FMG in California, MD or what?

[ut_cougar]

Okay, so if I am an FMG from caribbean and my school is not accredited in California does that mean when I am in California I am no longer a physician or doctor? In other words I am nothing to Cali? Also, can I as an MD do research or work in another field other then patient/hopitalal interaction when I go to Cali? I am wondering if I ever feel the urge to go to Cali for a year or something, will I be able tof ind work to support myself as a FMG without CA approval? I mean as long as I am not handling patients would I be able to find a job?

[Miklos]

Okay, so if I am an FMG from caribbean and my school is not accredited in California does that mean when I am in California I am no longer a physician or doctor? In other words I am nothing to Cali? Also, can I as an MD do research or work in another field other then patient/hopitalal interaction when I go to Cali? I am wondering if I ever feel the urge to go to Cali for a year or something, will I be able tof ind work to support myself as a FMG without CA approval? I mean as long as I am not handling patients would I be able to find a job?

Without a license, you cannot practice medicine anywhere. In addition to that, California does not allow you to use the title 'doctor' or make people think that you are a physician. So, your degree from an unapproved school would be, in all likelyhood worthless.

In theory, you could do non-clinical research (good luck getting someone to hire you), but you couldn't get near a patient with a 10 foot pole or call yourself a physician.

[microphage]

So it'd be like Dr. Jekyll/Mr Hyde...

[Doc]

Without a license, you cannot practice medicine anywhere. In addition to that, California does not allow you to use the title 'doctor' or make people think that you are a physician. So, your degree from an unapproved school would be, in all likelyhood worthless.

In theory, you could do non-clinical research (good luck getting someone to hire you), but you couldn't get near a patient with a 10 foot pole or call yourself a physician.

You really should look into this further as I believe you might be mistaken. This misconception is taken from the cases of Dentists (DDS) obtaining online M.D. degrees from California-unapproved medical schools, then using the title of M.D. in their practice. It was deemed that this was not permitted as per California Law.

However, the Law that is being referenced is the Law which states that you cannot practice Medicine in California without a Medical License from the State Medical Board of California. By placing an M.D. behind their names in their practice, they were misleading patients to believe that they were licensed to practice medicine in California.

Somehow, some users on ValueMD have misinterpretted this to mean that it is illegal to call yourself "Doctor" in California if you do not carry a current Medical License from that state. In fact, I've seen it posted that it is illegal to do this in other States and even other countries as well. This is simply not true. It is only true if you are using that title to practice medicine in that state because you would be practicing medicine without a license.....not because you called yourself "Doctor" without a license.

Think of it this way, the California Medical Board grants you permission to practice medicine.....not to call yourself "Doctor". If it were the latter, then other Doctorates would be required to get these licenses as well (i.e. PhD). But if a PhD. were to practice medicine in California without a license, that would be a different story.

The simplest of examples would be the large number of visiting professors at the California Medical Schools. Professors do not need to have medical licenses to teach (assuming there is no patient contact). Therefore, many retain their titles even though they might not have a license to practice medicine in California. This is perfectly legal.

Want a more complex example? What about the Washington licensed physician who is travelling under his proper title of "Dr." and has a connection in California. Do you think there will be cops waiting for him at the terminal? Nope. Again, perfectly legal since he was not practicing medicine without a license.

Sorry to pick on your particular post, but I've seen this misconception posted quite a few times and thought I'd make the correction. However, I encourage you to do the research about it and verify through proper sources such as the State Medical Board of California. Please let us know if you find anything to the contrary.

[Scott1981]

ive got a scenario that i have not seen played out on VMD.

the doctor is licensed in another state and went to a non approved cali school. now his pt travels to cali for a vacation and calls the office for you to call in a prescription to the los angeles pharmacy near his hotel.

what happens?

[jpryor]

ive got a scenario that i have not seen played out on VMD.

the doctor is licensed in another state and went to a non approved cali school. now his pt travels to cali for a vacation and calls the office for you to call in a prescription to the los angeles pharmacy near his hotel.

what happens?

George just answered this on a different thread.

You can call in a prescription for any medication anywhere (unless it is controlled, of course...you can't call them in period). You can do this for any patient you see in your practice. You cannot, in theory, see someone in a state in which you are not licensed and treat them there, because that is practicing medicine. Already established patients on vacation etc. are utilizing an already established relationship with their MD. G

[ut_cougar]

I think Docs point hit what I was wondering. When you are an MD, your always going to be an MD. It is the same as anyone who has a bachelors, they will always have their bachelors...MD is just a degree...but when in CA you can not practice medicine as a physician...what I want to know is if I ever travel to Cali for a year stint and decided "hey I am going to make some extra money" then I could find a job under my medical degree...some sort of research position or teaching position, working for a TV show or pretty much anything. I mean I can put MD on my resume which is all that matters...I just can't see patients.

[Miklos]

You really should look into this further as I believe you might be mistaken. This misconception is taken from the cases of Dentists (DDS) obtaining online M.D. degrees from California-unapproved medical schools, then using the title of M.D. in their practice. It was deemed that this was not permitted as per California Law.

However, the Law that is being referenced is the Law which states that you cannot practice Medicine in California without a Medical License from the State Medical Board of California. By placing an M.D. behind their names in their practice, they were misleading patients to believe that they were licensed to practice medicine in California.

Somehow, some users on ValueMD have misinterpretted this to mean that it is illegal to call yourself "Doctor" in California if you do not carry a current Medical License from that state. In fact, I've seen it posted that it is illegal to do this in other States and even other countries as well. This is simply not true. It is only true if you are using that title to practice medicine in that state because you would be practicing medicine without a license.....not because you called yourself "Doctor" without a license.

Think of it this way, the California Medical Board grants you permission to practice medicine.....not to call yourself "Doctor". If it were the latter, then other Doctorates would be required to get these licenses as well (i.e. PhD). But if a PhD. were to practice medicine in California without a license, that would be a different story.
I looked it up once. I'll look it up again and post it here.

