Newport, WA
North Central Bronx Hospital – Bronx, NY
Northeast London Mental Health Trust, UK
Ohio Valley Medical Center, Wheeling, WV
Orlando Regional Medical Center, Orlando, FL
Prince George\'s Hosp. Ctr., Cheverly, MD
Queen Marys Sidcup, Sidcup, Kent, UK
Rush Medical Center, Chicago, IL
Sacred Heart Women’s Hospital, Spokane, WA
Schwab Rehabilitation Hospital, Chicago, IL
South Lake Hospital, Clermont, FL
South Shore Hospital, Chicago, IL
Staten Island University Hospital, New York, NY
St. Helena Community Health Center, Greensburg, LA
Swedish Covenant Hospital, Chicago, IL
Trinity Hospital, Chicago, IL
University of Alabama School of Medicine, Birmingham, AL
University of Tennessee, Knoxville, TN
Vanderbilt Univ. Medical Center, Nashville, TN
Wayne State University School of Medicine, Detroit, MI
Weill Cornell Medical College – New York, NY
Yale University School of Medicine – New Haven, CT


CORE SITES:

FL
Florida Hospital,
Kissimmee

Florida Hospital,
Orlando
GA
GMC Group,
Atlanta
IL
Jackson Park Hospital, Chicago

Affiliated Institute of Medical Education, Chicago

Michael Reese,
Chicago
MD
Sheppard Pratt Hospital, Baltimore

Harbor Hospital Center, Baltimore

St. Agnes Hospital,
Baltimore
MI
Synergy Medical Education Alliance, Saginaw
MO
Christian Hospital Recovery Center, St. Louis

Christian Hospital, Dept. of Psych, St. Louis

St. Johns Mercy Hospital, St. Louis

Forest Park/DePaul Hospital, Bridgeton
NY
Cabrini Medical Center, New York

NY (cont.)
Peninsula Hospital Center,
Far Rockaway

St. Barnabus Hospital,
Bronx

St. John’s Episcopal Hospital, Far Rockaway

Wyckoff Heights Medical Center, Brooklyn
OH
Huron Hospital,
Cleveland
VA
Northern Virginia Mental Health Institute, Falls Church
UK
Stepping Hill Hospital, Stockport

Whipps Cross Hospital, London

Barnsley District General Hospital, Barnsley

[2cents]

and your point is....

this does not tell anyone what rotations this 'friend' allegedly took several years ago

[IMG2006]

My point was that the rotations are still far appart. Unless your school has rotations and classes in the same place, you may want to check this issue out. It seems that the board may be getting a little picky on what exactly constitutes central and continuous. Whatever you do, don't take my word for it though. Please post the board's response. I'll be calling tomorrow.

He rotated in the Atlanta and Chicago sites... same as me, that's how we got on the subject of licensure trouble. It wasn't a matter of ACGME, it was a matter of the central organization. I didn't see ACGME as a requirment for TN licensure anyway. The Chicago rotations are signed off by Michael Reese and Jackson Park (I did JP). The ones in Atlanta by Southwest (closed last year) and Atlanta Medical Center. He was blocked before SW went down.

Look.. Don't shoot the messenger. If you don't want to hear it from my "friend," wait and see what the board says. I'm not sure why you're so anti-hearing this, but I suppose foreign schools will make you a bit skeptical. I wouldn't take anyone's word for it either.

For the record, I'm not advocating what happened, I was just responding to the original question on the thread. I have a quasi-personl experience with this issue and want it resolved too. On the contrary, I really hope that I can license in TN. I have been extremely vigilant in accepting rotations to make sure that things were in the "green." I passed my boards, and things are looking good for residency. It's really maddening to think that no matter what I do, someone out there is going to wave a finger in my face and say no way. Especially when there are US schools who...
don't require MCATS (Brown only recently started taking them), admit without grades (some colleges are all pass/fail), allow "away rotations" (some even out of the country), continually have students who fail the boards on the 1st and even second attempt, conduct medical school on a pass fail basis, and graduate students who go on to loose their license for unethical practice. In the end, it just makes more sense to reward on merit than punish by the group.

[IMG2006]

I just heard back form the TN Board of Medical Examiners. Here is what she said:
On February 6, 2006 a new rule became effective requiring all International Medical School Graduates must show proof that "The school's admission standards must meet or exceed those of medical schools accredited by the Liaison Committee on Medical Education (LCME)." Hope this answers your question.

Marsha Arnold, Unit Manager
Board of Medical Examiners


http://www.lcme.org/standard.htm

Here's the site for the standards... The not-for-profit issue doesn't sound too good, though it says "should," not must. I know SMU if for-profit. What's SABA's tax credit designation?

[DrVinsk]

A friend of mine is finishing rotations there and has already secured a position with a family practice......in TN.

[IMG2006]

A friend of mine is finishing rotations there and has already secured a position with a family practice......in TN.


BE CAREFUL!!!!!!!!!! You can do a residency in a state and not license. read the rules section of the TN medical code. These are not the same license. Residents get a training permit. A girl in my class this year was offered an FP pre-match in TN. She asked about this issue then, and they didn't know much. She didn't sign because of all this.

I made this mistake before I went down to the island. I searched and found residents from all these schools all over the place, even TX. I thought the same thing you seem to be... If you can train, you can work. It's fair, but it's not the case.

That's been one of the central points in the letters I've sent to medical boards. The position that someone who is unfit to license is fit to work as a senior resident supervising interns just doesn't hold water with me.

