I have read on some forums that “some states allow MG’s to do a fellowship (equal in no of years) instead of Residency”. It states that if you go this route you will be state certified but not board certified. Can someone give me more info about this.
Fellowships instead of residency
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Moving to a more appropriate forum
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I believe you have misunderstood.
Fellowship is not a replacement for residency. In the US, it is an advanced period of training, done after completion of a requisite number of years or completion of residency.
Some FMGs who have trained outside the US for residency, have used a US fellowship either to gain skills not available in their home country, or as an entry way to a US based practice.
Fellowships vary in regards to what is considered acceptable residency training. Some may require US residency training or Board Eligibility. Others may find certain foreign training programs acceptable; these are commonly non-ACGME programs and do not lead to US board certification (because of the common requirement to have completed a US based residency program).
States do not certify medical professionals. They license them based on a credentialing process. States will vary in what they require in terms of training to offer someone trained outside of the US a medical license and there are various types of licenses (full and unrestricted, institutional, restricted, training, etc.). Thus holding a medical license and being board certified are different things: the latter requires the former but the reverse is not true.
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Everything that WS has mentioned is true, although I am afraid she may have confused you in the process. Plus, the rules regarding this have just changed.
1. A medical license is required to practice medicine in the US. Each state gives out it's own license, but the rules are mostly the same. You must pass all 3 steps of the USMLE, and you must have some minimum amount of US training (usually 3 years). All physicians get the same license, regardless of what field they practice. You must have a license to practice
2. Board certification is an administrative process that "proves" that you know the minimum amount about your field to practice it competently. Each different field has a different mechanism for proving board certification. In order to be board certified, you need to complete a US residency/fellowship in that field, and then pass whatever tests they require for certification. You do not need to be Board Certified to practice (but see below).
So, IMG's had two choices. The "best" choice is to come to the US for residency and complete it. This then allows the IMG to be licensed and board certified in that field. But there was a "back door". IMG's could complete a base residency (such as IM, or surgery) in another country. Then, they could come to the US and do a fellowship. In that case, the time spent training in the fellowship counts towards the minimum needed for licensure -- so as long as the fellowship is at least 3 years long, the IMG can be licensed. However, most boards require core certification in order to be certified in the subspecialty -- so the IMG can't be Board Certified.
Problems with this plan:
1. It was very difficult to get a fellowship without completing a core US residency. Possible, but very very difficult.
2. Not being board certified can be a big problem. Some insurance companies won't allow you to be listed on their provider lists without it, many hospitals won't allow you to be on staff, etc. But there are exceptions.
3. Perhaps most importantly, the ACGME just changed the rules. Starting in July 2015, fellowships are ONLY allowed to accept residents who completed ACGME, ACGME-I, or the Canadian equivalent training. There might be exceptions, each RRC can decide for themselves. This rule has two major outcomes -- IMG's will no longer be able to use fellowships as a door to a US license, and DO's who complete an AOA residency will not be able to complete an ACGME fellowship.
1. A medical license is required to practice medicine in the US. Each state gives out it's own license, but the rules are mostly the same. You must pass all 3 steps of the USMLE, and you must have some minimum amount of US training (usually 3 years). All physicians get the same license, regardless of what field they practice. You must have a license to practice
2. Board certification is an administrative process that "proves" that you know the minimum amount about your field to practice it competently. Each different field has a different mechanism for proving board certification. In order to be board certified, you need to complete a US residency/fellowship in that field, and then pass whatever tests they require for certification. You do not need to be Board Certified to practice (but see below).
So, IMG's had two choices. The "best" choice is to come to the US for residency and complete it. This then allows the IMG to be licensed and board certified in that field. But there was a "back door". IMG's could complete a base residency (such as IM, or surgery) in another country. Then, they could come to the US and do a fellowship. In that case, the time spent training in the fellowship counts towards the minimum needed for licensure -- so as long as the fellowship is at least 3 years long, the IMG can be licensed. However, most boards require core certification in order to be certified in the subspecialty -- so the IMG can't be Board Certified.
Problems with this plan:
1. It was very difficult to get a fellowship without completing a core US residency. Possible, but very very difficult.
2. Not being board certified can be a big problem. Some insurance companies won't allow you to be listed on their provider lists without it, many hospitals won't allow you to be on staff, etc. But there are exceptions.
3. Perhaps most importantly, the ACGME just changed the rules. Starting in July 2015, fellowships are ONLY allowed to accept residents who completed ACGME, ACGME-I, or the Canadian equivalent training. There might be exceptions, each RRC can decide for themselves. This rule has two major outcomes -- IMG's will no longer be able to use fellowships as a door to a US license, and DO's who complete an AOA residency will not be able to complete an ACGME fellowship.
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Thank you for the clarification aPD. I did not intend to confuse the OP.
Coming from the surgical world, there are a fair number of non-ACGME fellowships (usually less popular specialties) which do not require US residency training and accept applications from foreign trained physicians. Changes to ACGME regulations will not impact those.
Whether that continues as we move forward, remains to be seen, but it has been a common pathway for non-US trained physicians to enter US medicine, typically in academic institutions with an institutional medical license.
Coming from the surgical world, there are a fair number of non-ACGME fellowships (usually less popular specialties) which do not require US residency training and accept applications from foreign trained physicians. Changes to ACGME regulations will not impact those.
Whether that continues as we move forward, remains to be seen, but it has been a common pathway for non-US trained physicians to enter US medicine, typically in academic institutions with an institutional medical license.
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Without making this more complicated than is necessary....
I think, based on what I heard in New Orleans from a Medicine RRC representative, that the Medicine RRC will vote to allow for exceptional candidates to complete Fellowship training. The terms outlined for this are clear and clearly not intended to apply to DOs. My personal view of this is that the ACGME rule changes for fellowship are designed to close the door on DO core residency --> ACGME Fellowship.
The ACGME is leaving the door open for exceptional IMGs who would likely come for some sub-sub specialty training and who do not anticipate practicing in the US. There are a number of places this happens, usually in advanced procedure specialties. These folks can have programs apply for the exception, enroll as Fellows, complete training and return home.
Now, it is true that the medicine RRC has not actually voted to make this true, but I suspect that will happen in the next few months. In any event, everything above is probably more important than I wrote here.
I think, based on what I heard in New Orleans from a Medicine RRC representative, that the Medicine RRC will vote to allow for exceptional candidates to complete Fellowship training. The terms outlined for this are clear and clearly not intended to apply to DOs. My personal view of this is that the ACGME rule changes for fellowship are designed to close the door on DO core residency --> ACGME Fellowship.
The ACGME is leaving the door open for exceptional IMGs who would likely come for some sub-sub specialty training and who do not anticipate practicing in the US. There are a number of places this happens, usually in advanced procedure specialties. These folks can have programs apply for the exception, enroll as Fellows, complete training and return home.
Now, it is true that the medicine RRC has not actually voted to make this true, but I suspect that will happen in the next few months. In any event, everything above is probably more important than I wrote here.