The simplest of examples would be the large number of visiting professors at the California Medical Schools. Professors do not need to have medical licenses to teach (assuming there is no patient contact). Therefore, many retain their titles even though they might not have a license to practice medicine in California. This is perfectly legal.
Actually, getting appointed to a medical faculty as a visiting professor with an MD can be a route to a licensure, called a special faculty license. See, for instance, http://www.deans.medsch.ucla.edu/visa/specialp.html

There was also an article about a British professsor at one of the Southern California medical schools with one of the special faculty licenses who was trying to build a practice outside the medical school. The medical board said that they did not view his practices as legal, as the special faculty license limited his work to within the medical school and that he could not charge for his services. I'll also try to find that article. Update: Here's the link (http://www.valuemd.com/state-medical-licensing-information/30368-california-board-seeking-more-clout-over-guest-doctors.html).

Want a more complex example? What about the Washington licensed physician who is travelling under his proper title of "Dr." and has a connection in California. Do you think there will be cops waiting for him at the terminal? Nope. Again, perfectly legal since he was not practicing medicine without a license.
No, what I meant to say is that without a license, one cannot make others believe one is a physician.

Sorry to pick on your particular post, but I've seen this misconception posted quite a few times and thought I'd make the correction. However, I encourage you to do the research about it and verify through proper sources such as the State Medical Board of California. Please let us know if you find anything to the contrary.
I will, probably later on today.

[Miklos]

Without a license, you cannot practice medicine anywhere. In addition to that, California does not allow you to use the title 'doctor' or make people think that you are a physician. So, your degree from an unapproved school would be, in all likelyhood worthless.

In theory, you could do non-clinical research (good luck getting someone to hire you), but you couldn't get near a patient with a 10 foot pole or call yourself a physician.

Somehow, some users on ValueMD have misinterpretted this to mean that it is illegal to call yourself "Doctor" in California if you do not carry a current Medical License from that state.

[SNIP]

Sorry to pick on your particular post, but I've seen this misconception posted quite a few times and thought I'd make the correction. However, I encourage you to do the research about it and verify through proper sources such as the State Medical Board of California. Please let us know if you find anything to the contrary.

Please see below.


2054. (a) Any person who uses in any sign, business card, or
letterhead, or, in an advertisement, the words "doctor" or
"physician," the letters or prefix "Dr.," the initials "M.D.," or any
other terms or letters indicating or implying that he or she is a
physician and surgeon, physician, surgeon, or practitioner under the
terms of this or any other law, or that he or she is entitled to
practice hereunder, or who represents or holds himself or herself out
as a physician and surgeon, physician, surgeon, or practitioner
under the terms of this or any other law, without having at the time
of so doing a valid, unrevoked, and unsuspended certificate as a
physician and surgeon under this chapter, is guilty of a misdemeanor.

(b) A holder of a valid, unrevoked, and unsuspended certificate to
practice podiatric medicine may use the phrases "doctor of podiatric
medicine," "doctor of podiatry," and "podiatric doctor," or the
initials "D.P.M.," and shall not be in violation of subdivision (a).



2055. Notwithstanding any other provision of law, a person issued a
physician's and surgeon's certificate by the Medical Board of
California pursuant to the provisions of this chapter shall be
entitled to use of the initials "M.D."

[jpryor]

Awww, Miklos...you're normally better than this...I'm surprised you didn't pick up on the distinction... Note that in section 2055 the code distinctly states "issued by...Medical Board of California" while in section 2054 (a) that it states "a valid, unrevoked, unsuspended certificate as a physician...". Therefore, as long as non-California licensed physician is not engaged in rendering treatment it is not illegal to use the title MD.

[pruritis_ani]

Awww, Miklos...you're normally better than this...I'm surprised you didn't pick up on the distinction... Note that in section 2055 the code distinctly states "issued by...Medical Board of California" while in section 2054 (a) that it states "a valid, unrevoked, unsuspended certificate as a physician...". Therefore, as long as non-California licensed physician is not engaged in rendering treatment it is not illegal to use the title MD.
Doesnt't the section 2054 say the "certificate must be "valid, unrevoked, and unsuspended certificate as a
physician and surgeon under this chapter, is guilty of a misdemeanor."? Isn't the "under this chaper" wording meaning that it must be issued by CA?

[jpryor]

No. If you read California codes, as with most states, when it is specific to the state it states it clearly, as in 2055.

[Miklos]

Doesnt't the section 2054 say the "certificate must be "valid, unrevoked, and unsuspended certificate as a
physician and surgeon under this chapter, is guilty of a misdemeanor."? Isn't the "under this chaper" wording meaning that it must be issued by CA?

Precisely. Thanks for saving me the time to point it out.

[Miklos]

No. If you read California codes, as with most states, when it is specific to the state it states it clearly, as in 2055.
You are grasping at straws. The chapter clearly refers to California statue, not some other state's.

http://www.leginfo.ca.gov/statute.html

California Statutes are the Chaptered Bills. A bill is "chaptered" by the Secretary of State after it has passed through both houses of the Legislature and has been signed by the Governor or becomes law without the Governor's signature. Statutes are available starting from 1993.

[pruritis_ani]

No. If you read California codes, as with most states, when it is specific to the state it states it clearly, as in 2055.
Well, I am not a lawyer, but the phrase "under this chapter" seems pretty clear to me. I would certainly interpret that as under the CA chapter, which means the CA chapter needs to issue that licesnse.

If I am misunderstanding the wording, please let me know how.

[Miklos]

jpryor:

Here's the reference.


2000. This chapter shall be known and may be cited as the Medical
Practice Act. Whenever a reference is made to the Medical Practice
Act by the provisions of any statute, it is to be construed as
referring to the provisions of this chapter.

[jpryor]

Well, I think you guys are trying to make much ado about nothing. To have it your way, California would have law enforcement officials arresting every physician who stepped off a plane coming to Disneyland. Pity the retired physician who comes to San Diego for the great golf year round. And woe be the physician author who moved from Michigan to enjoy Monterey bay.

To reverse Teratos' posting from yesterday...a physician vacationing in California can phone in a prescription for his patient back in Nebraska.

[Miklos]

Well, I think you guys are trying to make much ado about nothing. To have it your way, California would have law enforcement officials arresting every physician who stepped off a plane coming to Disneyland. Pity the retired physician who comes to San Diego for the great golf year round. And woe be the physician author who moved from Michigan to enjoy Monterey bay.
It is not 'my' way. It is the law. My original reply was to the OP's question. I think that my reply fairly represented the law.

