How to rank... potential issues with future license eligibility

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path4me

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Hey folks,

US IMG here from a small low-tier Caribbean school. Thanked my lucky stars to have gotten 5 IVs this season, 2 of which are from programs in my home state of residence. Geography is an important factor, and ideally, I would like to remain in my home state (spouse's job, house-- the whole shebang). Thus, logically, my inclination is to rank these two programs ahead of the others.

My issue is that my state has vague guidelines with regard to license eligibility for IMGs. Upon making repeated phone calls to the state medical board and trying to find answers elsewhere, there still appears to be a lot of gray area in terms of granting licensure to IMGs, and it is primarily granted on a case-by-case basis.

Specifically, the state does not grant licensure to graduates of schools on the California Disapproved Schools. However, nothing is clearly stated about the California Approved Schools list as a prerequisite. Now unfortunately, my medical school is not California approved Thus, it is not on the Approved schools list; however, it is not on the Disapproved Schools list either. What I deduce from this situation is that if I were to hypothetically begin residency in this state, when it came time to apply for licensure, my application would be reviewed on a case-by-case basis, but with great scrutiny.

Upon reviewing the track record of where students from my medical school have ended up, nobody has ever matched in my home state, which is very unsettling, as I have little point of reference. However, the 3 other states where I have interviewed are all states where I am sure students from my school have completed residency and obtained a license, and they're known to be more IMG friendly states in general anyway.

Should I go ahead and rank programs based on geographical preference (as I had initially intended)? If I were to match at one of the two programs in my state, I feel like the process of applying for licensure 3 years down the road will be a rocky and uncertain one, and it is clearly giving me anxiety now, even before the Match. My school administration has been useless in providing guidance (a gross understatement), the state medical board can't give me a clear answer, and program directors of the places I've interviewed are clearly uninformed about this specific scenario (I'm sure this never crossed their minds when they invited me to interview, as I did away rotations at both of these programs, so they are really more like automatic 'courtesy' interviews).

How to rank??

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Hey folks,

US IMG here from a small low-tier Caribbean school. Thanked my lucky stars to have gotten 5 IVs this season, 2 of which are from programs in my home state of residence. Geography is an important factor, and ideally, I would like to remain in my home state (spouse's job, house-- the whole shebang). Thus, logically, my inclination is to rank these two programs ahead of the others.

My issue is that my state has vague guidelines with regard to license eligibility for IMGs. Upon making repeated phone calls to the state medical board and trying to find answers elsewhere, there still appears to be a lot of gray area in terms of granting licensure to IMGs, and it is primarily granted on a case-by-case basis.

Specifically, the state does not grant licensure to graduates of schools on the California Disapproved Schools. However, nothing is clearly stated about the California Approved Schools list as a prerequisite. Now unfortunately, my medical school is not California approved Thus, it is not on the Approved schools list; however, it is not on the Disapproved Schools list either. What I deduce from this situation is that if I were to hypothetically begin residency in this state, when it came time to apply for licensure, my application would be reviewed on a case-by-case basis, but with great scrutiny.

Upon reviewing the track record of where students from my medical school have ended up, nobody has ever matched in my home state, which is very unsettling, as I have little point of reference. However, the 3 other states where I have interviewed are all states where I am sure students from my school have completed residency and obtained a license, and they're known to be more IMG friendly states in general anyway.

Should I go ahead and rank programs based on geographical preference (as I had initially intended)? If I were to match at one of the two programs in my state, I feel like the process of applying for licensure 3 years down the road will be a rocky and uncertain one, and it is clearly giving me anxiety now, even before the Match. My school administration has been useless in providing guidance (a gross understatement), the state medical board can't give me a clear answer, and program directors of the places I've interviewed are clearly uninformed about this specific scenario (I'm sure this never crossed their minds when they invited me to interview, as I did away rotations at both of these programs, so they are really more like automatic 'courtesy' interviews).

How to rank??

Have you contacted the medical board to ask if you are eligible for a training license with your medical school?

If you can, then rank your preference. If your program would require a permanent unrestricted license during training, that could be harder. For most IMG/FMG candidates, that would require 3 years of training to even be eligible. If you are looking at a 3 year residency program, then it doesn't matter.
 
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I have not inquired about a training license, but the general consensus is that the state medical board does not have a clear answer about obtaining a license through my medical school at all, whether it be a training license or a permanent unrestricted one. I suppose it's a good idea to find out about the training license. But even if I'm eligible for it, my fear is that I'm falling through the cracks now and when the time comes to apply for a permanent license, there will be an issue and I will purely be at the mercy of the board members granting approval. I'm looking at 4 year programs, and correct, I wouldn't even be eligible to apply until I complete 3 years of training.
 
Have you contacted the medical board to ask if you are eligible for a training license with your medical school?

If you can, then rank your preference. If your program would require a permanent unrestricted license during training, that could be harder. For most IMG/FMG candidates, that would require 3 years of training to even be eligible. If you are looking at a 3 year residency program, then it doesn't matter.
You bring up an interesting scenario. If I were to match and begin residency at a program with a training license, but I eventually find out that the program requires me to obtain a permanent license later on, and I cannot obtain this due to restrictions via my medical school . . . does this mean I cannot complete the program?
 
If you can't get a clear answer in writing from your state medical board before your rank order list is due, I'd suggest you play it safe and rank those schools where you know you'd be able to get licensed ahead of the others.

Consider the relative downsides -- Your spouse would have to move and find a new job, but that's almost certainly possible. Versus you might not get to practice medicine, which is much harder, if not impossible, to fix.
 
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You bring up an interesting scenario. If I were to match and begin residency at a program with a training license, but I eventually find out that the program requires me to obtain a permanent license later on, and I cannot obtain this due to restrictions via my medical school . . . does this mean I cannot complete the program?
yes, it would...basically being able to be licensed is a requirement for the residency and if you can't get it, then you very well can lose the spot. This happen a few years ago in massachusetts at st vincents in worcester...a couple matched there, they were, I think st matthews graduates and they were not able to get the training license in mass and ended up losing their spots. The program tried really hard and were very supportive, but the Mass board can be a sticky one. While this is very rare, states are usually pretty liberal with training licenses, there are some sticky states.
 
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I think you're overthinking this.

Most states have a training license for residents. Getting a training license is easy-peasy, because only residents in training in the state are eligible. The Board doesn't even review these licenses -- as long as the paperwork is completed, the training license is granted. If your school was on the disapproved list, that might be a real problem. But otherwise, it's very unlikely to be an issue.

Assuming you want to stay in the state, doing training there and having supporting letters from the PD in your program (in that state) will be a great way to get the Board to give you a license.

There are some exceptions -- Cali is one, where all residents must get a full license for their PGY-3. Why don't you post what state it is here, or PM it to me.
 
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