[LastDance]

So what are the LCME admission standards that tennesse is going by? Aren't medical schools on the LCME list's entrance reguirements "tougher" than those of all carribbean medical schools? and therefore couldnt tennesse still deny residency placements to ANY carribbean grad? Basically, carribean medical schools are easier to get into than LCME accredited med schools, so isnt this a bad thing for carribean grads?

thanks for clearing up the confusion

[solideliquid]

My point was that the rotations are still far appart. Unless your school has rotations and classes in the same place, you may want to check this issue out. It seems that the board may be getting a little picky on what exactly constitutes central and continuous. Whatever you do, don't take my word for it though. Please post the board's response. I'll be calling tomorrow.

He rotated in the Atlanta and Chicago sites... same as me, that's how we got on the subject of licensure trouble. It wasn't a matter of ACGME, it was a matter of the central organization. I didn't see ACGME as a requirment for TN licensure anyway. The Chicago rotations are signed off by Michael Reese and Jackson Park (I did JP). The ones in Atlanta by Southwest (closed last year) and Atlanta Medical Center. He was blocked before SW went down.
.

So do you know what the problem was afterall? Was it because he rotated at SouthWest hospital? (btw- I did a rotation at SouthWest)

[AUCMD2006]

So what are the LCME admission standards that tennesse is going by? Aren't medical schools on the LCME list's entrance reguirements "tougher" than those of all carribbean medical schools? and therefore couldnt tennesse still deny residency placements to ANY carribbean grad? Basically, carribean medical schools are easier to get into than LCME accredited med schools, so isnt this a bad thing for carribean grads?

thanks for clearing up the confusion

kind of. the US avg is a 28mcat and a 3.6 gpa that means there are extremes at both ends. take a look at the stats for meharry, marshal, wayne, howard, etc. they are on par with some better carib schools.

they most likely will interpret it as having the same admision requirements such as mcat, 90 hours undergrad, set of admision criteria etc. but who knows for sure?

[Scott1981]

i still think many are jumping the gun here with the speculation.

[IMG2006]

So do you know what the problem was afterall? Was it because he rotated at SouthWest hospital? (btw- I did a rotation at SouthWest)

Jesus H. Christ!

[Scott1981]

Jesus H. Christ!

i dont get it :confused:

was there something amazing about where he did rotations for that response?

[solideliquid]

Jesus H. Christ!


who? .......................

[Aviv Imanuel]

Can you quote them? I am yet to see one. I will apologize and stand corrected once this can be substantiated.






It has been a very long time since I checked, but when I checked there were several prominent LCME schools in the US (in addition apparently to the Canadian schools listed above) that specifically did not require the MCAT.

[wcb22]

i believe in the laws of supply and demand more than this one dumb medical board.

they will need us more than they know, especially as these baby boomers start retiring, and baby boomer docs start retiring; they could hire every single one of us, and there still will be a shortage of docs in the coming days.

[Miklos]

Can you quote them? I am yet to see one. I will apologize and stand corrected once this can be substantiated.

I can only offer technical exceptions, which I've listed below. It appears that of the schools which I remembered not having an MCAT requirement when I had a copy of the MSAR (I do not have one now and haven't for a number of years, so anyone that does have a current copy, please feel free to correct me), all now appear to require the MCAT.

Minor technical excepotions:

Harvard (http://hms.harvard.edu/admissions/default.asp?page=requirements). MCAT not a requirement, but considered a plus. (I suspect that very few applicants get in without it.)
Dartmouth. (http://dms.dartmouth.edu/admissions/costs.shtml) Similar to Harvard, but states that "Students who choose not to submit MCAT scores will be at a disadvantage in our highly competitive admissions process."
The **/MD combined programs such as Kentucky's (http://www.mc.uky.edu/meded/bsmd/admissions.asp).
Programs such as the Texas A & M Partnership (http://medicine.tamhsc.edu/studentaffairs/pcc01.htm) for Primary Care Program.

[bhs2a]

So did we find out if the new law was referring to admission to medical school? We have now established that there are lcme schools that don't require the mcat but now what about physics? Can't we e-mail the board and ask point blank what the law is referring to?
Thanks

[miasma]

lcme schools don't require physics. the school in canada i mentioned before does not require ANY pre reqs. check the website and see for yourself. and the school is of course, lcme accredited. www.normed.ca

[Scott1981]

I can only offer technical exceptions, which I've listed below. It appears that of the schools which I remembered not having an MCAT requirement when I had a copy of the MSAR (I do not have one now and haven't for a number of years, so anyone that does have a current copy, please feel free to correct me), all now appear to require the MCAT.

Minor technical excepotions:

Harvard (http://hms.harvard.edu/admissions/default.asp?page=requirements). MCAT not a requirement, but considered a plus. (I suspect that very few applicants get in without it.)
Dartmouth. (http://dms.dartmouth.edu/admissions/costs.shtml) Similar to Harvard, but states that "Students who choose not to submit MCAT scores will be at a disadvantage in our highly competitive admissions process."
The **/MD combined programs such as Kentucky's (http://www.mc.uky.edu/meded/bsmd/admissions.asp).
Programs such as the Texas A & M Partnership (http://medicine.tamhsc.edu/studentaffairs/pcc01.htm) for Primary Care Program.

i went to go check like you. i remember 2 years ago johns hopkins didnt require it. now they do.

[Miklos]

i went to go check like you. i remember 2 years ago johns hopkins didnt require it. now they do.
Sorry about that, as I could have saved you the time to check JH out, as it was one of my first searches.

But, you know what they say: "It never pays to publish negative results."

[ASIANDOC]

you guys making such huge issue on this for nothing,forget about the MCAT because none of the international schools asks for it except few in the carribean and as I remember I got to Ross & AUC without it also.
if you finish residency and get your board certification I believe you will be fine ,Oklahoma tried to use equivalency between carribean and its med school LCME standards,it failed,their supreme court told the board that is unconstitutional and the applicant did training here in USA and that is equivalent to US LCME grads,and ordered the board to give the plaintiff full unrestriceted license.

