Foreign Medical Doctors - Do they all have to recertify in the U.S.?

[aceplace57]

I've read news articles about Doctors that immigrate to the U.S. that aren't allowed to practice.

The best known case was Haing S. Ngor (Acadamey Award winner Killing Fields). Trained as a surgeon and gynecologist in Cambodia. He was imprisoned in a concentration by the Khmer Rouge. He survived and came to America. He was never allowed to practice medicine.
After the fall of the Khmer Rouge in 1979, Ngor worked as a doctor in a refugee camp in Thailand and left with his niece for the United States on August 30, 1980.[5] Ngor was not able to resume medical practice in the U.S.[7] He never remarried.
http://en.wikipedia.org/wiki/Haing_S._Ngor

Does the U.S. accept any medical doctors from other countries? For example, Canada, England, France, Germany. Would we refuse to accept a Doctors qualification from a country with medical facilities equal to the U.S.? Is there a list of countries that we won't accept their immigrants as doctors?

What about the reverse? Can a U.S. doctor practice medicine in France, Britain, Cambodia, Africa etc. without having his credentials challenged?

[Ferret Herder]

The way I know of is that a foreign-trained doctor will take a version of the testing (http://en.wikipedia.org/wiki/ECFMG) that US-trained doctors take, and then go through a residency in the US. At least, this is what I can see from looking online and what I've encountered in working in the medical field.

Your medical school also has to have been recognized (http://en.wikipedia.org/wiki/International_Medical_Education_Directory) by the country you studied in. I don't know what countries don't have a school on that list.

[aceplace57]

Sounds like Canadian Doctors can work in the U.S. and American Docs can work in Canada.

I know Doctors without Borders sends teams to third world countries to work. My mom did anesthesia cases for an eye doctor in my hometown. He went to South America every year for a couple weeks to operate on patients that needed care. Mom thought about going with him to volunteer but she was always too busy with cases at the hospital.

Medical schools in Canada that award the M.D. are not assessed by ECFMG, because the Liaison Committee on Medical Education historically accredited M.D.-granting institutions in both the U.S. and Canada (today, Canada has its own accrediting body that generally follows U.S. standards). M.D. graduates of American and Canadian institutions are not considered IMGs in either country.

[Hari Seldon]

A high percentage of graduates from McGill med decamp to the US upon graduation. There is a reason. New MDs are essentially required to go to the boonies and many refuse. But med school here is cheap, so...

[aceplace57]

I saw several foreign doctors & nurses the last time I was in the hospital. I had wondered what process they went through to get certified here.

It does seem odd that a Brit or French doctor couldn't work in the U.S. without testing. Heck, their med schools are just as good as ours.

[suranyi]

I know quite a few doctors who went to medical school outside the U.S. but now practice within the country. First, as Hari Seldon said, it's common for McGill med school grads to go to the U.S. to practice. I know several. Beyond that, the medical practice I go to is the Palo Alto Medical Foundation, which is one of the most respected in Northern California, and if you go to their "Find a Doctor" (http://www.pamf.org/providersearch/?sitecfg=41&vs=search) web page, you'll see that many were educated outside the U.S.

[Great Antibob]

I saw several foreign doctors & nurses the last time I was in the hospital. I had wondered what process they went through to get certified here.

Foreign students who went to American schools? Or with foreign credentials?

[irishgirl]

The issue isn't exams, it is residency.

For a US doc to work in the UK, they sit an exam and can apply for any job they feel they have the qualifications to perform.

For a UK doc to work in the US they have to sit exams and enter residency.

Now, that isn't a big deal if you're a 28 year old newly qualified Dr.

That is a HUGE deal if you've been a successful consultant with your own team and 20years experience in medicine.

[Eva Luna]

The issue isn't exams, it is residency.

For a US doc to work in the UK, they sit an exam and can apply for any job they feel they have the qualifications to perform.

For a UK doc to work in the US they have to sit exams and enter residency.

Now, that isn't a big deal if you're a 28 year old newly qualified Dr.

