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.

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.

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Sometimes in life we have to be honest with ourselves in what it is in our best interest, even though it goes against our "want's" or egos.

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

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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.

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?

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?

I think its called reprecocity

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!!!

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

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