Has anyone had licencing issues because their med school rotations weren't green-book?

[Wolf02]

---

Members don't see this ad.

Hi everyone.

This currently is not happening to me, but I was reading another forum and heard someone mention this term that I hadn't heard or thought about in quite some time. "Green book clinical rotations"

I came from a Caribbean medical school and currently I'm currently an intern in a family medicine residency and I remember having to worry all the time as a student about whether my rotations were Green-book or not . I was just wondering if anyone ever ran into problems with this and if so, what does one do in that situation as it seems to be "closing the barn door after the horses got out" scenario. thanks all!

 

[RangerBob]

What is a green book clinical rotation?

 

[Shikima]

What is a green book clinical rotation?

IIRC, Associated with a residency.

 

[gutonc]

What is a green book clinical rotation?

This.

 

[RangerBob]

This.

Thanks--I wasn't aware it was a common term. I thought it was just an informal thing used by a few people, but apparently there are whole threads on it.

OP--I guess I really don't know how to answer your concern as I'm just not familiar with the concept. Sorry--I was hoping to be more helpful.

 

[the argus]

It is an informal term. There apparently is/was a book published by the ACGME that lists all the accredited training programs (residency/fellowship) in the US. It at one time was green, hence "greenbook."

This is an issue that mostly applies only to Caribbean grads. Some state medical boards have the requirement that rotations done within the US by IMGs must be at a hospital that has a residency/fellowship in that specialty/subspecialty. If this is not the case, they would deem your medical education not up to snuff, and deny you a license. The majority of these regulations only apply to 3rd year core rotations, but each state is a little different. And further, it doesn't necessarily have to be at the home institution for the residency program. If you do your OBGYN core at a community hospital that is staffed by residents from the nearby university program, that rotation would also be considered "greenbook."

California, for instance, has the "family medicine umbrella" rule which states that any core done at a hospital that has a family medicine residency program is considered OK because they figure the institution is academic. Texas on the other hand not only requires the specific residency for each specific core, but they also require all 4th year electives to be covered by a residency/fellowship. Most states are somewhere in between.

That said, Texas has the backdoor that any physician that has a license in another state can get a license in Texas. For instance, if you did a radiology elective during 4th year at a hospital without a radiology residency, and you tried to get a license in Texas directly after finishing residency, they would deny you because your radiology rotation during medical school wasn't "greenbook." But if you went to Oklahoma for 2 years after residency and got a license, you could then go to Texas and get a license no problem.

And all this presumes your medical school is on the approved list for the state in question. You could go to all the trouble of making all your rotations "greenbook," but if you went to a rinky-dink Caribbean school that isn't approved for that state you'd be out of luck.

So for the OP, if you did run into this problem, worst case scenario would be you couldn't get a license in the state in question and would have to practice somewhere else.

 

[Wolf02]

Thanks for all that great info! My question now is, is it possible to be able to match in a program in a state where your school isn't approved?

In other words, am I safely out of the woods since I'm in residency?

 

[Ericslv]

Thanks for all that great info! My question now is, is it possible to be able to match in a program in a state where your school isn't approved?

In other words, am I safely out of the woods since I'm in residency?

You may need to be board certified in some states in order for them to make the exception. Once you have a license and certified and worked for a year or two as an attending in another state you should be fine.

 

[gutonc]

Thanks for all that great info! My question now is, is it possible to be able to match in a program in a state where your school isn't approved?

In other words, am I safely out of the woods since I'm in residency?

Why don't you give a concrete example? And then check the Board of Medicine website for that state for a specific answer.

Because the only generic answer is "maybe".

 

[so721]

If this is the case, a lot of DO graduates would have issues with getting licensed since most of our rotations for 3rd year are at community hospitals without residencies.

 

[gutonc]

If this is the case, a lot of DO graduates would have issues with getting licensed since most of our rotations for 3rd year are at community hospitals without residencies.

Different story. Nothing to see here. Move along.

 

[the argus]

If this is the case, a lot of DO graduates would have issues with getting licensed since most of our rotations for 3rd year are at community hospitals without residencies.

This discussion only has to do with IMGs doing rotations within the US, and more specifically except for a few exceptions (i.e. Texas), 3rd year core rotations within the US. Therefore it really only has implications for caribbean students.

