Opinion on state to state licensing of foreign medical gradu

[MB]

Hi

Ok, so here is what I really dont understand. How can a state determine the quality of health care that the the residents of that state will receive. This becomes especially ambiguous when you rate the quality of a physician simply on the basis of good doctor bad doctor. For example, lets say that one of the top 50 pediatricians in the state of New York with excellent credentials, excellent reviews, and a neighborhood filled with patients who trust this physician with their life decides to relocate to California, but suddenly realizes that he/she would have to surrender his/her profession despite being an excellent physician, just because he/she may have graduated from a foreign medical school not approved by that state. Obviously all foreign medical graduates are held to the same standard as those students who graduate american schools, so it seems almost dangerous and unfair, as far as the hypothetical example of this post is concerned, to deny the citizens of California or for that matter any other state the high quality of health care that foreign graduates can provide. I mean who is to say that the state of California is any more qualified to determine the value of a physician than any other state in the US. You can essentially make the argument that the people in the state of Massachusets must know their doctors best because they have their Harvard university, or maybe the folks from Maryland since they got Johns Hopkins and one of the best hospitals in the country, or maybe we should just simply state that the some of the best medical universities and programs in the world are located on the east coast. Finally just to play devil's advocate, I am an employee at Rockefeller University in NYC, so I know a few of the MD/PhD students from Cornell University. At best simply based on just being around them, I would not trust them with a broken nail. Sure they got their 3.8 GPAs and their 40's on the MCAT, but hopefully they will build their careers in clinical research, and stay away from patients.

[emerson24]

It's called being biased, prejudice, favoritism, or medical politics. Pick.

It doesn't have anything to do with quality. I believe it to be the stigma. However, the "stigma" can't be totally accurate because they do allow some FMG's in to become licensed. Others schools simply probably won't ever get privelages.

Idaho won't let you get licensed if your school was founded after 1975. What's the point to that ? It makes no sense. Really.

On the flip side playing devils advocate, or rather just trying to assume I'm on the board. I have heard that some of these board members are old. They have been around a long time. So they don't really know too much about FMG's. I'm just assuming of course. But based on the "older" generations and the closed mindedness that some or most have, I can see why. Now if you're older, don't take this personally. I am just saying that my father and most people his age High 50's and above aren't as open to the changes of the world that are going on. Predominantly the men, as I...see it.

So this thought of some people being unwaivering makes it difficult. Perhaps they are knowledgeable. Maybe they do look at statistics with boards or appreciate talent when they see it. Maybe we ought to kindly write to them. Perhaps something pro-active can be done.

I myself don't see any real solid reason that states make it difficult for FMG's other than certain issues that I think of. I'm not saying that I'm right at all. I just can't think of many other things. Would be open to other opinions.

I do feel that if some one comes in that is an FMG and has trouble with the language or their training isn't equivalent to the US, then their should be roadblocks. Because as a patient , I would hope that my EVERY word is understood. Also, when I say equivalent, i'm not speaking of superiority arrogantly, but in some sense, yes in the terms of quality. There is also the factor that there are differnt environmental conditions that we have that other countries have and vice-versa. At the same token I shouldn't be allowed into another area of the world that has different problems that I'm not well versed to treat.

Peace.

[Picard]

Medicine, just like any other profession, involves politics. And the US Constitution has no provisions or allowance for the federal government to control the licensing of any profession not directly impacting the operation of a federal agency. So, medical licensure has always been ruled as the right of each individual state... same as lawyers, law enforcement officers... A senior FBI agent with 20 years on the job, and an expert in organized crime cannot transfer into San Francisco PD as a detective because his federal law enforcement credential is not recognized by the state of California... Being an ex-law enforcement officer, I'm entitled to be armed in the state of California... but I become an instant fellon if I cross into New Mexico with my sidearm... my background and training does not cease at the boarder, but my privileges granted to me by one state ceases at the boarder. It's silly politics... but that's our system.