That is a HUGE deal if you've been a successful consultant with your own team and 20years experience in medicine.

And if you haven't touched your basic sciences in 20 years because you've been working in a specialty area, it's going to be wicked difficult to pass the boards.

(My first job was resettling Soviet refugees, and my office had 200+ doctors as clients. By the time I left that job, 2 of them had managed to pass the boards, and only one of those had been accepted into a resdiency.)

[aceplace57]

I'm not sure. Several of my nurses were from the Philippines. One of my consulting doctors was an older guy from India. Sounded like Apu on the Simpsons. ;)

I wasn't worried. I knew they had to meet U.S. requirements to work here. The nurses may have trained here. I didn't ask.
Foreign students who went to American schools? Or with foreign credentials?

[alphaboi867]

...(My first job was resettling Soviet refugees, and my office had 200+ doctors as clients. By the time I left that job, 2 of them had managed to pass the boards, and only one of those had been accepted into a resdiency.)

My mom once worked with a nurse's aid who was a heart surgeon in Cuba before he came over. She works with alot of nurses from the Phillipines too. Some of them used to be doctors.

[Ferret Herder]

My mom once worked with a nurse's aid who was a heart surgeon in Cuba before he came over. She works with alot of nurses from the Phillipines too. Some of them used to be doctors.
Yeah, at my last job, one of the echocardiography technicians had been a doctor back in the Philippines.

[irishgirl]

Which is sad.

Not only are their home nations deprived of doctors, but the US is employing people who quite possibly have the skills and expertise to work as doctors, but who may not be able to demonstrate them in the prescribed way needed to work in the USA, at jobs which do not fully utilise their skills.

Lose-lose for both nations, and I guess only a win for the immigrant doctor if the potential financial gain is worth the decrease in job satisfaction and the loss of family and community support triggered by the move to a new country.

"A better life" has to mean more than just "richer", doesn't it?

[Eva Luna]

My mom once worked with a nurse's aid who was a heart surgeon in Cuba before he came over. She works with alot of nurses from the Phillipines too. Some of them used to be doctors.

Yeah, we used to place a lot of Soviet doctors as hemodialysis techs - no additional exams or licensing required.

[Balthisar]

My wife is a foreign-trained dentist, and back when I investigated what it would take in Michigan, the requirements were some hours of dental legal courses and passing a state exam in English. She decided not to pursue it, though.

It's largely a state matter. Her alma mater produces graduates that are qualified practice immediately in the state of California, for example. That's because the state and the university reached a consensus on a curriculum that would allow such.

[oedipus88b]

indeed its sad to know that foreign medical doctors cannot practice the profession without first passing the three steps Step 1 (basic), Step 2 ( 2 parts clinical and and theory) Step 3 ( theory). Even if you pass these steps you still have to be matched for the residency training. I have known a lot of foreign doctors who have been practicing their respective specialty fields but were unsuccessful to pass especially step 1. The big question is why do they have to take all these three steps? Why cant they just go apply for residency directly at least and just take the last step instead . I would agree on taking the three steps if the foreign medical graduate did not undergo a residency training abroad but if he had finished one, then at least step 3 would be sufficient. If one will go around USA one can find foreign trained doctors working not as doctors. Majority works in allied healthservices i.e. technicians, phlebotomists etc. A great deal also went to nursing, surgical assisting and medical coding. (FYI: residency training abroad depending on the field is from 3 to 5 years after this you take an exam written and oral if successful you become a fellow, then you take a specialty fellowship program 1 to 2 years as a sort of subspecialization and then yountake another exam and once successful you become a subspecialty fellow . An example is you take residency in surgery then you pass the exam, you become a fellow of general surgery then go for a subspecialization and took for instance pediatric surgery then afterwhich you become a pediatric surgeon)

[ToeJam]

Part of it (the Step 1,2,3) is to ensure proper certification and training- as the most common influx of medical graduates are from the Caribbeans. It's cheaper to be trained there, less competitive to get into those locations (vs. a Medical school in the US), can usually finish up in 3 years, and a great location to live/study in. That said, many Americans go there for medical training, finish up and then try to come back to the United States to be placed into Residency. The way to 'Standardize" those students and compare them to the ones who've trained in US locations is to compare their scores on the Step 1,2,3's basically.