But as an aside, I think the above quoted comment would be great for some of the haters out there (i.e. certain cat lovers, etc), who love to trash Caribbean schools for providing a subpar education, to understand. Many DOs train in non-academic environments, yet I don't hear any whining/complaining from the haters about this. Its almost as if they apply a double standard and have opinions ruled by ideologic stupidity rather than a logical assessment of the actual situation. Funny...

 

[galactus]

I believe this question has already been asked (and answered) repeatedly in the IMG forums.
Can this thread be moved?

 

[Wolf02]

Couldn't find anything in there about post residency issues. Did you have better luck than me?

 

[rokshana]

Couldn't find anything in there about post residency issues. Did you have better luck than me?

texas...unless things have changed, texas requires all rotations to have been done where there is a residency program (de facto green book) for an unrestricted license, but not the training license...BUT once you are BC then they don't care.

really you should check out vmd for I/FMG related things...there are plenty of threads on this topic (because it impacts the posters there moreso than on sdn)

 

[Doctor4Life1769]

IMGs hating on DOs, lol.

DOs are US grads. You should have applied and gone DO and you wouldn't have issues.

 

[rokshana]

IMGs hating on DOs, lol.

DOs are US grads. You should have applied and gone DO and you wouldn't have issues.

did, got accepted, said no, thank you very much (and don't have issues, got my residency, fellowship, and working)...

yeah, yeah, yeah...

in the eyes of the NRMP US seniors are allopathic students... US Grads are graduates of allopathic schools...DOs fall under independent applicants...don't believe me?

http://www.nrmp.org/wp-content/uploads/2015/05/Main-Match-Results-and-Data-2015_final.pdf

look at page VI..its in the definitions...

The NRMP classifies applicants for the Main Residency Match® into seven types:

•  Senior of U.S. Allopathic Medical School (U.S. Senior): A fourth-year medical student in a U.S. allopathic school of medicine accredited by the Liaison Committee on Medical Education (LCME) with a graduation date after July 1 in the year before the Match. U.S. seniors are sponsored by their medical schools.
  
  
•  Previous Graduate of U.S. Allopathic Medical School (U.S. Grad): A graduate of a U.S. allopathic school of medicine accredited by the LCME with a graduation date before July 1 in the year before the Match. Previous U.S. graduates are not sponsored by the medical school.
  
  
•  Student/Graduate of Canadian Medical School (Canadian): a student or graduate of a Canadian school of medicine accredited by the Committee on Accreditation of Canadian Medical Schools (CACMS).
  
  
•  Student/Graduate of Osteopathic Medical School (Osteo): a student or graduate of a medical school accredited by the Association of American Colleges of Osteopathic Medicine (AACOM).
  
  
•  Student/Graduate of Fifth Pathway Program (5th Pathway): A graduate of a U.S. Fifth Pathway program
  
  
•  U.S. Citizen Student/Graduate of International Medical School (U.S. IMG): A U.S. citizen who attended an international medical school
  
  
•  Non-U.S. Citizen Student/Graduate of International Medical School (Non-U.S. IMG): A non U.S. citizen who attended an international medical school
  
  In some tables and figures in this report, applicant types are combined into a smaller number of groups.
  •  Foreign-Trained Physicians: U.S. citizen and non-U.S. citizen students and graduates of international medical schools.
    
    
  •  Independent Applicants (IA): All applicant categories excluding U.S. allopathic seniors.
    
    
  •  Others: Includes previous U.S. graduates and Canadian, Osteopathic, and Fifth
    
    Pathway applicants.

 

[Doctor4Life1769]

did, got accepted, said no, thank you very much (and don't have issues, got my residency, fellowship, and working)...

yeah, yeah, yeah...

in the eyes of the NRMP US seniors are allopathic students... US Grads are graduates of allopathic schools...DOs fall under independent applicants...don't believe me?

http://www.nrmp.org/wp-content/uploads/2015/05/Main-Match-Results-and-Data-2015_final.pdf

look at page VI..its in the definitions...

The NRMP classifies applicants for the Main Residency Match® into seven types:

•  Senior of U.S. Allopathic Medical School (U.S. Senior): A fourth-year medical student in a U.S. allopathic school of medicine accredited by the Liaison Committee on Medical Education (LCME) with a graduation date after July 1 in the year before the Match. U.S. seniors are sponsored by their medical schools.
  