So, what this means for IMG is that we need to be vigilent and educated about our career options and choices... from the choice of medical school, clinical rotations, to where you choose to live eventually. Ask yourself and your potential school/residency/family these questions. And set long-term goals. Saying, "oh, I'm never going to need that... or no, we'll never settle down there... " is fine now... but be prepared to live with these decisions down the line... Information is power... what you don't know/find out now will someday come back to haunt you... Murphy's Laws...

I'm not saying it is fair. A board certified world famous neurosurgeon working at Harvard med who went to XYZ medical school not recognized by California does not cease to be what he is simply because California does not recognize his or her education. Assuming he is a competent physician in his field, California cannot take away his accomplishments. But what California has a right to do, is to regulate it's licensure laws... It's not always fair, but life is not fair... And being IMG's, that's the game we have to play...

So, I guess what I'm saying is, keep your eyes and ears open, educate yourself on all your options, both short and long term.... and make informed decisions.

P

[MB]

I totally agree with you, and at this point in my life I realize that you cannot make sense of politics. The quote at the end of your post is great, but although the sheep can contest the vote it can never be armed well enough to correct the injustice. Thus it is exactly the danger which exists in our so called free society. Consider for example that one of the worst US medical schools for malpractice exists in the state of California, and it is in the top 5 world wide of the worst of all domestic and foreign medical schools whose graduates are licensed to practice medicine in the US. In addition have you read the front page of the August 12th New York Times, one day we talk about the reality of life, the next day we try to figure out what went wrong. So although in theory, to those less informed, regulation of a society such as this one is meant to protect its citizens, in reality most of us are sheep just hoping not to get eaten.

[jim]

just a point of note. if you hold a full medical licens in one state, you are eligible in every other state. doesnt matter where you went to med school, as long as you have a diploma! thats the only thing that keeps places like st mathews and spartan going!

[dt]

just a point of note. if you hold a full medical licens in one state, you are eligible in every other state. doesnt matter where you went to med school, as long as you have a diploma! thats the only thing that keeps places like st mathews and spartan going!

Is this correct? Even practice in California?

[Suzzallo]

just a point of note. if you hold a full medical licens in one state, you are eligible in every other state. doesnt matter where you went to med school, as long as you have a diploma! thats the only thing that keeps places like st mathews and spartan going!

Jim, I don't understand. Can you elaborate your point further? Is it some kind of trick for St Mathew grads to work in CA? What do you mean by full license? Is there a half-license?

[bevo]

I think its called reprecocity

[jim]

the word is reciprocity. and there are full licenses, and limited licenses. limited are for interns. they say you cant just go practice soemplace. some states require you to have a limited license for the entire residency. some just intern year. you need a full license to moonlight(glad my state has only intern year requirements!, that $125 an hour in an ER in bumblef#*k will come in handy!!!;)

[teratos]

No, Jim, that is not the case at all. The only instance you can practice in all 50 states with a license in one state is in the VA system. Otherwise your licensure process is the same as every NEW applicant in the states. I am licensed in Maryland. Had I gone to St. Matthew's I could still NEVER be licensed in CA. There are no back doors, and there is no "reciprocity". Show me one person licensed in california who went to St. Matthews. If you go to [/url] www.docboard.org and look for a person, it will tell you where they went to school. If you can show me someone from a non-approved school practicing in CA, I will send you a crispy new $1 bill. G

[jim]

i think you are misunderstanding me. if you look at licensure, after you have held a license in another state, usually for a set amount of time(usually i seem to recall it was like 5 years), then you can apply to any other state. so my SC license is no good in cali, but in a few years, i can apply for a cali license( a moot point, as a ross grad i can apply anywhere). but yes, i believe that once you have been licensed in one state for a peroid, you can get one anywhere. st mats hasnt beena round enough to get licensed anywhere by this route.

