Proposal to allow medical profs 5 years to pass tests irks d

[azskeptic]

Rocky Mountain News

http://www.rockymountainnews.com/drm...625257,00.html
Proposal irks doctors
Measure would give foreign physicians at CU a break

By Bill Scanlon, Rocky Mountain News
February 3, 2004

Several Denver doctors and hospital officials are bristling over a bill that would give foreign doctors teaching at the University of Colorado up to five years before they have to pass a basic science test.

They say it's unfair to single out academic teaching hospitals for the waiver and that five years is too long to wait to make sure a doctor knows the science.


But CU officials say a five-year window is essential if they are to lure top teaching doctors from Europe and elsewhere and not lose the recruiting battle to other American medical schools.

They say the doctors they seek are experts in their specialties, but often are in mid-career and may have trouble on a test covering basic science that has changed so much since their medical school days.

The controversy highlights the reliance Colorado places on foreign doctors, not just at CU, but also at rural hospitals.

The CU Health Sciences Center employs five foreign doctors to teach medical students and residents, said spokeswoman Sarah Ellis. In the past five years, some 25 foreign doctors have taught at University Hospital or CU's affiliates: Denver Health Medical Center and Denver's Children's Hospital.

Colorado's strapped rural hospitals, which can't offer the salaries that urban and suburban hospitals can to U.S.-trained doctors, often recruit doctors right out of foreign medical schools.

Colorado's Board of Medical Examiners doesn't keep track of the number of licenses given to foreign doctors, said director Susan Miller.

The bill, which moved rapidly through the Senate and now is being considered by the House, would change from two years to five years the time foreign doctors at academic hospitals can apply to stay without passing the test.

The bill's Senate sponsor, Dan Grossman, a Democrat from Denver, said the change would enable Colorado to compete with other states to recruit top foreign physicians.

He said he limited the bill to academic hospitals because he doesn't want to encourage foreign doctors to come here to practice medicine. Instead, he wants to make sure the CU School of Medicine can recruit foreign doctors to teach specialties that aren't being taught by American doctors.

One of the reasons CU wants the bill involves Children's Hospital's highly recruited head of cardiology, Dr. Francois LaCour-Gayet of France, who will have been here two years in July.

"This is a factor in his case," said Dr. Moritz Ziegler, surgeon-in-chief at Children's Hospital.

Asked if LaCour-Gayet had taken and or passed the test, Children's spokesman Rachel Robinson would say only that "Dr. LaCour-Gayet is an active participant in the licensing test."

LaCour-Gayet deferred to Ziegler for comment on this story.

Ziegler called the hiring of LaCour-Gayet, who earns $750,000 a year, a huge coup for Colorado.

"The recruitment of (Dr. LaCour-Gayet) has changed the face and level and skill of cardiac surgery available to Colorado's children," Ziegler said.

Ziegler said Colorado faces substantial shortages in the areas of radiology, heart surgery, neurosurgery and anesthesiology, among other specialties.

"This bill tries to say that for a variety of good reasons - language barriers, time between basic science training and clinical training - there should be some flexibility to the exam process," Ziegler said. "Every hospital would still have a rigorous credentialing process."

Doctors describe the U.S. Medical Licensing Exam as difficult, especially the first of the three parts that deals with basic science.

Last year, 91 percent of U.S. medical school graduates and 64 percent of those from countries other than the U.S. or Canada passed the basic science test on their first try, according to the National Board of Medical Examiners.

Of those who had to take it a second time, 64 percent of those from U.S. schools passed, while just 36 percent of those from foreign schools passed.

But Dr. Roger Barkin, a pediatric emergency room specialist at Rose Medical Center, said the bill isn't fair. He said many foreign physicians who work in Colorado have had to complete the Board of Medical Examiners' test before they start working.

"Why should we have an inequity between physicians who work in the academic setting and those that work in other settings?" he asked.

CU School of Medicine Dean Richard Krugman said recruiting is a particular problem for academic hospitals because other hospitals are raiding their doctors by offering more money. CU and other academic hospitals can't match the compensation packages offered by private or nonprofit hospitals, he said.

"On the other hand, there are highly qualified people at medical schools in the United Kingdom, Europe and other parts of the world who would love to come to our institution," Krugman said.

Krugman said CU's competition for those doctors isn't hospitals, but medical schools in other states. Six states are considering extending the window up to five years, or already have done so, Krugman said.

Krugman said that after 14 years as dean, he's not sure he could jump right back into pediatrics practice, but is still in top form in his specialty area, child abuse work.

"The basic science I learned 40 years ago has changed. We don't ask physicians in their 40s to retake the basic science exam every five years. We ask that they keep up in their specialties. The hurdle is the basic science exam. Two years is too short a time."

Most of Colorado's hospitals also have shortages in certain disciplines and try to recruit foreign physicians on occasion, said Linda Kanamine, spokeswoman for Health One.