[DominusMedicus]

Getting back on topic, there is no proof besides the sob story from this guy's friend's, cousin's half-sister's uncle who was rejected for unknown reasons.

Anyone hear from the board?

[Scott1981]

you guys making such huge issue on this for nothing,forget about the MCAT because none of the international schools asks for it except few in the carribean and as I remember I got to Ross & AUC without it also.


back in the day, that may have been the case for auc. not anymore.

[IMG2006]

Anyone hear back yet? Did the whole week go by without a reply from the TN board? I tried to call between cases this week but couldn't hold on anymore. My current doc is a real task-master.

[miasma]

well, the TN board got back to me. basically, they said the requirements are all on the TN med board site, and what it says there is what the rules are (so no, all 4 years DON'T have to be in the location of the school). that's all the info i received.

[IMG2006]

well, the TN board got back to me. basically, they said the requirements are all on the TN med board site, and what it says there is what the rules are (so no, all 4 years DON'T have to be in the location of the school). that's all the info i received.

I got similar stuff from GA about a year back when I pressed them on whether or not they actually meant to bar anyone from licensure based on clerkships. They actually went on record (Jan 2005 minutes) as saying that they used residency training and not clerkships for the basis of licensure. They then sent me a hard copy of the rule along with the minutes which clearly states that all clerkships must be completed in ACGME approved teaching hospitals.

Here's what I sent TN today, we'll see if they say anything more.



To: TN Medical Board
RE: IMG Licensure Rules
I am writing on the behalf of a concerned group of international medical students who would very much like to have clarification of the following questions.
We have reviewed your rules and application, but would like to have the following questions specifically addressed.

1- Does TN require that medical school clerkships (clinical training) and basic science education (class work) be completed in the same country? This inquiry is derived from the meaning of the requirement that international medical education must be continuous and centrally organized.
To give an example, if students from a school located OUTSIDE of the United States complete all clinical training INSIDE the United States, will this present an issue for the applicant?

2- What methods are being used to evaluate whether or not a non-LCME school meets or exceeds the requirements of LCME accredited schools?

3-Under what circumstances would the board refuse to license an international medical graduate who has successfully completed 3 years of an ACGME approved residency training program and or who holds a specialty board certification in cases where there is NO disciplinary or criminal basis for such denial?

4-Can graduate medical education (ACGME residency) be used as a means for establishing that all requirements have been met by the international medical graduate? Assume for the purposes of this question that ECFMG certification has been obtained and that the applicant has passed all phases of the USMLE.

5- Are there any foreign schools from which the board specifically does or does not consider graduates fit for licensure?
Thank You For Your Time,




__________________________________________________ _____________

BTW: Anyone else who wants to drop TN a line here's the address:

tn.health@state.tn.us

[bhs2a]

Great job IMG2006. I think you addressed all the questions very well. I hope they don't feed you some bull crap line and just answer the questions. Can't wait for the reply.
Thanks so much.

[DominusMedicus]

They are going to ignore IMG2006's questions because they are too long. Simple questions work well with gov't employees. Mark my words.

[Soon2BDoc]

that is ridiculous and really does not make sense. why would you want to do clinicals in another country and learn it in the other country's way? should I go back to the carribean and do my rotations then? that is true non-sense.

[IMG2006]

They are going to ignore IMG2006's questions because they are too long. Simple questions work well with gov't employees. Mark my words.

Hey, I have an idea... why don't you send them some concise questions. That's a better use of your energy.

[Soon2BDoc]

while they keep passing laws to make our lives illegal, lets pass some laws to make what they are doing illegal.

[Soon2BDoc]

its scary for those who are already in residency now in TN. What are they going to do? not get licenced? are they going to not renew their contracts? its all a huge fraudulent game they seem to play.

[IMG2006]

while they keep passing laws to make our lives illegal, lets pass some laws to make what they are doing illegal.

Yeah baby... now you're cooking with gas.

Here are the problems I see with this. We've got to get beyond these humps.

1- Most of us are broke. We're going to have trouble getting legal representation.

2- We're a very fractured special interest group. We've got to get some unity and find a way to keep everyone abreast. I have proposed that we form something of a union, but it's going to take some time and resources. valuemd is great, but it's not set up for this kind of action.

3- To sum... we've got to pool resources and energy. IMGs aren't the most cohesive lot.

...but I think you're on to something. What we really need to be doing is questioning the constitutionality of these rules. They're not actually laws in most cases. They are board rules.... that means they aren't ratified by the federal or state gov't, though the boards derive their power from state statutes. That provides us some defialde for a case.


Our stance: Does the state board have the legal right to refuse licensure (in the absence of a conduct or criminal basis) to an MD who has met the federal requirements for licensure? Well... they seem to be doing it, but that doesn't mean that it is defensible in court. I read a post about someone who had actually taken his/her case to the Oklahoma supreme court and won. Can we look into the validity of this case. A precident would help.

This is a true case of descrimination. A group of people are being denied rights despite demonstration of competency. They are making use of IMGs as interns, but are denying them a license... Before the onslaught about my "friend's sister's uncle's, roomate," this issue is in place in many states, so let's keep it constructive please.


You know, once you pass step 3, you can work in any federal hospital (VA, etc)... in any state. To me, this clearly demonstrates a double standard. If someone is unsafe, why should they be allowed to work anywhere. If they are safe, why not allow them to practice as they choose. I think it is reasonably clear that IMGs cannot be totally eliminated, so let's put some backs to the wall on this.

And by the way... where the hell is the ECFMG on this issue? Do we not have a credible national body which is in place to address these issues? If not, we sure as hell need one. In the end, I think this is going to be like everything else for us. If we wait for our schools or anyone else to do something, then we're going to continue to loose ground. We need to start making some noise on a large scale here.