[Picard]

No, there's NO SUCH THING AS 50-STATE RECIPROCITY for ANY professional license. The federal law simply does not provide that. Medical license is the domain of each individual state. There's NO SUCH THING that if you hold a full medical license in one state for ANY AMOUNT OF TIME, the other state has to allow you licensure -- THIS IS SIMPLY URBAN LEGEND. The only state issued "licensure" that is recognized in all 50 states is drivers license and marriage license -- through interstate packs signed by all 50 states. There is simply no such pack for medical licensure.

Case and point -- California has a list of approved foreign medical schools. If your school is not one of these schools, you will NEVER, EVER, be licensed in the state of California for medical licensure -- period, end of story. You can be a world-famous neurosurgeon, board-certified for the past 30 years, holds the title of His Excellency Chief of Neurosurgery at Harvard Med... Now, if you went to a medical school NOT on California's "approved list"... guess what, you will NEVER, EVER, be licenesed to practice medicine in California... ABSOLUTELY NO LOOPHOLES... And NEVER, EVER means NEVER, EVER. California medical board is very clear about this. If you know any graduates of foreign medical schools not approved in CA who are practicing in CA... well... San Quintin State Penitentry will be admitting a new guest for felony "practicing medicine without a license..."

Nation-wide Reciprocity sounds nice, but this simply does not exist for medical licensure. Sure, some states may have reciprocity among them, but there is no nation-wide reciprocity for medical licensure... would be nice, but we simply don't have it.

P

[bevo]

Im not sure I have all the facts straight on this matter, but I'll throw my hat into the ring anyways.

Im not sure if things have changed in the past 30 years.

My father is a graduate of UAG. I do not know if this is regonized by Texas at all. He is licensed in Conneticut(sp?). We have never lived in the state of Conn. He has been practicing Internal Medicine in Texas for the past 30 years because of reprocity. He introduced me to this concept last year when we started looking at foreign medical schools.


I dont know much more than that.

[Picard]

I'm not saying that reciprocity does not exist. I'm sure there are states out there that form reciprocities among themselves for various licensures, including medical licensure.

What I am saying is that, there is NO SUCH THING AS NATIONAL, 50-STATE reciprocity for medical licensure. Meaning, if you get licensed by one state, it DOES NOT mean that you will be automatically eligible for licensure in the other 49 states. In fact, if you are an IMG, the odds are, there may be states you will NEVER be eligible for licensure, ever!! So yes, reciprocities exist, but it's not nation-wide.

P

[jim]

I was not saying that your license in one state was good for another. I was saying that when i was searching for a residency, i checked licensure in about 35 different states(yea, i wasnt very particular about where i went!) EVERY one of those states said if you had a license in another state in the US, usually for a certain time frame, you were eligible for licensure in that other state. is 35 every state in teh US? no. i didnt want to go anywhere near california, so i have no idea about them. I was just pointing out that reciprocity exists in some way, shape and form in most states(most being more then half). the bottom line is this....check state licensure regs before you think about applying for residency. that is what is good about Ross, you have no worrys as they are licensable(new word?) in every state in the US. there are alot of other little things you should check long before you apply to med school too. i saw that some states wont give a license to people who have no undergrad degree. i also saw soem states who would not grant licensure to anyone who had ever attended more then one med school( i.e.transfers). if you have your heart set on one state in particular, you need to knwo their license regs well in advance.

[teratos]

CA will never license anyone from a non-approved state. In states where you CAN get licensed, reciprocity can make it easier, but you still have to apply. In states where you CAN'T get licensed, then it isn't worth the paper it is written on. G

[ashnayd]

The question of whether or not a state accepts fmg's to practice in their state is arises because current doctors in that state, along with thier influence try to prevent the increasing supply of other md's. This is because they want more pateints and perhaps to charge higher prices as well. If there are two doctors in one neighborhood, you have a chioce, but if theres only one then everyone goes to them. The single doctor is very happy and does not want another one taking away his business. I would think this happens with high specialties not regualr physicians which are more abundant. It has little or nothing to do with your skills or knowledge of medicine.