As far as enforcement goes, that is a different matter.

Regarding the Disneyland or San Diego physican tourists go, so long as they don't go treating Californians, I'm pretty sure that they won't be facing the law.

As far as the physician author goes, read the article regarding the visiting professor (http://www.valuemd.com/state-medical-licensing-information/30368-california-board-seeking-more-clout-over-guest-doctors.html).

Perhaps you can take it up with the Med Board?

To reverse Teratos' posting from yesterday...a physician vacationing in California can phone in a prescription for his patient back in Nebraska.
This has nothing to do with the OP's question. This physician wouldn't actually be practicing in California.

[jpryor]

It is not 'my' way. It is the law. My original reply was to the OP's question. I think that my reply fairly represented the law.

I wasn't aware we were debating the issue as it pertains to the practice of medicine. I agree, the law is very specific on that. I understood we were talking about the use of the title MD without being licensed in California.

[Doc]

Miklos:

I've been following along and I believe that we are talking about 2 different points. I purposely underlined practicing medicine in CA because we all agree that this is against California Law if you are not specifically licensed in that State.

But the argument is that it is not illegal to use the title of "Dr" without a medical license so long as it is not involving the practice of medicine (think about all the PhD's and other academic "doctors" who use the title). However, using the title of "Dr" in the scope of the practice of medicine in the state of California without a CA Medical License IS illegal.

In the example that you showed about the author, the part that was implied to be illegal (debatable) was the part advertising that the person was a "Los Angeles physician" (misrepresentation of credentials since it implies that he holds a CA Medical License), not that the person was using the title of "Dr".

The fact is that the author IS a "Dr", but is NOT a "Los Angeles" doctor. Had he not included "Los Angeles", there probably wouldn't be an issue. Why? Because there is no patient care involved (Actually, in that specific case there was restricted patient care involved, but the point is the same). If it were simply that he used the title of "Dr" when writing or promoting the book, than it would be illegal for anyone who doesn't currently carry a California Medical License to use the title of "Dr." to sell any books in that State, including "Dr." Phil, "Dr." Laura, etc. (assuming they don't have a CA Medical Licenses).

In addition, the visiting Professors that you gave examples about were ALL involved in patient care, and that is why they required special licenses. It was in reference to Section 2113, which includes the limited practice of medicine in CA for foreign docs under specific conditions. If they didn't have patient contact, again, it probably would not have been an issue.

However, perhaps I'm misunderstanding. So please correct me if I'm wrong.

Disclaimer: I am not an attorney and I am not posting this message to represent the views of VMD. These are my own personal views. Please check with an attorney and/or the State Medical Board of California to verify anything stated.

[ASIANDOC]

The key issue is you can't practice medicine without a license,otherwise if attending a meeting,giving lecture via tv[like this spartan grad on ITV hosting med talk all over including CA],wearing name tag in academy meeting identify you as doctor I believe its legal.Also when I was doing locum work overseas and lots of Californians expatriates recieving care from unapproved grads in a foreign land,is this legal?what about many who training CA physicians how to practice [unapproved grads directing residencies like Boston Univ ]and such grads practice in CA education recived by CA unapproved grads?where we draw the line>>>>

[Picard]

I think the point is, California regulates the title "MD" as a licensed title, rather than an academic degree. Sort of like "RN." This means, unless you hold a medical license in California, you cannot legally advertize the title MD in public, because that title is exclusively associated with being a physician in public eyes... meaning, when an average Joe sees "John Smith, MD", he will assumed that John Smith is a physician.

As for being called a "Dr," this is where most misconceptions occur. There are many academic degrees that entitles one to be called Dr. in social/academic settings. Heck, I sometimes call my priest "Dr." because he holds a DD (Doctor of Divinity) degree. Where the law draws the line is when a patient is involved. Case and point -- In my previous practice, we had two PA's with terminal degrees in related fields. One has a DNS (Doctor in Nursing Science), the other a Ph.D. in medical microbiology. Both can be called "Dr." in social settings because of their academic degrees. The one with PhD still teaches microbiology, so he is called "Dr. so-and-so" in his academic settings. However, when they are in clinical settings interacting with patients, they are VERY careful not to refer to themselves as "Dr's," and actively correct others who called them "Dr.'s" in clinical setting... because doing so would violate California law.

As for out-of-state MD's visiting California on vacation -- I'm sure no one is going to hassel them for calling themselves "Dr's" socially. As long as they are not advertizing their services as physicians within the state border. The key differences is advertizing services of a healing art.

As for unlicensed MD's in university research positions -- Yes, I believe technically they cannot put "MD" behind their name if they are doing medically-related clinical research, as lay public may see that as "advertizing" oneself as a physician when they see "MD" behind the researcher's name in association with the univeristy. Will anyone forcibly enforce this if they don't see patients and no patients complain? Most likely not.

P

[Picard]

As for prescribing medications -- this is what a pharmacist told me as far as the actual law goes... A licensed physician can phone in a prescription (subject to some state's regulation on controlled substances) ANYWHERE in the U.S. as long as the physician is physically located within the state he or she holds a license. So yes, a NY physician can phone in a prescription for his patient who is vacationing in California, as long as that physician is physically in the state of New York. Your ability to practice medicine ends at the border of the state that licenses you. So, the reverse is not legal -- a New York licensed physician vacationing in San Diego CANNOT legally call a prescription back into NY for his/her patient. This is because when you are PHYSICALLY in California, California laws apply. The act of picking up a telephone and calling in a prescription IS practicing medicine. So, if you are not licensed in a given state, you cannot legally pick up a phone in that state and call in prescriptions, even back to the state of your license. This was explained to me by a pharmacist and confirmed by a few medical boards.

P

[Doc]

Picard:

Although I agree with much that you've said, I just wanted to elaborate. The "MD" and "Dr" can be used almost interchangeably in my previous post. In other words, the main point is that so long as the "Dr" or "MD" is not involved in any type of practice of medicine, the State Med Board of CA has no say in their use of this. Why? Because the CA Med Board deals with the practice of medicine and not with alleged fraud cases or whatever other legal aspect you might be implying by the use of those terms (unless it is used, whether implied or not, to practice medicine in CA).