[Picard]

We're a very fractured special interest group. We've got to get some unity and find a way to keep everyone abreast. I have proposed that we form something of a union, but it's going to take some time and resources. valuemd is great, but it's not set up for this kind of action.


There are no constitutional issues here. Licensure of any sort is in the State domain. As long as one is not discriminated based on federally protected civil rights (sex, race, religion... etc), there are no constitutional issues.

Does the state board have the legal right to refuse licensure (in the absence of a conduct or criminal basis) to an MD who has met the federal requirements for licensure?

Again, there is NO such thing as "federal requirement" for licensure. Federal governments are prohibited by our constitution to regulate licensure of professions -- these rights are reserved for the state. There are PRIVATE national bodies that accredit medical schools such as LCME. ECFMG is also a private entity that does nothing except providing "secretarial" service for IMG"s to register them for exams. USMLE/FSMB are also private entities. ANY state can at ANY TIME decide not to follow guidelines of these private entities and set its own state guideline -- perfectly legal. Most states follow these private entities out of convenience.

I read a post about someone who had actually taken his/her case to the Oklahoma supreme court and won. Can we look into the validity of this case. A precident would help.

Not this again. This has been discussed multiple times. There were NO, ZERO, NADA, ZIPO constitutional issues in the Oklahoma case. Oklahoma medical board lost in OKLAHOMA court for one simple reason -- OK Medical Board did NOT follow Oklahoma licensing laws when they denied IMG licensure. OK medical board over-extended it's authority UNDER EXISTING OKLAHOMA laws. That's all. That's very different from California where the state laws EXPLICITLY give CMB the authority to deny licensures of IMG"s from unapproved grads. In fact, California laws SPECIFICALLY prohibits CMB from granding IMG"s from unapproved schools licensure. If CMB were to grand licensure to unapproved grads, CMB itself would be in violation of California laws. Now, those states that have adopted the California list -- as long as it is explicitly written in their laws, it's perfectly legal.

Problem with offshore IMG's is that not all offshore schools are equal in terms of their quality... and we do a very poor job policing our own standards. We need to start policing offshore school standards FIRST and bring all offshore schools' quality up to par BEFORE we start demanding "equal treatment." Otherwise, this WILL back-fire. All it takes is an united push by medical boards for all offshore schools (pseudo-American schools sending 99+% graduates back into the US) to meet LCME standards NOW to effectively close the door to MOST offshore grads except those from schools currently approved by California, as California is the only current entity that evaluates offshore schools to LCME standards. Yeah, we want to be "treated equally" -- they will want this to start at the medical school level by requiring our schools to meet LCME standards. And at this time, most offshore schools except SGU/Ross/AUC/Saba have ZERO chance of meeting LCME standards.

Be careful what you wish for.

P

[miasma]

yup. true and well said picard.

[bhs2a]

Is there any new info? Did they answer the IMG2006's questions?? What do we need to do now?

[DominusMedicus]

Is there any new info? Did they answer the IMG2006's questions?? What do we need to do now?

Of course they didn't answer the questions because they already answered the questions by referring us to the online application requirements.

[bhs2a]

So what does that mean?? Can IMG"s practice in TN or not? They are using a cop out.

[DominusMedicus]

So what does that mean?? Can IMG"s practice in TN or not? They are using a cop out.

It says clearly in the documentation that Caribbean school grads can apply for licensure sans prejudice. BUT, if you are an ********, then you will be denied using the deliberatly written ambiguous rules regarding international medical students.

In short, if you are a good person with good stats then you are welcome to TN and if you are suspect then you are not.

[IMG2006]

Is there any new info? Did they answer the IMG2006's questions?? What do we need to do now?

Well... I got a reply, but it only said that my questions were "under review" and that "a representative of the board" would contact me. I'm not calling run-around yet, but it's close. I was clear cut and they didn't put anything in text.
I just found out I'm moving to Florida for the next few years (not my residency A plan), so, frankly, I haven't had any time to push the matter. I'll give it a few weeks and follow up after I finish my last rotation.
Basically, I'm right where I didn't want to be: starting my residency in 3 months with no solid ground waiting at the end of the road. I'll go on record though, anyone who denies me a license at the end of all this is just being an A$$h0le. Put that in your pipe and smoke it.


--"Just because you're paranoid, doesn't mean they're not after you."

IMG2006

[bhs2a]

Please stay after them for us IMG2006.

[IMG2006]

Names removed, please go back and read the questions I posted. I'm done arguing with anyone about this. If you want to hear it from the horse's mouth, email them the same questions.
I hope this will inspire some of you to join together instead of attacking anyone with bad news.
__________________________________________________ _____________

Dr.-----------

Please explain the first question. It is unclear what you are asking.

The second question asks about LCME requirements, the school must meet or exceed the requirements.

Yes, the Board can refuse to license anyone that doesn't fulfill all the requirements for licensure (question 3).

No, to question #4.

As for question 5, yes the Tennessee Medical Board uses the California listing as a guideline for acceptable medical schools.

----------------, Unit Manager
Board of Medical Examiners

[cubmd]

Yeah, we want to be "treated equally" -- they will want this to start at the medical school level by requiring our schools to meet LCME standards. And at this time, most offshore schools except SGU/Ross/AUC/Saba have ZERO chance of meeting LCME standards.