"We get no grace period. Before they can practice, they have to pass state licensure," she said.

[Miklos]

I simply don't believe it. If these guys are such brainiacs, they certainly should be able to pass the USMLEs in two years time (especially when earning $750,000).

This is ridiculous

[october]

Originally Posted by Miklos

I simply don't believe it. If these guys are such brainiacs, they certainly should be able to pass the USMLEs in two years time (especially when earning $750,000).

This is ridiculous

NOt at all and quite to the contrary. These docs from abroad already passed basic science exams many years ago in their country. Give Michael Debakey (one of the worlds premiere heart surgeons) of Texas basic science exams and see if he passes .after doing heart surgery for decades. Not likely.

after you have been in clinical practice for ten years see how well you do on basic sciences.

[Miklos]

Originally Posted by october

NOt at all and quite to the contrary. These docs from abroad already passed basic science exams many years ago in their country. Give Michael Debakey (one of the worlds premiere heart surgeons) of Texas basic science exams and see if he passes .after doing heart surgery for decades. Not likely.

after you have been in clinical practice for ten years see how well you do on basic sciences.

I disagree. The point of the USMLE is one uniform standard for all applicants. If someone is being paid $750,000 per annum, he should have no problem finding the motivation to pass Step 1 within two years (or paying someone to tutor him).

The fact that he is French may have something to do about it. If you know anything about French culture, he is solving his problem in the archetypical French way, by using connections. In his case, by having the law rewritten for him. Oh, Francois, you can't pass the exam? Not a problem, we'll rewrite the law for you, so that you have an additional three years.

I find this disgusting. (Never mind the fact that he is earning money prior to passing his exams!)

Europe (especially Southern and Eastern Europe) is fundamentally corrupt when it comes to accommodating the priviledged status quo. You need a ticket fixed, a fine waived, a permit, paperwork taken care of, etc... call your connection; don't bother going in the front door where you won't get service.

The fact that Coiorado is in the process of accommodating this lazy flunky by rewriting the law in his favor is very bad news for Colorado's citizens. It demonstrates that there are politicians who (a la the French) believe in two systems of law; one for the priviledged and one for everyone else. Were I a Colorado resident, I would be raising hell with my state representatives.

[Japhethi]

I didn't study my entire life for StepOne and I am NOT a heart surgeon. Since most surgeons are academically active to some extent, I see no excuse him not adhering to the rules.

I totally agree. Colorade stoe, being normally very tough on foreign grads is doing a BIG mistake here. Next time they will yield to political correctness and customize their state board reqs who knows what they would do?!?!

This could raise a hell of a presedence. What is next? Affirmative curving?

Shocking.

Sons Of Jafeth

[october]

such laws in colorado can be your great ally as it can be used to bolster antidiscrimination in training and licensure cases (lawsuits)


there you go again, bashing southern europe etc is an immature self centered response. some might argue how students are accepted to us schools ater a monetary donation to the school. it certainly happens. is it not corrupt

you are so brainwashed by usmle etc etc that you actually believe other countries doctors cannot be equally capable.

[neilc]

if there is somebody practicing as a doc, it is not unreasonable to make him sit for his exams in 2 years.

do a 6 week kaplan course, or whatever it takes. all he has to do is pass.

[Miklos]

Originally Posted by october

such laws in colorado can be your great ally as it can be used to bolster antidiscrimination in training and licensure cases (lawsuits)


there you go again, bashing southern europe etc is an immature self centered response. some might argue how students are accepted to us schools ater a monetary donation to the school. it certainly happens. is it not corrupt

you are so brainwashed by usmle etc etc that you actually believe other countries doctors cannot be equally capable.

Wow.

I'd be very grateful if you took a minute to edit and depersonalize your post.

I decry corruption universally. It does not matter to me whether it takes place in the States, in Europe or wherever. I believe it to be a poison to any society anywhere.

I also believe that there are significant problems in the US med school admission process, such as the legacy admissions, which to my meritocratic sensibilities are a form of corruption.

I praise systems that fairly set equal standards for everyone. In some European countries admission to med school is strictly determined based on a point system that is published for everyone to see (I will note the Nordics and Germany as examples).

France, by my reckoning, is an extraordinarily corrupt country. This is not only my opinion, but the opinion of many independent observers. An elite exists that runs the system for its own benefit. I offer the still on-going ELF scandals and the role of Chirac as proof. If you want to debate this further, I think that we should move to the relaxing lounge.

Regarding the capabilities of doctors from other countries, I have always said that each system prepares doctors for local practice for better or worse. Very fine physicians exist all over the world.

My original point remains. Two years and $750,000/year and he can't pass the USMLEs--> this makes him a lazy flunky in my book, even if he is the French pediatric equivalent of DeBakey.

Miklos