If someone puts "MD" behind their name in a non-medically related way, such as "John Smith, MD" registering to stay at the "Hotel California", the CA Med Board has absolutely no jurisdiction over this matter, even if they wanted to pursue it. They have no way to determine whether or not John Smith is or is not an MD. They can only determine whether or not John Smith is licensed to practice medicine in the state of California.

Further, "John Smith, M.D." can even carry around business cards with his full name (including "M.D." or "Dr") on it while visiting California (assuming the info on the cards does not state or imply his practice is in CA), and the CA Med Board still has absolutely no say in this.

I'll go even further and say that he can tattoo "John Smith, M.D." or "Dr. John Smith" to his forehead while visiting CA, and still nothing can be done against him by the CA State Med Board.

However, if "Dr" Smith should engage in anything related to practicing medicine while visiting California, the CA State Med Board would have complete justification and jurisdiction over this illegal activity.

If you want to see a live example, simply visit any national medical conference in California. You will see that the many unlicensed M.D.s (unlicensed in CA because they live and practice elsewhere) proudly display their titles. And even further is that you will notice that the guest lecturers, many from outside of CA (therefore do not have CA med licenses), also clearly display their titles for all to see. They even provide handouts with their titles clearly stated and pass out business cards on occasions.

In fact, the AAFP Scientific Assembly was just held in San Fran, CA a few months ago. Thousands of Physicians from around the world attended (most are NOT licensed in CA). However, not one of them were charged by the CA Med Board because none were in violation of any laws pertaining to the CA Med Board (regarding our discussion).

The problem that I have is when one implies that they are doing so (in the examples with visiting MDs) only because the CA Med Board doesn't want to enforce some law that is being broken. I disagree and will say that no law is being broken (in these examples where no patient care is involved) and that is why the CA Med Board is not doing anything about it.

You said it yourself, "Where the law draws the line is when a patient is involved.". That statement pretty much sums everything up.

Disclaimer: I am not an attorney and I am not posting this message to represent the views of VMD. These are my own personal views. Please check with an attorney and/or the State Medical Board of California to verify anything stated.

[Miklos]

The problem that I have is when one implies that they are doing so (in the examples with visiting MDs) only because the CA Med Board doesn't want to enforce some law that is being broken. I disagree and will say that no law is being broken (in these examples where no patient care is involved) and that is why the CA Med Board is not doing anything about it.

Doc, I think that Picard made most of the points I wanted to make.

Regarding the example of the visiting professors, the med board is quoted as saying that they don't have an appropriate enforcement mechanism for the perceived violation of the law. As to how true this is, is another matter and you may well be right.

Your points regarding visiting physicians are well taken, however as far as the OP is concerned, and as Picard points out above, that would not apply in his case. He is talking about working in a research position, where presumably his only degree would be his MD from an unapproved medical school.

[Doc]

Doc, I think that Picard made most of the points I wanted to make.

As I said, I also agree with many of his points.

Regarding the example of the visiting professors, the med board is quoted as saying that they don't have an appropriate enforcement mechanism for the perceived violation of the law. As to how true this is, is another matter and you may well be right.

I might be wrong, but I think that the quote you’re referring to was in reference to visiting professors who were practicing medicine in CA (or advertising as being licensed to do so) under section 2113. The key words are “practicing medicine”. If they were only teaching without any patient contact, they would not be required to have a CA medical license.

Your points regarding visiting physicians are well taken, however as far as the OP is concerned, and as Picard points out above, that would not apply in his case. He is talking about working in a research position, where presumably his only degree would be his MD from an unapproved medical school.

I should also clarify that I was not addressing the OP scenario in my examples. However, in his case, it would depend what type of research is being done. If it is something that requires a licensed physician, such as clinical trials with patient contact, then it would not be permitted. However, if it is a research position without any type of patient contact or practice of medicine, the CA Medical Board doesn’t have a say. In fact, many of the research positions are filled by non-M.D.s, so why would it even matter if the M.D. is recognized by the CA Medical Board, or even if the M.D. is licensed anywhere if it’s not required to have a current medical license for the position?

I’ll give a pretty far-fetched example to illustrate my point. Let’s say my private CA company called “Doc’s Research Co.” wanted to research the average temperature in San Francisco, CA over a 1 year period. So I decided to hire 4 M.D.s (one licensed to practice in CA, another licensed in Ohio but graduated from a CA “unapproved medical school”, another licensed in Ohio but graduated from an CA "approved medical school", another licensed in India but with the proper work/research visa) , and a non-M.D. high school grad……all for the same research position involving stepping outside the CA based research facility daily and noting the temperature. Which one(s) is doing the research illegally according to the CA Medical Board? :confused:

I realize that this is a silly example, but it should illustrate the point that the CA Med Board only oversees certain things which revolve around the scope of the practice of medicine in CA. Outside of this scope, they have very little say.

This is my understanding, but please correct me if I'm wrong.

Disclaimer: I am not an attorney and I am not posting this message to represent the views of VMD. These are my own personal views. Please check with an attorney and/or the State Medical Board of California to verify anything stated.

[Miklos]

I might be wrong, but I think that the quote you’re referring to was in reference to visiting professors who were practicing medicine in CA (or advertising as being licensed to do so) under section 2113. The key words are “practicing medicine”. If they were only teaching without any patient contact, they would not be required to have a CA medical license.

Reading through the code, I believe that there is another section of the law which addresses this (as well as the physician's meeting you mentioned above).

Section 2060. Nothing in this chapter applies to any practitioner from outside this state, when in actual consultation with a licensed practitioner of this state, or when an invited guest of the California Medical Association or the California Podiatry Association, or one of their component county societies, or of an approved medical or podiatric medical school or college for the sole purpose of engaging in professional education through lectures, clinics, or demonstrations, if he or she is, at the time of the consultation, lecture, or demonstration a licensed practitioner in the state or country in which he or she resides. Such practitioner shall not open an office or appoint a place to meet patients or receive calls from patients within the limits of this state.