P

Exactly...... California can disapprove a Caribbean Medical school based on their rules and regulations (MCAT, etc) but, then approve other medical schools that don’t follow their rules and regulations for admission, don’t have the same medical curriculum, and they don’t even know how the schools work. Most of Cuban medical schools are approved by California and they don’t meet their requirements because they don’t have the same medical curriculum of LCME US medical schools. They are very good medical schools established for more than 100 years and with a really good reputation, but I doubt the medical board of California visits Cuba to inspect these schools. Can you exlain why the California medical board is so inconsistent with the accreditation of foreign medical schools.:confused:

last time i checked Cuba was a Caribbean island approved in California but without meeting the """" LCME standars"""""
:rolleyes:

[cubmd]

Yesterday (CA).....today (TN)....tomorrow ( who knows.......)....this is **

......we have to do something.............I just don't know what..:twisted:

[AUCMD2006]

Exactly...... California can disapprove a Caribbean Medical school based on their rules and regulations (MCAT, etc) but, then approve other medical schools that don’t follow their rules and regulations for admission, don’t have the same medical curriculum, and they don’t even know how the schools work. Most of Cuban medical schools are approved by California and they don’t meet their requirements because they don’t have the same medical curriculum of LCME US medical schools. They are very good medical schools established for more than 100 years and with a really good reputation, but I doubt the medical board of California visits Cuba to inspect these schools. Can you exlain why the California medical board is so inconsistent with the accreditation of foreign medical schools.:confused:

last time i checked Cuba was a Caribbean island approved in California but without meeting the """" LCME standars"""""
:rolleyes:


because if you read the bylaws of the medical board they state that any school with a divided curricula (basic science in one place, clinicals in another) or a school that is not a true domicile school ( a school intended for training of local doctors) needs to be evaluated.

this means that any school that caters to US citizens needs to be evaluated. that is a great policy to have because there are many schools that start out with such lack of resources, no standards for acceptance/profs etc without any sort of oversight. there are more than 30 of these barnyeard schools in the caribbean alone and more english porgrams cropping up in europe that may or may not have the resources to stay around..in the last 4 years there have been at least 4 schools that have closed down and various others on the brink and many that have been around almost a decade without a single licensable grad.

the service that cali provides making the list is invaluable in protecting students from fly by night operations. this has nothing really to do with quality of education or what doctor you wioll become because thoise are taken care of by licensing exams and residency...this to me is all about insuring that a school has adequate resources to stay around.

it takes much more financial comittment to do the things needed to be a cali approved school and shows students that these schools are serious while just setting up a school and buying a charter can be done with less than 500k, you can get that back and make a nice profit before any of your students even get to licensure time then close if need be and reopen as another entity...

the true dmicile schools have been there a long time, they can survive without american students, and are there to train their own doctors. none of the US bodies should have any say on what they require to meet US standards they aren't training US doctors while our schools wouldn't remain open for a day without american students so it is perfectly fair to require those schools training US doctors to practice Us medicine and doing clinicals in the US to meet certain guidelines.

have any of you seen the cali requirements? they are minimal and i would hope that any medical school would be able to meet them. things like a library, an integrated curriculum, a way to track students, adequate campus, qualified professors.... all of them are basic and nothing that any properly funded school wouldn;t be able to meet.

[IMG2006]

because if you read the bylaws of the medical board they state that any school with a divided curricula (basic science in one place, clinicals in another) or a school that is not a true domicile school ( a school intended for training of local doctors) needs to be evaluated.


So if I go to school in Peru... in a school for Peruvians, by Peruvians and of the Peruvians... and I learn the very latest in 5000 year old medicine... I mean everything from making Monkey darts out of mule urine and how to coax evil spirits out of the mentally ill with powerful halucinogens... then... California doesn't need to evaluate that? I've got it.

I can see where the two years of US clinical training is cause for alarm. I mean Jesus... we wouldn't want that... I'd much rather be treated by someone who spent his or her clinical years in a country where you can't drink the water.

If you are from Peru, and this offends you... then please substitute a 3rd world country of your choice.

[pruritis_ani]

So if I go to school in Peru... in a school for Peruvians, by Peruvians and of the Peruvians... and I learn the very latest in 5000 year old medicine... I mean everything from making Monkey darts out of mule urine and how to coax evil spirits out of the mentally ill with powerful halucinogens... then... California doesn't need to evaluate that? I've got it.

I can see where the two years of US clinical training is cause for alarm. I mean Jesus... we wouldn't want that... I'd much rather be treated by someone who spent his or her clinical years in a country where you can't drink the water.

If you are from Peru, and this offends you... then please substitute a 3rd world country of your choice.

First of all, if this is how you think 3rd world countries educate doctors, I think you would be in for a surprise. Many of them have crappy facilities, but do the best they can. A key ingredient to the recognition/success is the fact that the doctors they train STAY HOME. That is a powerful incentive to provide a good education. That beins said, even third world countries have some strong technology and education. The field of medicine does tend to attract resources everywhere. People need good healthcare.

Another point...merely being on the approved list means very little other than the fact that you can apply to CA. If the local witch doctor slides through the USMLE, gets an ECFMG certificate, and then comes in front of the board in full regalia, swinging some burning sage and offering to clear the room of evil spirits with a chant or two....well, let's just say the board member's are not likely to sit there, scratch their heads and say "well, he DID go to an approved school, so I guess we gotta let him in".

[estudiante]

Sadly true but necessary were the political action groups composed of parents of US citizens studying medicine abroad that were instrumental in preventing/reversing such seemingly wonton board policies.

PLASMA parents league of american students of medicine abroad was one such entity active during the late 70's 80's. Nowadays with the internet, such an organization is much simpler to organize and maintain. You students should devote your time to studying and let your family do the political gunslinging.

A handful of affluent students hiring attorneys is not as effective as the above well oiled machine.

An American attorney by the name of Bernard Ferguson, was instrumental in winning cases against organized medicine trying to shut the doors on aspiration and dreams of those who had studied so dilligently. Mr Fergusons own children fell victim to this as they were IMG's.

If current IM students have family members practicing law why not get them involved. Organized Email and telephone call campaigns to politicians were very effective.