It's not so much the influx of doctors who've been training for 20+ years and all, but the system is more for those students who have just finished their training overseas and want to come back to the US to practice. The US medical system wants to ensure their training and qualifications are just as equivalent to those here in the US.

[coffeecat]

It's not so much the influx of doctors who've been training for 20+ years and all, but the system is more for those students who have just finished their training overseas and want to come back to the US to practice. The US medical system wants to ensure their training and qualifications are just as equivalent to those here in the US.They could change the requirement to U.S. exam and residency or X years experience. I'm with irishgirl. What a foolish waste.

[kayaker]

They could change the requirement to U.S. exam and residency or X years experience. I'm with irishgirl. What a foolish waste.

Is there a shortage of MDs in the US?

[AK84]

This came up in another thread and as I said there I am surprised as I know a Doctor who trained in Pakistan (Cardiologist) ad had about 10 years in the field. In 2000 his wife who worked for the UN was posted to NYC and he went with her and got a job as a consultant in a Hospital in the city pretty easily. I asked how long the certification process took and he said it was just interviews and showing his credentials. Basically by the time their house was set up he was good to go.

Maybe being the spouse of a UN worker helped? or maybe their is discretion to permit clearly qualified Docs?

[Nava]

Or maybe you don't need the same credentials to be a consultant as to be "the guy who signs the prescriptions".

[Eva Luna]

Is there a shortage of MDs in the US?

Certain kinds of MDs, yes - primary care, and many kinds in rural and other areas where it's considered less than desireable to live. There's a whole program (http://travel.state.gov/visa/temp/info/info_1288.html#health) under which state health departments can request that foreign doctors who have come to the U.S. to pursue graduate medical training (who would normally be required to return to their home countries for 2 years before being allowed to return to the U.S. on most kinds of temporary visas, or as permanent residents) be exempt form the requirement to return to their home countries in exchange for years of service as medical doctors in shortage areas.

[Eva Luna]

Or maybe you don't need the same credentials to be a consultant as to be "the guy who signs the prescriptions".

Precisely. As long as he's not treating patients, the recertification requirements for M.D.s don't apply.

[Ruken]

Is there a shortage of MDs in the US?There's plenty of demand for what supply we have. More MDs might put some competitive pressure on wages. Whether that would translate to cheaper prices for the consumer is for someone else to answer.

[bump]

They could change the requirement to U.S. exam and residency or X years experience. I'm with irishgirl. What a foolish waste.

I'll be willing to say that not all doctors are created equal; X years of (almost) witch doctoring experience in some third world shithole probably doesn't compare well relative to exam & residency.

I mean, would you really think that a Dr. with 10 years of experience in say... Chad would have ever seen an MRI machine? Or be up on modern treatments and pharmaceuticals?

Personally, I'm glad the various states set the bar high; it may screw some qualified doctors, but it probably culls out and prevents at least as many incompetent and/or inadequately trained foreign doctors from practicing here.

[si_blakely]

I'll be willing to say that not all doctors are created equal; X years of (almost) witch doctoring experience in some third world shithole probably doesn't compare well relative to exam & residency.

I mean, would you really think that a Dr. with 10 years of experience in say... Chad would have ever seen an MRI machine? Or be up on modern treatments and pharmaceuticals?Maybe not, but they have probably seen and treated a bunch of stuff a western doctor has never seen...

A friend of mine was a top pediatric surgeon in NZ. After he retired, he went to Pakistan to re-establish a surgical unit in a mission hospital. One of the things he had to face and treat was established club foot (http://en.wikipedia.org/wiki/Club_foot). It is pretty easy to treat this as in an infant with the right resources and without surgery. When it is a teenager who has had no treatment at all, it involved obtaining an old surgical manual, and sterilizing a hammer and chisel.