I should also clarify that I was not addressing the OP scenario in my examples. However, in his case, it would depend what type of research is being done. If it is something that requires a licensed physician, such as clinical trials with patient contact, then it would not be permitted. However, if it is a research position without any type of patient contact or practice of medicine, the CA Medical Board doesn’t have a say. In fact, many of the research positions are filled by non-M.D.s, so why would it even matter if the M.D. is recognized by the CA Medical Board, or even if the M.D. is licensed anywhere if it’s not required to have a current medical license for the position?

I’ll give a pretty far-fetched example to illustrate my point. Let’s say my private CA company called “Doc’s Research Co.” wanted to research the average temperature in San Francisco, CA over a 1 year period. So I decided to hire 4 M.D.s (one licensed to practice in CA, another licensed in Ohio but graduated from a CA “unapproved medical school”, another licensed in Ohio but graduated from an CA "approved medical school", another licensed in India but with the proper work/research visa) , and a non-M.D. high school grad……all for the same research position involving stepping outside the CA based research facility daily and noting the temperature. Which one(s) is doing the research illegally according to the CA Medical Board?

I realize that this is a silly example, but it should illustrate the point that the CA Med Board only oversees certain things which revolve around the scope of the practice of medicine in CA. Outside of this scope, they have very little say.

This is my understanding, but please correct me if I'm wrong.

Disclaimer: I am not an attorney and I am not posting this message to represent the views of VMD. These are my own personal views. Please check with an attorney and/or the State Medical Board of California to verify anything stated.

To answer your scenario: None would be doing the research illegally.

The problem with the physicians that lack a license in California would be that they could not use their M.D. title, as that is reserved for licensed physicians as is outlined by the laws.

[Doc]

To answer your scenario: None would be doing the research illegally.

The problem with the physicians that lack a license in California would be that they could not use their M.D. title, as that is reserved for licensed physicians as is outlined by the laws.

Under which law can a Physician who lacks a CA medical license not use the title of "M.D." if unrelated to any type of practice of medicine?

[teratos]

My AMEX has M.D. after my name. I bet it's still good on Rodeo Drive. ;)

[Miklos]

Under which law can a Physician who lacks a CA medical license not use the title of "M.D." if unrelated to any type of practice of medicine?

That's how I read these sections...

2054. (a) Any person who uses in any sign, business card, or
letterhead, or, in an advertisement, the words "doctor" or
"physician," the letters or prefix "Dr.," the initials "M.D.," or any
other terms or letters indicating or implying that he or she is a
physician and surgeon, physician, surgeon, or practitioner under the
terms of this or any other law, or that he or she is entitled to
practice hereunder, or who represents or holds himself or herself out
as a physician and surgeon, physician, surgeon, or practitioner
under the terms of this or any other law, without having at the time
of so doing a valid, unrevoked, and unsuspended certificate as a
physician and surgeon under this chapter, is guilty of a misdemeanor.

2055. Notwithstanding any other provision of law, a person issued a
physician's and surgeon's certificate by the Medical Board of
California pursuant to the provisions of this chapter shall be
entitled to use of the initials "M.D."

[Picard]

Doc,

I think are spliting hairs in reality. However, if we were to follow the strict "letter of the law," I believe those not licensed in California, and not in a visiting professor capacity, cannot legally use the title "M.D." in public settings except in casual private social environments.

Section 2054(a) actually has two parts. The first part deals with the use of "Dr." and "MD" in advertizement/letter head... etc. One does not need to be engaging in actual practice of medicine to violate this portion, merely imply one to be a physician in association/advertizement of medicine is illegal. This is the portion that Miklo underlined in the above post. This is the section that prohibits our PA's from being called Dr's in clinical settings.

The second part of the section, in bold faced below:
2054. (a) Any person who uses in any sign, business card, or
letterhead, or, in an advertisement, the words "doctor" or
"physician," the letters or prefix "Dr.," the initials "M.D.," or any
other terms or letters indicating or implying that he or she is a
physician and surgeon, physician, surgeon, or practitioner under the
terms of this or any other law, or that he or she is entitled to
practice hereunder, or who represents or holds himself or herself out
as a physician and surgeon, physician, surgeon, or practitioner
under the terms of this or any other law, without having at the time
of so doing a valid, unrevoked, and unsuspended certificate as a
physician and surgeon under this chapter, is guilty of a misdemeanor.
This bold letter portion deals with merely holding one to be a physician/surgeon (again one does NOT need to be engaging illegal practice of medicine or even interact with any patients -- just the mere holding of oneself to be a physician) is illegal. Since the lay public equates MD with physician, it can be inferred that it's illegal for to put MD behind ones name in public without a license. Again, we are not talking about engaging in illegal practice of medicine (which is dealt with in another section), the law deals with public perception of the usage of MD. Using the term "Dr" does not violate this section because there are many other situations where a person can be called Dr. without being a physician... so by addressing someone as "Dr." so-and-so in public IN AND OF ITSELF does not creat the illusion of being a physician... whereas presenting oneself with the title "MD" in public certainly implies one being a physician.

Again, I think we are splitting hairs in reality. California medical board's investigators (who, by the way, have full peace officer authority in California to enforce ANY California laws as long as their primary mission is to enforce medical licensing laws) are not going to hassel Dr. Smith, MD from Cleveland who put "John Smith, MD" on his hotel registration card in San Diego. Would it be in technical violation of Section 2054 -- yes!

One thing you learn in law enforcement is that vast majority of the time, we enforce to the spirit of the law, not to the letter of the law. And we have a very wide degree of discretion in doing so. Think about it, if we enforce to the letter of the law, we would be giving out tickets to every driver who drives even just one mile above the speed limit.

P

[CaliforniaEquality]

we are the people who will make the law!

It is very plain and simple that the ca board is discriminating us by our educational background. We are not foreigners, we are citizens of california. So we should not keep quiet, and let those people to ban us from practicing medicine forever!

We should not just come to this board and complain, we need to get organized, contact our politicians, get them involved!

[ut_cougar]

Woah, you guys lost the point of my Thread. I am already positive that someone without CA licensure can be a "doctor or MD" in Cali...the question is...those graduating from SCHOOLs who are not accredited by California. I guess it is easy to answer...any physician can work in Cali or live there and be called MD as long as they have an MD from their respective school they graduated from, University of timbucktoo school of medicine is still a doctor and a physician as long as he/she can practice medicine somewhere in the world or USA...but that person can not work for a hopital or treat patients, write prescriptions, etc unless their school is accredited by Cali board of education or whomever does the accredation process. I mean I heard those that are ECFMG and WHO and pass usmle's can still work in a VA in California or something like that even if their school is not accredited by California.

