We need national FMG/IMG licensure

[Miklos]

Originally Posted by FLK

I think every state should just use the California criteria and then establish a national database.

if you want to work in any particular state, you pay the usual fees to that state

great idea

I am not certain I understand what you mean. Are you saying that each state should investigate every med school?

[FLK]

CA did that already

[teratos]

If you just go by CA's list then people at all the schools other than the "Big 3" are kinda hosed. Some may qualify for CA approval, but I understand they look at things like campus and library etc. Lots of schools lack that. Who knows. I like the idea of national licensure, though. G

[bts4202]

Even if they wanted to, they could never just take Cali's lists and apply them nationally. Many states would be up in arms and kill the proposal. The only way to do it is to adopt similar standards as Cali and make all school redo an approval process. Plus, considerations have to be made for new schools. Even the ACGME has a sliding scale of rules for newer schools, understanding that it is impossible for a school to begin and immediately be of the same standard as well established schools. There are some things that are obviously paramount and non-negotiable, but some things are given leaway for a limited amount of time.

[neilc]

i really also doubt that any licensing standards will apply nationally. however, i would not be surprised if several states do adopt california's "approved list". i understand that such a deal would likely screw the newer, smaller schools but that is really not going to bother many states. if they have the objective of limiting access to schools that are percieved as inferior for whatever reason, then this list is the way to do it. the argument of "wait, we are new, too small, etc..." will likely just give the a great reason to deny applicants. who wants to be the state that lets in the grads of a new school and sees if they are qualified?

anyhow, national anything is going to be a pipe dream. but, look out for states using the cali list. new mexico does it, texas used some legislation from cali, and i would bet many states add the list, or wording such as "school must not be disapproved in any state". it may not happen everywhere, but i would be very surprised if more states don't adopt it in some way, shape or form. fair? maybe not...but, they certainly have the right to do it, and the new schools will have zero leverage in fighting it.

[teratos]

I really don't think that many states would be that up in arms about it. The rules really apply to Carib (et.al) schools that are aimed at US citizens and a few third world country schools. They could do it. The only thing that makes it unlikely is the physician shortage. G

[Miklos]

Originally Posted by teratos

The only thing that makes it unlikely is the physician shortage. G

I am not convinced that this would stop them, unless the situation became near catastrophic.

You need only look north of the border to the mess the Canadian system is in with regard to the shortage of physicians. A lot of FMGs are driving taxis in Toronto, Montreal and Vancouver as they are kept out of the system by design.

Until recently, one proposal in California was to accredit (for a limited time) Mexican physicians to deal with the underserved Spanish speaking patient population. This proposal died somewhere during the legislative process, after vigorous lobbying by the California Medical Association. At the same time, the California approval process for foreign med schools (in its present form) severely limits USIMGs.

The sad truth of the matter is that the system is designed by AMGs to hinder USIMGs from competing with them.

[DoctorJ]

I agree with Dr. Durst. If a lot of midwestern states "follow" the Calif list, they will be deprived of MDs in the rural parts of the state.

One program I interviewed at in OH has a resident from Antigua. He's USIMG who was an optometrist for over 15 yrs. Is he a good family doc? Certainly. He's willing to practice in the middle of nowhere to server the underserved b/c he's from there.

Will AMGs live there? Most likely not. Will an Pakistani/Indian IMG fit in that part of the country? I doubt it. The locals just arent too receptive to the idea. Discrimination? Sure. But what can you do??

[bts4202]

Originally Posted by teratos

I really don't think that many states would be that up in arms about it.

I think that states would be up in arms because a lot of states look at cali as an extreme example of liberalism gone haywire. Many people, state reps and constituents, might be reluctant to just adopt cali's rules without adding their own additions and/or subtractions. They may also feel a sense of jealousy, that one state gets to make the rules for everyone. That may also spawn rebellion. Senators are people and all people get jealous of others with power. It is possible.

[raj]

If they really want;