subspecialty training for overseas

[NDESTRUKT]

I've seen and heard of people from other countries come to the US to train in a subspecialty fellowship without having to do a residency here. They end up going back to their country after finishing.

Is that possible as a US citizen then as well? Let's say I wanted to do plastics overseas (like in China) and just needed training. Could I learn enough to do that and not have to do a fellowship?

Basically saying, is there a way to train to do advanced procedures (ENT, uro, ortho) without doing the full on residency/fellowship for learning purposes and using them in other countries (volunteer work, etc)?

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[Pilot Doc]

Generally yes.

Practically speaking, you need to be board certified in something to get operative privileges at a US hospital. Ditto for malpractice insurance.

But with that US training behind you, if you can document training/experience in a particular niche, even overseas, you can parlay that into additional privileges for specialty procedures. This is highly variable with locality. Generally, if someone is already doing a procedure and makes the hospital lots of $$, you won't succeed. If you are bringing a new procedure (read revenue source) to a hospital, you probably will. The example I know of is a general surgeon going to england to do a year of non-cardiac thoracic and then adding that to his practice.

 

[Winged Scapula]

I think your success in getting credentialed to do such procedures without training in the US acceptable to the hospital may be somewhat fraught with difficulty.

That is, if there are PRS trained surgeons on staff and you want to do plastics based on some techniques you learned in China without having done a PRS residency either here or there, I would imagine that the credentialing board would not allow you to do so. If you're in a smaller community without other specialists around to do the procedures and you can convince the hospital that you possess adequate training to do the procedure, then you may have a shot. I have known US plastic surgeons to go to Australia for microsurgery fellowships, but these are approved and full training programs in that country.

In general, the wording on credentialing procedures outside of the realm of general surgery is sort of vague. For example, I know a general surgeon who has assisted on a few breast augmentations and is requesting credentials to perform such procedures. The language from the hospital says something like "its ok as long as you can provide evidence that you provide satisfactory training to do so." Whatever "satisfactory training" is I do not know.

In essence, going abroad to learn to do a technique not widely done in the US is not uncommon, but to use it to avoid doing full training in a recognized specialty is probably not wise...besides the difficulties in getting credentialed, you might face some trouble doing certain procedures that patients and insurance companies expect to be done by a specialist.

If your goal is to only use those procedures while on volunteer mission trips, that's a different story, although those trips have plenty of BC plastic surgeons (as an example) along, so am not sure your skills would offer anything special that the PRS guys couldn't handle.

Just my two cents...

 

[NDESTRUKT]

I think I didn't communicate my question right.

What I meant was...if I was a US trained surgeon. Could I enroll informally into a PRS program or somehow learn how to do plastics procedures without doing a formal fellowship? Then I could use these skills and practice in another country.

I'm not sure how else one could learn surgical technique unless someone was willing to teach them (aka fellowship)

 

[Winged Scapula]

I think I didn't communicate my question right.

What I meant was...if I was a US trained surgeon. Could I enroll informally into a PRS program or somehow learn how to do plastics procedures without doing a formal fellowship? Then I could use these skills and practice in another country.

I'm not sure how else one could learn surgical technique unless someone was willing to teach them (aka fellowship)

After my response I was wondering if the above was what you meant.

While I think it possible that your plan could work, remember that the US is one of the easiest countries for foreigners to work in and I'm sure you've heard stories about how hard that is. Thus, practically I'm not sure you could get permission to work in another country easily under such a plan as you are suggesting. There are issues of your education being approved, visas, malpractice, etc.

But let's say you could find someone to arrange a mentorship to teach you a technique or two and you were willing to go through all the redtape it would take, then it may be possible to use this technique to work in other countries.

I think the reason you haven't gotten many responses is:

1) not many of us have tried or know someone who has tried to get surgical experience in another country outside of a formal education program

2)what you are proposing is a bit unorthodox. Doesn't mean its impossible but frankly I'm not sure its practical - it seems an awful lot of red tape and frustration to not do some sort of formal training (which you could then use if you wanted in the US...perhaps).

I'd be interested to hear if anyone knows anyone who has attempted this. If its PRS you're particularly interested in, you might ask in that forum.