[wizard17]

the test was missed... any non-cali approved school grads practicing in cali??? a simple one person verification would end this whole arguement. any further debate is heresay.

[docdad]

See Page - 4 on ---

http://www.valuemd.com/state-medical-licensing-information/51478-state-medical-boards-lists-approved-disapproved-schools.html

[consumer]

No, Jim, that is not the case at all. The only instance you can practice in all 50 states with a license in one state is in the VA system. Otherwise your licensure process is the same as every NEW applicant in the states. I am licensed in Maryland. Had I gone to St. Matthew's I could still NEVER be licensed in CA. There are no back doors, and there is no "reciprocity". Show me one person licensed in california who went to St. Matthews. If you go to [/url] Administrators in Medicine (http://www.docboard.org) and look for a person, it will tell you where they went to school. If you can show me someone from a non-approved school practicing in CA, I will send you a crispy new $1 bill. G

I believe as a consumer its all politics,have you been to LA ER ,we wait hours and when we get in we do not get the proper attention and time,they always say "the doctors are busy" ,If any good well trained doctor apply we need to give them the opportunity to help us and it seems the states that giving hard times to qualified doctors having most problems in healthcare like just few days ago when I opened yahoo it said an LA hospital ICU reopened its door after closure due to few death related to med care[psudomonas infection related to not cleaning equip.],you hear about huge med error that killed few babies due to heprin overdose in IN,above 2 sytates seems to be mentioned here a lot as touhies!!!!
also for the doc message above,you guys here posted a person that is from what the board lists as disapproved[UTESA school] and licensed,is this diffrent UTESA from that the disapproved one?confusing ,may be that UTESA is in spain,just trying to educate myself.

[if that UTESA same as the one listed,I will send my bank info so teratos can wire that 1 billion he promised [I hope he did not mean 1 dollar!!/judt some sensehumor]

confused consumer .....






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Physician Information




Licensee Name:.............., MDLicense Type:PHYSICIAN AND SURGEONLicense Number:License Status:LICENSE RENEWED & CURRENT (http://javascript<b></b>:windowOpener3(6301,10))Public Record Actions:NONE AVAILABLE ON WEB SITE (To find out what information is and is not available on the Web site, please ... deleted.)Original Issue Date:deleted Expiration Date:DECEMBER 31, deleted Address:County:






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Education







Medical School:TECHNICAL UNIVERSITY OF SANTIAGO SCHOOL OF MEDICINE AKA UTESAYear Graduated:1986

[consumer]

the test was missed... any non-cali approved school grads practicing in cali??? a simple one person verification would end this whole arguement. any further debate is heresay.

I did some research and from previous old messages here That person was discussed and he is from UTESA in the Domanican repubilc and licensed after the disapproval of the school,and the license been renewed,strange that on the board site when you verify this physician tells you his education meets the requirements in CA,so as a consumer why his is qualified and non of his classmates who took exact same course are not?and if he is from disapproved school why keep renewing the license?we the consumers are told that this school grads are not good doctors but just one is ok!!!!that is misleading and deception to us "the consumers".

just a consumer fed up with the healthcare system....

[handy388]

Obviously all foreign medical graduates are held to the same standard as those students who graduate american schools

Simply put, NO, and no, it's not obvious how ALL foreign medical graduates, such as those from Spartan or CMU, are hold to the same standard as JHU or Yale.

Finally just to play devil's advocate, I am an employee at Rockefeller University in NYC, so I know a few of the MD/PhD students from Cornell University. At best simply based on just being around them, I would not trust them with a broken nail. Sure they got their 3.8 GPAs and their 40's on the MCAT, but hopefully they will build their careers in clinical research, and stay away from patients.

Complete with insult to American grads, nice.