  
•  Previous Graduate of U.S. Allopathic Medical School (U.S. Grad): A graduate of a U.S. allopathic school of medicine accredited by the LCME with a graduation date before July 1 in the year before the Match. Previous U.S. graduates are not sponsored by the medical school.
  
  
•  Student/Graduate of Canadian Medical School (Canadian): a student or graduate of a Canadian school of medicine accredited by the Committee on Accreditation of Canadian Medical Schools (CACMS).
  
  
•  Student/Graduate of Osteopathic Medical School (Osteo): a student or graduate of a medical school accredited by the Association of American Colleges of Osteopathic Medicine (AACOM).
  
  
•  Student/Graduate of Fifth Pathway Program (5th Pathway): A graduate of a U.S. Fifth Pathway program
  
  
•  U.S. Citizen Student/Graduate of International Medical School (U.S. IMG): A U.S. citizen who attended an international medical school
  
  
•  Non-U.S. Citizen Student/Graduate of International Medical School (Non-U.S. IMG): A non U.S. citizen who attended an international medical school
  
  In some tables and figures in this report, applicant types are combined into a smaller number of groups.
  •  Foreign-Trained Physicians: U.S. citizen and non-U.S. citizen students and graduates of international medical schools.
    
    
  •  Independent Applicants (IA): All applicant categories excluding U.S. allopathic seniors.
    
    
  •  Others: Includes previous U.S. graduates and Canadian, Osteopathic, and Fifth
    
    Pathway applicants.

Ok, someone's got a massive chip on her shoulder.
You probably went to a well-know Carib school. There's all these new random ones popping up and they aren't recognized as well and run into issues.
My post wasn't even TO YOU. Calm down, I've noticed you are pretty chippy in a lot of your replies and you aren't even funny either.

 

[rokshana]

Ok, someone's got a massive chip on her shoulder.
You probably went to a well-know Carib school. There's all these new random ones popping up and they aren't recognized as well and run into issues.
My post wasn't even TO YOU. Calm down, I've noticed you are pretty chippy in a lot of your replies and you aren't even funny either.

well since you posted right after me...

but no, did clerkship with UNE and Kirksville students, trained with grads from LECOM (Pa and Fla) so no issues in fact IMO we share a lot of the same issues...but not sure why you even felt the need to post...the topic isn't relevant to you as a DO anyway...so what exactly was your point in posting other than to somehow turn this into and DO vs MD thing?

but the definition isn't mine...its the NRMP.

 

[Doctor4Life1769]

well since you posted right after me...

but no, did clerkship with UNE and Kirksville students, trained with grads from LECOM (Pa and Fla) so no issues...not sure why you even felt the need to post...the topics isn't relevant to you as a DO anyway...so what exactly was your point in posting other than to somehow turn this into and DO vs MD thing?

but the definition isn't mine...its the NRMP.

I didn't post my reply because of your post.
I read some folks highlighting on perceived rotations that some DO schools have their students rotate through and cause a hissy fit over that compared to where IMGs rotate. It was a reply to that, and not yours in particular. I was on my phone and my phone sucks so I couldn't do a direct quoted reply.

I know DOs are not considered "US grads" via NRMP definition. However, they are still technically graduates of the US and not overseas, hence there would not be issues with regards to licensure since DOs are given equivalency to US MDs.

 

[rokshana]

I didn't post my reply because of your post.
I read some folks highlighting on perceived rotations that some DO schools have their students rotate through and cause a hissy fit over that compared to where IMGs rotate. It was a reply to that, and not yours in particular. I was on my phone and my phone sucks so I couldn't do a direct quoted reply.

not sure about who had a hissy fit, but it isn't that uncommon, or wasn't uncommon when i was a student (other than Pa which doesn't allow foreign students to rotate in the state as med students) for there to be a mix of students at many hospitals (especially in the NE)...we were the only foreign school students (due to a NJ law that also does not allow foreign students to rotate unless grandfathered), but there were UNE students in peds with me, Kirksville and UMDNJ DO students doing electives, and 5th pathway students from Mt Sinai as well as Mt Sinai MD 3rd years (again in peds) doing rotations...same preceptors, same schedules, same lectures...the Kirksville students said that the had rotations all over the country because they didn't have a home hospital (or maybe it wasn't big enough, it was a while ago, so don't remember exactly)

we all end up working together and unless its on your name tag, its not like you can tell who is what...