[Doc]

You've taken a very small section of the Business and Professional Code dealing with the "physician's and surgeon's certificate." It is specifically referring to those practicing medicine in CA. It defines this as one authorized "to use drugs or devices in or upon human beings and to sever
or penetrate the tissues of human beings and to use any and all other
methods in the treatment of diseases, injuries, deformities, and
other physical and mental conditions."

That quote, among other sections, is included within that part of the code that you are referring to. See here (http://www.leginfo.ca.gov/cgi-bin/waisgate?WAISdocID=34153720414+1+0+0&WAISaction=retrieve)

You can't just take out one specific section and apply it to everyone. Reading it the way you posted, it would be illegal to call yourself "Dr" if you had a PhD, DC, DMV, etc.....which we all know is not the case. If it were the case, literally thousands of professionals would be breaking the law everyday. I know that the CA Law is notorious for unusual references, but I doubt this is the case.

I'm not a lawyer, so I might be reading this wrong, but I'm pretty sure that the law is not written to prevent anyone from calling themselves "doctor" who does not have a current CA medical license. However, if you said that same statement and included "and to practice medicine in CA", I would totally agree.

To the OP, sorry to have hijacked your thread. I usually do not even participate in these discussions. I hope you find the answers you were looking for.

To the others, thanks for the friendly debate and useful info. I look forward to reading your posts and learning more about it, but please excuse me if I don't reply.

[Picard]

You are right in that Section 2054 does NOT prevent people who are not licensed by CMB to be called "Doctors" -- I never said that. Obviously folks who are Ph.D.'s EdD's ScD's... etc are entitled to be called "Doctor," in the proper settings (ie socially, academically, publically... etc)... AS LONG AS it is not associated with the advertizement (using the code's own words) of medical practice (again, you do not need to be engaging medical practice to violate this section, just mere implication/advertizement will do). I never said that folks with other terminal degrees cannot be called doctors -- just not in the context of medicine/advertizing of medical services.

HOWEVER, my point is that the second part of the section 2054 (a) specifically states that one may not imply, or hold oneself to be a physician in California without a CA license. Again, the actual act of illegal practice of medicine is not needed to violate this section. And again there is the visiting professor exception as quoted previously. Now, this second portion means that it is technically illegal to put MD behind your name in California if not licensed in California -- because the title MD equates to "physician" in public eyes. The simple title of "Dr." does NOT in-and-of itself imply being a physician. This is why it's perfectly legal for folks with other terminal degrees to call themselves "Dr's" outside of any hint of medical references in California.

So, to sum up, the first part of Section 2054 deals with using "MD" and "Dr" IN CONNECTION with any advertizement of medical practice. This is the part that makes it illegal for PA's who hold PhD's to be called doctors in medical advertizement/settings. The second part of the section deals with the implication/hint/"hold oneself to be" phsycian when not licensed. This is the portion that makes it PERFECTLY LEGAL for PhD's to be called doctors outside of medical settings (as the title "Dr." does not in-and-of itself implies "physician."), but CONTINUES TO PROHIBIT the use of "MD" if not licensed because the title MD equates to physician in public eye. (Again, visiting professors excepted by another section).

Perhaps I'm not really explaining it all that well. This was explained to me by an attorney in much more elegant and clear way... perhaps I'm just not explaining it properly. California laws are not easy to read and understand. I hated the penal code portions of the police academy when I went through it... was up many sleepless nights studying it.

P

[Picard]

CA EQUITY,

It is very plain and simple that the ca board is discriminating us by our educational background

Hate to tell you this -- educational background is NOT a protected class in discrimination issues. Educational background is PRECISELY what each and every licensing authorities (NOT just medical boards) use to evaluate the fitness of candidates. It's perfectly legal to "discriminate" a candidate based on his/her educational background when it comes to licensing. This is exactly the primary function of every licensing authority. I don't want Joe who graduated from the local "Super Mall-Ninja security academy" to be sworn in as a police officer... and for the same reason, I don't want Joe from the local butcher academy practicing surgery.

You are not only barking up the wrong tree... you are digging a deeper and deeper hole for yourself. Your chance of "winning" and receiving a California license under current legislation (very unlikely to change for the better for IMG's in California) is ZERO. Many have tried, and all of them have failed. And once you lose, you will have a record of 'LICENSURE DENIAL by a US jurisdiction" on your record that you MUST report to every licensing agency you currently hold a license, and disclose that to every licensing agency you apply to in the future -- NOT a smart thing to do.

P

[Picard]

UT cougar,

I mean I heard those that are ECFMG and WHO and pass usmle's can still work in a VA in California or something like that even if their school is not accredited by California

This is a myth. While technically true under federal law, no VA's in California will hire you without a California license. All VA's in California are assoicated with California medical school, and vast majority of VA physician jobs in California require academic appointments in their affiliated medical school. Except in very rare situations, CA schools will not appoint you without California license. Plus, many aspects of VA medical practice tread into the state domain -- ie billing MediCal or other private insurances for those vet's who have dual insurances, writing scripts to be filled outside of VA... etc just to name a few. So, you do need a California license to fully function in a CA VA system. So, your chance of being hired in a CA VA is virtually non-existant without a CA license. Besides, VA pay is very much below private practice pay.

As for using the title MD/Dr... I guess you have not been following the thread very closely. It's technically illegal to use the term MD in public in California if not licensed by CA board, regardless of your academic degree. "MD" is a licensure title, not an academic title under California law.

P

[Doc]

As for using the title MD/Dr... I guess you have not been following the thread very closely. It's technically illegal to use the term MD in public in California if not licensed by CA board, regardless of your academic degree. "MD" is a licensure title, not an academic title under California law.

P

I respectfully disagree. But more importantly is that this is NOT an established fact and still up for debate. This is your interpretation of the Law. The fact that both of us have consulted attorneys who have said contradicting things about the same CA Laws indicates that it is probably alot more complicated than anything us layman (not attorneys) can interpret properly.

