IMG Related Question

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LebDoc

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I recently heard that even if you did not do your residency in the US, you can practice there if you complete two fellowships in the US. Does anyone know if this is true? The reason I am asking this is because it is very difficult to get into a US surgery residency ... so going through the double fellowship rout (if it's true) could be a way for people who want to do surgery to also practice in the United States
 
I heard it from a PGY-4 Orthopedic surgery resident in my home country who is planning to do 2 fellowships in the states
 
The answer is "sort of".

Here's the scoop:

In order to practice medicine in the US, you need a license.

In order to get a license, you need US clinical experience. Each state has a different amount of clinical experience necessary. In most it is 2-3 years. IMG's are often held to 3+ years, although some states will give anyone a license with only 1 year of experience.

In order to do a fellowship, you do not necessarily need to have done a residency.

Therefore, if you can convince someone to give you a fellowship spot (or more than one back-to-back) and complete the minimum number of years of training, you can get a license and practice medicine. There is nothing magical about "two fellowships", it simply come down to getting enough training.

Now for the bad news:

1. Getting a fellowship spot without completing a US residency is not easy. You'd need to convince a program that your skills are equivalent.

2. Said program might have more work / problems with your paperwork, as everyone else would have completed a full residency and would already have a full license to work.

3. You'd get a license, but you would not be board eligible in most cases. It's impossible for me to be certain in every case, but most boards do not allow you to get fellowship boarded unless you hold the requisite core residency board, which you would not qualify for.

4. Because you would not be boarded, you MIGHT have trouble getting a job. This is very specialty / field dependent.
 
An interesting topic. A few years ago, there were two cardiologists running UC Irvine's Cardiology division despite the fact that they were not licensed in California nor board certified. The problem was that neither of them had done a US internal medicine residency, but did secure cardiology fellowships (how? I'm not sure). As a result, they were not eligible for board certification. It ended up being quite a controversy at the time. My understanding is that they have both obtained licenses, but still do not have board eligibility.
 
Yes, it is possible to get license without board certificate. In states as KY, where I work I believe also alabama, tennessee, maine, some others you can work in university as faculty on limited one year license, which is renewed every year (something like limited license for residency). After 5 years being renewed for 1 year, you can apply for full unrestricted license, no USMLE's or other requirements. However you have to have "friends" in your department to do the paperwork for you. I know a german anesthesiologist who is working as faculty in anesthesiology, failed usmle step 1, once, but his boss in germany is very good friends with Anesth. chairman in KY and got him on that limited license, he will get full license in 5 years, the department even got him green card. He was board certified in europe, however I don't know if he will get anesth. board here. So yes, all things are possible if you have "friends". Sounds so unfair for IMG like me that is applying for residency..
 
Yes, it is possible to get license without board certificate. In states as KY, where I work I believe also alabama, tennessee, maine, some others you can work in university as faculty on limited one year license, which is renewed every year (something like limited license for residency). After 5 years being renewed for 1 year, you can apply for full unrestricted license, no USMLE's or other requirements. However you have to have "friends" in your department to do the paperwork for you. I know a german anesthesiologist who is working as faculty in anesthesiology, failed usmle step 1, once, but his boss in germany is very good friends with Anesth. chairman in KY and got him on that limited license, he will get full license in 5 years, the department even got him green card. He was board certified in europe, however I don't know if he will get anesth. board here. So yes, all things are possible if you have "friends". Sounds so unfair for IMG like me that is applying for residency..

I personally know people like that at one of the most prominent places on the west coast too. The main thing is you have to be board certified in your specialty in your country. Then you do not have to take the USMLEs, and you can get a license to practice only in that hospital/university setting. I am not sure whether there is a cap on this and whether this system is still in vogue in this day and age, but that seems to be one of the ways in which one can practice without doing a full residency in the USA.
 
I personally know people like that at one of the most prominent places on the west coast too. The main thing is you have to be board certified in your specialty in your country. Then you do not have to take the USMLEs, and you can get a license to practice only in that hospital/university setting. I am not sure whether there is a cap on this and whether this system is still in vogue in this day and age, but that seems to be one of the ways in which one can practice without doing a full residency in the USA.

This is totally legit in most states. There are generally options for licensing a "super specialist" foreign physician in most states. How that person is defined is generally left up to the institution sponsoring their Visa/GC. The requirements for training/board certification in their home country are state specific.

The director of oncology Phase 1 clinical trials @ UC-Denver is just such a person.

BUT....

They are given what amounts to a training license (the same as is given an intern on July 1) and they are not allowed to practice independently outside of that institution. If they leave the sponsoring institution for another location, it must be academic and they must not only sponsor the license but must sponsor whatever Visa (or take over GC sponsorship) the person was on initially.

So don't think that this is some magic ticket to a cush PP career without actually doing the appropriate training in the US. The OPs buddies in Ortho in Egypt (or Romania or India or wherever) aren't going to get to come over here, do a few years of spine fellowship and then go off and score a $1M/yr PP spine gig. But if they want to be (and stay) in academics, and can find a job like that, the possibility exists.
 
Thanks, I know. Being an old IMG, currently US citizen, I am applying for residency like everybody else. I just finished observership (which technically was externship) in poor, underserved FM office. I really enjoyed and think that I made a difference for some of the patients and this is what I want to do, work in Neuro/IM or FM practice, and there is no way going around that but residency. However, I still feel that is very unfair, even according to the state boards laws
 
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