Practicing without US residency

[rox]

I am aware that a foreign-trained radiologist can sit for the board in a matter of 3 or 4 years after finishing US fellowships. However, I started seeing the same for other specialties. Here are links for 3 attendings who graduated from AUB which is neither LCME-accredited nor ACGME-accredited in ENT, plastic surgery and urology.

Any input about this issue? Any special requirements? Can they really practice freely? Is that available in all specialties? What's the deal?!

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[Winged Scapula]

To practice in the US, you:

must be eligible for a medical license.

To get the medical license you must complete the relevant licensing exams and amount of training required for the license. This varies by state and is listed here: http://www.fsmb.org/usmle_eliinitial.html

All of the attendings listed completed the minimum amount of training required to get a license in the state they are practicing by doing a fellowship in the US.

"Practicing freely" depends on the state, the medical board and the employment opportunities. As you know, you cannot be Board Eligible in General Surgery without having done your general surgery training in the US (in most cases); but you don't have to be BE to get a job, although it is much harder in private practice due to hospital and insurance company requirements.

But yes, doing a fellowship in the US has been a traditional way of getting into US medicine without having done medical school or residency in the state

 

[rox]

Interesting. BTW, is sitting for the board and becoming BC a privilege of radiology only?

 

[Winged Scapula]

Interesting. BTW, is sitting for the board and becoming BC a privilege of radiology only?

I'm not sure what you are asking.

All Boards offer Board Certification; not just for Rads.

 

[reapplicant5]

One more faculty member with just the fellowship portion of his training done in the US.

http://wuphysicians.wustl.edu/physician2.aspx?PhysNum=3607

 

[rox]

I'm not sure what you are asking.

All Boards offer Board Certification; not just for Rads.

Well, I was referring to radiologists who did their residency abroad then came to the states for fellowship training. They are allowed to sit for the american board of radiology. I am quite sure about that but can't seem to find the link.

So I was wondering if the same applies for other specialties; that is, can a plastic surgeon, for example, who just did fellowship training in the states become BC?

 

[Winged Scapula]

Well, I was referring to radiologists who did their residency abroad then came to the states for fellowship training. They are allowed to sit for the american board of radiology. I am quite sure about that but can't seem to find the link.

So I was wondering if the same applies for other specialties; that is, can a plastic surgeon, for example, who just did fellowship training in the states become BC?

Each board has different rules; there is no one set rule for every specialty. Here are the rules for PRS:

https://www.abplsurg.org/ModDefault.aspx?section=TrainingRequire

 

[NotAProgDirector]

In Internal Medicine, this is not allowed. In order to sit for any subspecialty board, you first must pass the IM boards, which requires an IM residency.

However, a foreign trained physician can do an IM Fellowship. And then, they can get a license to practice in the US (assuming the fellowship is long enough to satisfy the state's criteria, usually 3 years). They just can't be board certified.

 

[RegularNihilist]

To practice in the US, you:
As you know, you cannot be Board Eligible in General Surgery without having done your general surgery training in the US (in most cases); but you don't have to be BE to get a job, although it is much harder in private practice due to hospital and insurance company requirements.

Oh? What are the obstacles? Does this only apply to surgery?

 

[Winged Scapula]

Oh? What are the obstacles? Does this only apply to surgery?

Oh? What are the obstacles? Does this only apply to surgery?

Obstacles?

I'm not sure what are you referring to.

To be Board Certified in General Surgery, currently requires completion of a US General Surgery residency. Within the last 3 years, the American Board of Surgery (ABS) has given partial "credit" for some foreign training. However, to be given the credit, you have to be enrolled in a US general surgery residency and can only be given credit for a maximum of two years for those who have completely finished foreign training and hold the equivalent of US Board Certification. See: http://home.absurgery.org/default.jsp?certintlgraduates

So, you can work in the US as a surgeon upon completion of a surgical fellowship (if you can find a fellowship that allows you to enter without being US Board Eligible or Board Certified - there are a few), but you cannot be Board Certified without having completed a full US general surgery residency.

A common point of confusion is that you are not required to be Board Certified to work as an attending in the US. Despite the links above to surgeons working in the US, this does not imply BC or even BE.

Obstacles come from insurers and employers. Every hospital I have privileges (to evaluate, admit and operate on patients) requires that I am at least Board Eligible. Thus, foreign trained surgeons would not currently be eligible for privileges at these institutions barring completion of training in the US. One hospital requires Board Certification by reapplication (ie, 2 years after initial appointment).

All insurance companies and medical defense providers ask for information about Board Certification and when you are taking the exams. It is not farfetched to believe that some will require BC to be on the plans and to provide malpractice insurance. Without being on insurance plans and having malpractice insurance, you are effectively limiting 90% or more of your patient population and exposing yourself to major liability.

Finally, patients want BC physicians, or so they say. I've only been asked about it twice in the last two years (although maybe they look it up before they come in), so am not sure that it is really important to all of them.

All of these are obstacles although admittedly they are more obstacles, IMHO, for those in private practice. Working at a university provides you some protection - you will most likely get on insurance plans and malpractice under group policies without being BE/BC and patients will assume some measure of quality - true or not.

Hope that's what you were looking for.

 

[Ludicolo]

http://www.abms.org/Who_We_Help/Member_Boards/contactinfo.aspx

This is a link to the ABMS which subsequently provides links to all of the specialty boards' websites. Feel free to peruse what each specialty’s requirements for certification are. Every field is different, but it appears that the majority of them require completion of a US or Canadian residency. Also, the site allows the general public to check if a given physician is board certified. Which the three surgeons referenced in the OP aren’t.

 

[dragonfly99]

I don't think that training abroad and then just doing a fellowship in the US is a realistic way into US practice for the vast majority of people. It pretty much only works for academics...

 

[rox]

Here's the link from American Borad of Radiology for IMG's.

The requirement would be verification of full-time faculty appointment in an institution that has an ACGME- or RCPSC-approved diagnostic radiology residency training program. That would include being appointed as an instructor, assistant professor, associate professor, or professor; fellow; researcher; or resident.