For that reason, I'm going to propose that we agree to disagree on this subject unless anyone can present new information. That being the case, maybe it's best if we use phrases like "In my opinion", "The way I see it", etc, when describing this so that we don't give off the impression that either way is fact....at least until we can provide convincing evidence either way. Does that sound fair?

p.s. I'm feeling rebellious, so I'm still including M.D. in my name when I visit CA :twisted:. And I'm changing my will to include the placement of my remains in CA with the headstone including "M.D." :shock: :lol:

[ASIANDOC]

I am not interested in CA but I was contacted by mail by Naval hospital in San Diago few months ago for civilian position ,the recruiter told me we have nothing to do with the CMB ,you need valid license from any state,they have its own everything[hospital,pharmacy,clinics,...etc].
you guys are saying you can't work in federal and army facilities unless you hace CA approval and license and the government saying the opposite,also I read on St James website an alumni list ,an internal med resident in CA,is he in a VA or a typing mistake?

[Miklos]

also I read on St James website an alumni list ,an internal med resident in CA,is he in a VA or a typing mistake?

I'm assuming that you are referring to this listing:

http://www.sjsm.org/alumni.php
V.K. MD
Internal Medicine
Graduated 2004
Current Status
California

I don't see how that St. James grad could have gotten a residency in California. In order for an IMG to start a residency in California, one needs a postgraduate training authorization letter (PTAL (http://www.medbd.ca.gov/Applicant_International.pdf)). A grad from an unapproved school would presumably have his application returned with a note attached that the board cannot review their application, as the medical education is unrecognized.

[Cal454]

I guess you could always apply and work on a California Indian reservation.

[Miklos]

I guess you could always apply and work on a California Indian reservation.
Just browsing through the IHS job vacancies in California, I found this one (http://www.ihs.gov/JobsCareerDevelop/CareerCenter/Vacancy/act_job_view.cfm?kw=&sl=&dy=%2D11711&st=CA&ar=any&sc=any&sort=1&sr=21&jb=15090) (edited out contact info, emphasis mine):

Family Practice Phyisician Chapa-De - Auburn - Health Center
? - California Area
***** ***** ****** Auburn, CA 95603

Vacancy Number:
Tribal Hire
Open Dates: October 14, 2005 - Open Until Filled
Grades: Salary Series: 0602 Salary Range(s):
Contact ***** ******* for details. Positions: 1 Contact: ***** *******
Phone: ******* ****** *******
Fax: ******* ****** ******* Email: **** ****** *******
Notes:
Chapa-De Indian Health Program, Inc. is seeking a Board Certified/Board Eligible Family Practice Physician to provide outpatient care to Native Americans and the general public at our Auburn site. We offer medical, dental, behavioral health, pharmacy, optometry, podiatry, and health education services on site.

This is an excellent opportunity to join a well-established group practice in a beautiful and centrally located foothill community. Auburn is located just 35 miles east of Sacramento and less than two hours from San Francisco, the Napa Valley, and Lake Tahoe.

Benefit package includes competitive salary, retirement plan, malpractice coverage, paid vacation, health and disability insurance, CME allowance, and paid holidays. There is also an opportunity for loan repayment.

California license and board certification in Family Practice is required. For more information, email your CV or send to ***** ******, Clinical Administrator, Chapa-De Indian Health Program, ***** ***** ******* Auburn, CA 95603 or fax to ***** ***** ******* . It is not necessary to complete the Declaration for Federal Employment form.

[Miklos]

Here's another one:

http://www.ihs.gov/JobsCareerDevelop/CareerCenter/Vacancy/act_job_view.cfm?kw=&sl=&dy=%2D11711&st=CA&ar=any&sc=any&sort=1&sr=31&jb=19368

Physician Indian Health Center Santa Clara Valley
Indian Health Council of Santa Clara - California Area
***** ***** **** *****San Jose, CA 95125

Vacancy Number: 070805
Open Dates: July 8, 2005 - Open Until Filled
Grades: Salary Series: 0645 Salary Range(s): Contact ******* ******* for details.
Positions: 1 Contact: ******* ******* Fax: ******* ******* Email: ******* ****** (http://www.ihs.gov/JobsCareerDevelop/CareerCenter/Vacancy/dsp_job_request.cfm?kw=&sl=&dy=%2D11711&st=CA&ar=any&sc=any&sort=1&sr=31&jb=19368)

Notes:
Position Summary: Provides culturally competent primary care in a community health clinic serving American Indians/Alaska Natives and other low-income populations. Assists in the IHC’s chronic disease and health management programs. Provides instruction and training to medical staff as needed.

Background: The Indian Health Center is a nonprofit, community based organization that has been serving the American Indians, their families and other diverse cultural populations for more than twenty years. The Center offers Medicine, Dentistry, Community Health, substance abuse treatment, Counseling, a WIC program, a Medical Nutrition program, health education, outreach, and case management.

Minimum Qualifications:
• Possession of Medical Doctor degree or D.O. degree.
• One year of clinical experience in a clinic environment.
• Possession of CA Medical License in good standing.
• Must be insurable for liability as a General Practitioner.
• Current knowledge and skills in pediatric, adult primary care, and ambulatory OB/GN.
• Ability to maintain good working relationships with staff.
• A strong commitment to care for an under served population.
• Experience in providing care for multi-cultural populations.
• Experience in working with diabetics and geriatric populations.
• Superlative customer service skills.
• Knowledge of and ability to relate to the American Indian community and other minority populations.
• Fluency in English/Spanish a plus.
• Possession of a current California driver’s license and automobile insurance.

[Picard]

Doc,
Yes, I think we will agree to disagree. Until there is a case law, I think we are debating over details that are not really relavant in the reality of enforcement. Like you said, at least two attorneys (your friend and my friend) disagree already. The reality is, no one will hassel out of state doc's visiting California unless he or she is doing something really stupid.

P

[Picard]

I'm assuming that you are referring to this listing:

http://www.sjsm.org/alumni.php
V.K. MD
Internal Medicine
Graduated 2004
Current Status
California

I don't see how that St. James grad could have gotten a residency in California. In order for an IMG to start a residency in California, one needs a postgraduate training authorization letter (PTAL (http://www.medbd.ca.gov/Applicant_International.pdf)). A grad from an unapproved school would presumably have his application returned with a note attached that the board cannot review their application, as the medical education is unrecognized.