BTW; Mr Ferguson went on to be counsel for St George Grenada.

[IMG2006]

If the local witch doctor slides through the USMLE, gets an ECFMG certificate, and then comes in front of the board in full regalia, swinging some burning sage and offering to clear the room of evil spirits with a chant or two....well, let's just say the board member's are not likely to sit there, scratch their heads and say "well, he DID go to an approved school, so I guess we gotta let him in".


So wait a minute... NOW you're for making the decision based on the merit of the candidate? I thought that's what I was arguing for.

Let's go on that theory for a while though.... why then should Dr. Wallawallabingbang enjoy the opportunity to argue his case before the board and I should not? Was it the US clinical exposure?


BTW: I am fully recognized by the Caymanian Govt... so.... if I wanted to practice there, then that wouldn't be a problem. A very large portion of the school is owned by Caymanians. They inspect the school and it's clinical sites yearly with a comprehensive review. That's how medical school is done in the CI. So... again, I'm not following you with this.

[pruritis_ani]

So wait a minute... NOW you're for making the decision based on the merit of the candidate? I thought that's what I was arguing for.

Let's go on that theory for a while though.... why then should Dr. Wallawallabingbang enjoy the opportunity to argue his case before the board and I should not? Was it the US clinical exposure?


BTW: I am fully recognized by the Caymanian Govt... so.... if I wanted to practice there, then that wouldn't be a problem. A very large portion of the school is owned by Caymanians. They inspect the school and it's clinical sites yearly with a comprehensive review. That's how medical school is done in the CI. So... again, I'm not following you with this.
I am merely saying that I am for the applicants to be evaluated based on EVERYTHING, including medical school.

Step 1: Medical school. The CA board standard is either domicile school or approved school. This allows you to apply.
Step 2: everything else, from USMLE to ECFMG to GME to board certification, to criminal history, to drug use, to credit score, to whatever.

I think you are missing my point...my point is that I agree with having a minimal school standard. I also think that 99.9% of domicile schools out there do an excellent job, even though they may have less bells and whistles than SMU. And, I think that there are numerous safegaurds in place at domicile schools to assure at least that the students had the opportunity to learn decent, safe, medical practice.

If you don't want to go to a domicile school, and you want to get into CA, fine. Go to a school that has demonstrated a minimal ability to provide sound medical education, based on the LCME model (which these schools are saying they follow anyhow) and that has been evalutated. Then you can apply, and begin to jump through the rest of the hoops.

The fact that Dr. Wallawalllabingbing went to a domicile school satisfied the first step. That is why he gets to apply. Unfortunately, you do not even satisfy that first step, so you don't get to apply. Does that mean you suck? No. Does that mean you are not an excellent doctor? Nope. It only means that you cannot apply because your school did not pass the evaluation. Sucks, but the rules are at CA are not where the problem is. Those are the same for everybody, and there for a reason.....The problem is that your school didn't pass, and you went there anyhow. I am sure you will do well in medicine, but the fact is that many states do have some expectations for doctors all the way down to the medical school level. If a school cannot adequately demonstrate that they fulfull the states requirement, again, the trouble is with the school, not the state.

[solideliquid]

I am merely saying that I am for the applicants to be evaluated based on EVERYTHING, including medical school.

Step 1: Medical school. The CA board standard is either domicile school or approved school. This allows you to apply.
Step 2: everything else, from USMLE to ECFMG to GME to board certification, to criminal history, to drug use, to credit score, to whatever.

I think you are missing my point...my point is that I agree with having a minimal school standard. I also think that 99.9% of domicile schools out there do an excellent job, even though they may have less bells and whistles than SMU. And, I think that there are numerous safegaurds in place at domicile schools to assure at least that the students had the opportunity to learn decent, safe, medical practice.

If you don't want to go to a domicile school, and you want to get into CA, fine. Go to a school that has demonstrated a minimal ability to provide sound medical education, based on the LCME model (which these schools are saying they follow anyhow) and that has been evalutated. Then you can apply, and begin to jump through the rest of the hoops.

The fact that Dr. Wallawalllabingbing went to a domicile school satisfied the first step. That is why he gets to apply. Unfortunately, you do not even satisfy that first step, so you don't get to apply. Does that mean you suck? No. Does that mean you are not an excellent doctor? Nope. It only means that you cannot apply because your school did not pass the evaluation. Sucks, but the rules are at CA are not where the problem is. Those are the same for everybody, and there for a reason.....The problem is that your school didn't pass, and you went there anyhow. I am sure you will do well in medicine, but the fact is that many states do have some expectations for doctors all the way down to the medical school level. If a school cannot adequately demonstrate that they fulfull the states requirement, again, the trouble is with the school, not the state.

I wonder how many of the domicile schools in China, India, or Iran really give a damn about LCME standards and what CA wants.

You think if IRAN doesn't give a damn about what we think of their nuclear program they are going to conform to the CA medical school model?

Yet if I went to a school in Iran I could work in CA no problems. Is that not strange to you?

[pruritis_ani]

I wonder how many of the domicile schools in China, India, or Iran really give a damn about LCME standards and what CA wants.

The fact is they don't care about LCME. And they are not expected to. The LCME model has never been demonstrated (to my knowledge at least) to be the best model of medical education, nor has it been deemed the model the world must follow. But, when a government is overseeing the operation of a medical school that will produce doctors who care for the citizens of that country, you can be fairly certain that the country will do a very good job of maintaining high educational standards.

The contrast is the offshore schools. These all claim to be modeled on LCME, yet nobody is required to verify that they follow it very closely. They are typically located in countries that will not employ any (or very few) of the schools graduates. There is no inherent incentive for quality control. The island wants the dollars, and has no risk to the population if the school is inadequate. The school wants the dollars, and can claim whatever they want, as the government is not really providing anything in terms of oversight and accreditation. In this case, we are basically trusting school administrators, who are motivated by profit, to provide an adequate medical education. Call me cynical, but I just don't trust them to do a good, objective job of this.



