Qualifications from overseas?

[DrIng]

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Just wondering, does anyone know if it is possible to work as an attending in psychiatry in the US or Canda, without having to be board certified? Inother words can I use the FRCPsych and work in the US or can you work only if you have done a US residency? thanks for your help.

 

[whopper]

From my limited knowledge (I'm only a resident)---

You have to have done a residency in the US to practice, unless you were one of the old docs from another country that was able to get into the US decades ago before the requirement existed.

Once you pass USMLE Step III & finished the residency, you could practice. (I could be wrong about this). I believe you don't have to pass your boards, but passing them will add to your appeal when applying for jobs, and some places pay board certified docs more than they do the non certified ones.

 

[prominence]

Once you pass USMLE Step III & finished the residency, you could practice. (I could be wrong about this).

technically speaking, couldn't you open up a private practice in psychiatry after passing step 3 and completing 1 yr of residency, asuming u were eligible to get a state license to practice?

 

[Anasazi23]

Don't you have to pass Steps I, II, and III?

 

[whopper]

Don't you have to pass Steps I, II, and III?

Yes

You can't take Step III unless you've passed Step I & II.

You can't practice with 1 year of residency. I will clarify. To my knowledge you can practice so long as you have a state liscence. To get a state liscence, the requirements vary per state, but in general---you need to have passed Step III (I didn't mention Step I & II because you need to have passed those before you take Step III), further you need to have graduated from a US residency program.

Repeat--graduated from a program. 1 year of residency does not count.

And I will also clarify this--once you get those requirements out of the way--you have to apply and be granted the liscence. I didn't mention this before because I figured this was common sense. E.g. when you read an instruction manual on putting a computer together--the manual doesn't tell you to breathe--because you already know you're supposed to do that.

Now again, from what I understand this is the general gist of it for all the states, though each state's specific rules vary. E.g. In NJ, to practice, you cannot have failed Step III more than 3 times I believe. In several other states there is no limit.

 

[Miklos]

Just wondering, does anyone know if it is possible to work as an attending in psychiatry in the US or Canda, without having to be board certified? Inother words can I use the FRCPsych and work in the US or can you work only if you have done a US residency? thanks for your help.

The replies above are mostly correct, but there are a handful of exceptions.

If your question is about whether you can set up your own practice with solely foreign qualifications in the US, the answer is most likely no (unless there is an odd-ball state that recognizes your qualifications). As many have pointed out above, one needs to pass all the steps, complete a residency and get board certified.

However, there are tiny, but significant loopholes, as licensure and medical practice is regulated by individual states. A number of states grant exemptions to those rules for people demonstrating eminence in medicine or appointment to a medical faculty.

See http://www.ama-assn.org/ama/pub/category/10257.html for the list of states. However, my understanding is that these 'special faculty permits' are usually limited to practice at the university. Also obviously, one needs to be appointed to such a post.

Regarding Canada, that may well be easier (thanks to the Commonwealth). You may wish to check out the below links for more info.

http://rcpsc.medical.org/residency/certification/img_e.php
http://rcpsc.medical.org/residency/certification/img_page2_e.php

The Royal College of Psychiatrists (UK) is listed on the second link!

 

[DrIng]

Thank you to everyone for their helpful postings.

 

[Imhotep]

Just to clarify, Whopper....you CAN get licensed in at least 8 U.S. states after completing only 1 year of residency training (this is true for U.S. and IMG physicians). I should know, as I am licensed in two of them.

Of course, the other prerequisites are succesful passing of USMLE STEP's 1, 2, and 3.

Finally, it is true that some states have limits on the number of attempts it took you to pass each Step. For example, you cannot be licensed in Maryland if you failed any part of the USMLE exam 3 times.

For further details, I suggest visiting www.fsmb.org and www.docboard.org

To answer the OPs question, theoretically you could work under the Special License, which is offered to visiting foreign academicians etc. However it depends on the specialty, and your sponsoring institution would have to take care of the paperwork for you.

In certain fields such as radiology, where its almost impossible to hire in academics (due to the immense disparity in salaries compared to private practice), you can work as an academic radiologist at a University with all foreign credentials (and NO U.S. training), after four years of which, you are eligible to sit for the ABR.

 

[Miklos]

Just to clarify, Whopper....you CAN get licensed in at least 8 U.S. states after completing only 1 year of residency training (this is true for U.S. and IMG physicians). I should know, as I am licensed in two of them.

Apart from special faculty permits, using the AMA's info, I counted five that only require one year of US GME for IMGs;

Alaska, Arkansas, Iowa, Rhode Island, Wisconsin

The following states require two years for IMGs;

Connecticut, Florida, Hawaii, Illinois, Indiana, Kansas, Kentucky, Maine, Michigan, Minnesota, New Hampshire, New Mexico, Ohio, Oklahoma, South Dakota, Utah, Virginia, Washington

The remainder require three.

But independent practice, hospital priviledge committees and insurance companies may well require board certification.

 

[Imhotep]

And I counted 6, if you consider US virgin Islands. The point is, about two years ago, when I last checked these stats, there were 8-9 states where a person could get a full license after one year of residency.

I agree about the comment re: having difficulty getting priviledges and getting insurance companies to pay for services. Having said that, it is difficult, but not impossible to go to a rural area and practice general medicine without having completed residency. It is certainly not a recommended path. Other options are working in the state correctional facilities. Though they prefer a board certified/eligible person, I know of a couple people who were able to procure a job without having completed their residency training.

Again, it is not a recommended path because of the severe limitations in the scope of work you can perform, and the high risk of litigation.