This St. James graduate is NOT in a California VA. In fact, he is NOT in any VA anywhere in the country. I just had a collegue who works in the VA look him up on the "VA Phone Book" (on VA intranet). This lists all VA employees, including residents working or rotating through VA's, in the entire country. His name is not listed anywhere.

99% of "VA residencies" in California are based out of the parent medical school, and you apply through the parent university as the parent university's resident. VA is simply one of the sites these residents rotate through. The only VA program listed separately on it's own is the UCLA-West LA VA program (which, as of next year, will be merged with UCLA Cedar Sinai). I interviewed there when I was applying for residency. They ABSOLUTELY require IMG's to have California Letter regardless of federal law. This is because although they are listed separately, their residents are technically UCLA residents, and they rotate through UCLA hospitals/clinics that are COMPETELY outside of the VA system. So this St. James graduate CANNOT be working in this residency program without violating California law. St. James simply cannot have a graduate in residency in California... there simply isn't one he can legally work in.

As for working for the naval hospital in San Diego -- yes, it's a military installation under the control of DoD. Yes, you technically don't need a California license to work there as a civilian employee. I do know several military/navy physicians who work there because that's where I went to graduate school. Civilian positions are competitive due to location (San Diego :cool: ). Every civilian doc they know have California license.

P

[solideliquid]

Picard, I want to salute you for the link at the bottom of your posts. I also wanted to say that I have greatly enjoyed your posts on this matter.

I have only begun reading this forum recently so I will tell you all a bit about myself and where I stand on this issue. I am a recent graduate from St. Matthews, and I am a resident of California as well. I am now in the match (oh, come ON March 13th!) for Psychiatry. As to CA, I have lived in SouthernCA for the last 19 years with my family. When I joined St. Matts they were being looked at by the CMB. Only when I was in the middle of fourth year did the decision come down, St. Matts was rejected. It was a hard day. However I respect the CMBs decision, as I know the problems sited in the report to be true. The only way to "fight" the decision is for my school to adhere to the qualities CA is looking for and put its wrongs right. I do not enjoy reading all the finger pointing and insults, I have even gone as far as to apologize to Mrs. Park for CAEqualitiys' behavior.

I am no longer interested in practicing in CA, there are plenty of good states to practice in :) . I enrolled at SMU knowing they were not CA approved and gambled that they would be in the future. I knew and made my decision, and I accept the consequences. CAEquality, you should to, and stop this pointless hate and regret you keep showing us all.

P.S.>Picard, are you a med student/resident/in practice? What field?

EDIT: One thing I am wondering about, lets take the D.O. school in CA, Western University. Check their site, and you can see the average MCAT score for entering students is a 9.0, now can students from this school get licensed in CA? Why doesn't the CMB make the same argument that they did with the low GPA (2.8-3.0) students St. Matts accepts?

[swimguy23]

Picard, I want to salute you for the link at the bottom of your posts. I also wanted to say that I have greatly enjoyed your posts on this matter.

I have only begun reading this forum recently so I will tell you all a bit about myself and where I stand on this issue. I am a recent graduate from St. Matthews, and I am a resident of California as well. I am now in the match (oh, come ON March 13th!) for Psychiatry. As to CA, I have lived in SouthernCA for the last 19 years with my family. When I joined St. Matts they were being looked at by the CMB. Only when I was in the middle of fourth year did the decision come down, St. Matts was rejected. It was a hard day. However I respect the CMBs decision, as I know the problems sited in the report to be true. The only way to "fight" the decision is for my school to adhere to the qualities CA is looking for and put its wrongs right. I do not enjoy reading all the finger pointing and insults, I have even gone as far as to apologize to Mrs. Park for CAEqualitiys' behavior.

I am no longer interested in practicing in CA, there are plenty of good states to practice in :) . I enrolled at SMU knowing they were not CA approved and gambled that they would be in the future. I knew and made my decision, and I accept the consequences. CAEquality, you should to, and stop this pointless hate and regret you keep showing us all.

P.S.>Picard, are you a med student/resident/in practice? What field?

EDIT: One thing I am wondering about, lets take the D.O. school in CA, Western University. Check their site, and you can see the average MCAT score for entering students is a 9.0, now can students from this school get licensed in CA? Why doesn't the CMB make the same argument that they did with the low GPA (2.8-3.0) students St. Matts accepts?

whenever i have heard 9's for mcat it is always in reference to 9's in the section.....so they probably look at around 27 which is DO usually.....my friend who aced the mcats always says she got 15.....she got 15 in each section

[Picard]

Solide,

I don't necessarily agree with CMB's absolutism stance. I do, however, agree with their ability and state right to regulate medical licensure (or any other licensure for that matter) in the way they see fit. Their stance, while draconian, is based on solid legal ground without discrimination. And in a way, I can see their point about "the end does not justify the means"... This has been the foundation of our jurisprudence.

As for DO's... They are licensed under a separate board -- California board of Osteopathic medicine. So, CMB has no jurisdiction over DO's licensure. The osteopathic board, however, is governed under the same set of codes as the allopathic board. And no, neither board has set a minimum undergraduate (college) GPA or MCAT score for licensure. Instead, they focus on the admission standards of the medical schools they review.

There are plenty of places near So Cal you can practice -- Las Vegas and Pheonix for example. Both are within a few hours drive of So Cal.

As for the link at the bottom -- thank you for noticing. 911 hit us pretty hard. I'm former law enforcement, and we also have very strong family ties in law enforcement in New York.

As for what I do now -- I was in private practice as a hospitalist-intensivist up until recently when I was recruited to join the faculty of a pretty large medical school. I'm now an academic hospitalist/assistant professor of medicine. Sorry, I will not say which University I work for in public forums... too many wackos out there.

P

[solideliquid]

Solide,

And no, neither board has set a minimum undergraduate (college) GPA or MCAT score for licensure. Instead, they focus on the admission standards of the medical schools they review.


P

I know they don't, I only mentioned it since Park (of the CMB) has stated several times she (or he, I don't really know) doesn't want a medical graduate who had a 2.9 GPA to perform cholecystectomys on patients, among other things.