Yet if I went to a school in Iran I could work in CA no problems. Is that not strange to you?

This misconception has been stated over and over and over. As a grad of an Iranian school, there is no guarantee that you could work in CA. You can certainly APPLY, but that is only the first step in a very rigorous evaluation.

It is not strange to me at all. The government of CA decided that a school either had to be positioned so that adequate government oversight could be assumed (ie domicile schools), and if there was not oversight of this nature, the state would evaluate the school individually. If your school passed this basic first step, the graduates would be eligible to apply for licensure. It is actually a very simple concept.

[solideliquid]

The fact is they don't care about LCME. And they are not expected to. The LCME model has never been demonstrated (to my knowledge at least) to be the best model of medical education, nor has it been deemed the model the world must follow. But, when a government is overseeing the operation of a medical school that will produce doctors who care for the citizens of that country, you can be fairly certain that the country will do a very good job of maintaining high educational standards.

The contrast is the offshore schools. These all claim to be modeled on LCME, yet nobody is required to verify that they follow it very closely. They are typically located in countries that will not employ any (or very few) of the schools graduates. There is no inherent incentive for quality control. The island wants the dollars, and has no risk to the population if the school is inadequate. The school wants the dollars, and can claim whatever they want, as the government is not really providing anything in terms of oversight and accreditation. In this case, we are basically trusting school administrators, who are motivated by profit, to provide an adequate medical education. Call me cynical, but I just don't trust them to do a good, objective job of this.




This misconception has been stated over and over and over. As a grad of an Iranian school, there is no guarantee that you could work in CA. You can certainly APPLY, but that is only the first step in a very rigorous evaluation.

It is not strange to me at all. The government of CA decided that a school either had to be positioned so that adequate government oversight could be assumed (ie domicile schools), and if there was not oversight of this nature, the state would evaluate the school individually. If your school passed this basic first step, the graduates would be eligible to apply for licensure. It is actually a very simple concept.

Well all I'm asking for the chance to apply to the board. I don't care if they give me a no ten times in a row. As long as they say I may apply I am happy with that.

[pruritis_ani]

Well all I'm asking for the chance to apply to the board. I don't care if they give me a no ten times in a row. As long as they say I may apply I am happy with that.

Sorry to say it, but if you want that chance you have to meet the medical school requirements. You knew them before you went to school, decided for whatever reason that you didn't need to go to a CA approved school, and now you have to live with that decision.

Not trying to be a Richard about it, but it does serve to emphasise how important it is to think many, many steps ahead when deciding which school to attend. It is foolish, IMHO, to compromise anythhing in terms of licensure. There are simply too many schools that don't have any real restrictions out there to justify the limitation.

It is a crappy, painful lesson for the SMU folks. While the school may be great, the island second to none, the faculty and admin may be out of this world...but, if after you spend your 4 years there you have an expanding list of places you cannot work, it just doesn't seem worth it, does it? I personally would rather study medicine in a prison with nothing but a set of Kaplan books and a flashlight for 4 years, if it meant a degree that was good in all states, but that is just me.

The good news is that SMU will very likely gain approval next time. That would get SMU off many a poo poo list, even though CA would likely still be off limits. Even without CA, it is pretty likely that a LOT of states will be happy to have you practice there.

[Miklos]

Well all I'm asking for the chance to apply to the board. I don't care if they give me a no ten times in a row. As long as they say I may apply I am happy with that.

The good news is that SMU will very likely gain approval next time. That would get SMU off many a poo poo list, even though CA would likely still be off limits. Even without CA, it is pretty likely that a LOT of states will be happy to have you practice there.
http://www.medbd.ca.gov/Regs_IMS_ModifiedNotice.pdf

[solideliquid]

http://www.medbd.ca.gov/Regs_IMS_ModifiedNotice.pdf
And this is in regards to the CMB SMU decision/report?

[Miklos]

And this is in regards to the CMB SMU decision/report?

No, it was simply in regard to your desire to be able to apply to the board.

As I read these new rules (I am not an attorney), it appears that grads of formally disapproved schools will not be able to get licensed in California even if their schools are later approved.

This is unlike those who graduated from an unapproved (not formally disapproved) school that was later approved -- they are able to be evaluated on a case by case basis provided they meet the other requirements.

[solideliquid]

Just because the CMB has made the rules, put them down on paper and passed them into law, doesn't mean they are RIGHT.

So if I wanted to write a law that states pruritis my not itch any part of his body and everyone on VMD votes on it, and it PASSES, it means it is right eh?

Sorry to say it, but if you want that chance you have to meet the medical school requirements. You knew them before you went to school, decided for whatever reason that you didn't need to go to a CA approved school, and now you have to live with that decision.

Not trying to be a Richard about it, but it does serve to emphasise how important it is to think many, many steps ahead when deciding which school to attend. It is foolish, IMHO, to compromise anythhing in terms of licensure. There are simply too many schools that don't have any real restrictions out there to justify the limitation.

It is a crappy, painful lesson for the SMU folks. While the school may be great, the island second to none, the faculty and admin may be out of this world...but, if after you spend your 4 years there you have an expanding list of places you cannot work, it just doesn't seem worth it, does it? I personally would rather study medicine in a prison with nothing but a set of Kaplan books and a flashlight for 4 years, if it meant a degree that was good in all states, but that is just me.

The good news is that SMU will very likely gain approval next time. That would get SMU off many a poo poo list, even though CA would likely still be off limits. Even without CA, it is pretty likely that a LOT of states will be happy to have you practice there.