I also bet that some doctors from third world nations will spot a reemerging deficiency illness (rickets, or the like) faster than a western doctor.

Si

[Testy]

Foreign doctors do have to recertify in the US and Canada as well. I had an Australian friend that went through this recently in Vancouver. He was Australian and was an excellent oncologist but the Canadian medical organization wanted him to jump through a LOT of hoops before he could practice in Vancouver. OTOH, if he would agree to practice in Yellow Knife or the like, he could start right away. I thought this was messed-up on a lot of levels. If the guy wasn't considered good enough to practice in Vancouver, how did moving to an Arctic wasteland make him suddenly competent?
I'm very much with Blake on the requirement to set a high bar on coming to North America and practicing medicine. I've traveled a good bit and been appalled at some of the things doctors in other countries will try to do. Had a Dutch doc try to push Chinese herbal crap on me. Some of the Pakistani and Sudani docs in Saudi were absolute nightmares. If a doc is practicing in the US, I want to feel confident he knows his stuff and didn't get a medical degree in some third world shit hole because his dad was a big politician or his family had enough money to just flat out buy a degree in wherever he's from.
I figure that if a doc is good enough, he shouldn't have a problem certifying in the US. If he can't, I don't want him working on me and mine.

Regards

Testy

[Really Not All That Bright]

I mean, would you really think that a Dr. with 10 years of experience in say... Chad would have ever seen an MRI machine? Or be up on modern treatments and pharmaceuticals?
Most US doctors will never operate an MRI scanner or even interpret an MRI.

[Enola Straight]

The way I know of is that a foreign-trained doctor will take a version of the testing (http://en.wikipedia.org/wiki/ECFMG) that US-trained doctors take, and then go through a residency in the US. At least, this is what I can see from looking online and what I've encountered in working in the medical field.

Your medical school also has to have been recognized (http://en.wikipedia.org/wiki/International_Medical_Education_Directory) by the country you studied in. I don't know what countries don't have a school on that list.


ECFMG...I used to work there processing applications.

The exam contains two parts: one, is the medical proficiency (of course) and the other is fluency in english.

Not just the proper Queen's english, but the commonly spoken americanized version filled with idioms, colloquialisms, and slang.

"Hey doc...it's like this: I got a poundin' upside the noggin tha feels like somebody sapped me with a sledgehammer...knowhutimean?"

Foreign Medical doctors need to know medicine...AND the Lingo.

[Little Nemo]

There's plenty of demand for what supply we have. More MDs might put some competitive pressure on wages. Whether that would translate to cheaper prices for the consumer is for someone else to answer.I've heard this is a factor. Doctors in the United States control the certification procedures. And why would they set up those certification procedures to make it easy for foreign doctors to get certified and go into competition with them? They have every economic incentive to make certification difficult and keep the profession limited.

[Elendil's Heir]

Are there any U.S. states that have a reputation for being particularly easy for foreign-trained doctors to be admitted to practice?

[blue bird]

I'm a UK med school graduate who moved here to be with my American husband 2 years ago. I qualified as a general practitioner (board certified by the royal college of general practitioners) and worked in the British Army as a medical officer from graduation until I moved to the US. My residencies included peds, IM, derm, obgyn, ER. I've served in Iraq, Germany, South Africa and ran a single handed medical centre in Belize providing aeromedical evacuation to the entire country plus a large amount of routine general practice experience back in the UK. I'm soooo bitter that to work here I have to go back to the basics and study the stucture of an amino acid and the Kreb cycle. Is the physiology of the American body different?!? I must have missed that lecture.

[Elendil's Heir]

...ran a single handed medical centre in Belize providing aeromedical evacuation to the entire country....

Wow. That must have taken a LOT of planes!

[rekkah]

Or maybe you don't need the same credentials to be a consultant as to be "the guy who signs the prescriptions".

In the UK (and I believe in Pakistan, where AK84 is from) a consultant is the job title of fully qualified, senior doctors - I think the equivalent is attending under the US system.