[desai29]

I heard that Tennessee started to refuse to liscence students who didn't do ALL med school in their schools country of origin. Is this true? If it is, harder for any carib student to be liscenced in all 50 states, unless they do all their rotations on the islands.

OMG.. EVEN SGU, AUC, and Ross?

[IMG2006]

Ugh....

Ok we're on the Domicile school arguement again.... I think we can all agree that there are 4 yr int med schools that are great, and many that are beyond hope... Some seem to think that using this as a means for tossing an application is fine, others want a more individual evaluation. hey... I can see both sides of the coin. That's not the issue.


I think what we're here for is to determine if TN is barring 2&2 grads from applying, and that has been answered... Some, yes.


I think we should start a new thread for the 4 yr versus 2&2 debate, and leave this one to people who want to open TN up. That's not my call, I'm not a moderator... but we've got pages and pages here that don't say anything about trying to open up TN.

[estudiante]

A brief guide to Hungarian Medical Schools: A speech everyone considering attending medical school abroad should read (http://hungarianmedicalschools.blogspot.com/2006/09/speech-everyone-considering-attending.html)


Nice and altruistic and many good points, however, if memory serves me right,


#Mr ****** himself may have attended an Italian med school himself but did not graduate.

# when SGU first opened almost everyone and their mother got accepted


# there is nothing wrong with "open enrollment" in any field. sure there is attrition and people realize it is not for them, but THEY GET THE CHANCE to cut the mustard.

# were it not for SGU's US legal team, organized medicine would have done them in a long time ago.

[fammed2002]

Hello,
I talked to a lawyer in Nashville well connected to the board.
The situation in TN can be contested; but the applicant should
be strong and willing to appear before the board and then
have the case go to a judge. Unless someone has a strong
reason to pursue a license like being from TN or having a job
offer then it would require time and money. But there has to
be some people who grew up in TN that want to return home
and that have good academic records.

regards,
fammed2002

[ASIANDOC]

Hello,
I talked to a lawyer in Nashville well connected to the board.
The situation in TN can be contested; but the applicant should
be strong and willing to appear before the board and then
have the case go to a judge. Unless someone has a strong
reason to pursue a license like being from TN or having a job
offer then it would require time and money. But there has to
be some people who grew up in TN that want to return home
and that have good academic records.

regards,
fammed2002

I do not think TN is that complicated to challenge for many reasons:
first,TN has large # of grads from the carribeans and from CA unapproved schools and in the top hospitals in the state so its hard for the board to argue that such physicians educations are substandards,its easy to dispute this by showing half dozens of grads practice history.secondly TN doing all of this after negative campaign from some articles and not based on facts,its easily proven that the info in such publicity and articles were misleading,and thirdly if a BC well trained physician applied they probably will look at it as its happening elsewhere,as I see it things are getting better in favor of all very competent,well qualified,board certified physicians.

my thoughts and personal opinion..........

[estudiante]

If you guys/gals fail to organize effectively (families included) since med students/doctors tend to be paranoid and have the "don't rock the boat" mentality", what you can do is get licensed in a friendly state, save some money, then go to court in the state where you primarily want to be.

The fact that many non approved schools grads are already licensed in a state might be justification to argue that the state has waived its right to argue, lest thay unlicense all those grads they now accuse are subcompetent.

[ASIANDOC]

If you guys/gals fail to organize effectively (families included) since med students/doctors tend to be paranoid and have the "don't rock the boat" mentality", what you can do is get licensed in a friendly state, save some money, then go to court in the state where you primarily want to be.

The fact that many non approved schools grads are already licensed in a state might be justification to argue that the state has waived its right to argue, lest thay unlicense all those grads they now accuse are subcompetent.

EXAMPLE TAKEN FROM INTERNET:[personal details erased for privacy/just an example to make a point].

"Medical Training:


Spartan University
St. Lucia, West Indies
Internship:
T.C. Thompson's Children's Hospital
University of TN, Chattanooga, TN
Residency:
T.C. Thompson's Children's Hospital
University of TN, Chattanooga, TN
Board Certification:


Hospital Privileges:
Vanderbilt University Children's Hospital


Languages:

Memberships:

[My message]:there are dozens of excellent carribean grads practicing in TN's best hospitals for over 20 years and proven to be leaders and in the forefront of medicine,educating TN future physicians and hospitals as well as the citizens of TN very proud and privileges to have such caliber,dozens like above example can be found with simple search,lets just try to look at candidates based on credentials and certifications not color ,country of degree,or origin because in my personal opinion anyone disapproving qualified candidates is saying to all leaders in TN who signs the residency,or hospital privileges as well as national leaders at the American board of medical speciality that your certification is meaningless!!!!!!!!!!!!!!!!!!!!!and that is an insult to all of us in the main stream of American education.ECFMG,FSMB,residency directors,speciality board members [which represent the top authorities to assess med education] are the best possible expert to assess the competencies of any physician.



personal opinion shared[there are bad and good physicians from any school].

[Miklos]

Nice and altruistic and many good points, however, if memory serves me right,


#Mr ****** himself may have attended an Italian med school himself but did not graduate.

Ad hominem argument.

# when SGU first opened almost everyone and their mother got accepted

A lot has changed in more than 25 years. They have set the benchmark.

# there is nothing wrong with "open enrollment" in any field. sure there is attrition and people realize it is not for them, but THEY GET THE CHANCE to cut the mustard.

As long as the school makes this crystal clear, fine. Unless we are talking about French medical schools, where this is understood from the get go, I can't think of any others that adopt this policy.

# were it not for SGU's US legal team, organized medicine would have done them in a long time ago.

You got that right.

[archon218]

there is a number of IMG's working in TN, both as residents and attendings. There may be certain schools not accepted yet by the state, but its not a general rule for all IMG's