Tennessee Allows FMG practice without retraining

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maxxor

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maxxor said:
So instead of training American grads, how about they hire fmg attendings for 50k instead.

Every 2 years, lather, rinse, repeat.

Where was the Tennessee medical association on this?
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Gov Lee also campaigned on eliminating the CON requirement for building new ED’s (still there for now). So the goal there is Texas 2.0 I guess.
 
maxxor said:
So instead of training American grads, how about they hire fmg attendings for 50k instead.

Every 2 years, lather, rinse, repeat.

Where was the Tennessee medical association on this?
Click to expand...
Y'know, there's a devil sitting on my shoulder that kinda wants this to happen.

Why? Because if it's allowed to happen for a few years, it should at least be easy to convince the public that our ridiculous healthcare spending is *not* due to providers' 6-figure salaries. We would also have a relatively controlled experiment to inform whether FMGs provide care that is as good as American-trained docs.

I know, I know. FMGs suck, American docs are great. They shouldn't terk, er, take our jobs. This is known and I probably just have sour grapes from never getting the Vandy interviews 😀
 
hundreddaysoff said:
Y'know, there's a devil sitting on my shoulder that kinda wants this to happen.

Why? Because if it's allowed to happen for a few years, it should at least be easy to convince the public that our ridiculous healthcare spending is *not* due to providers' 6-figure salaries. We would also have a relatively controlled experiment to inform whether FMGs provide care that is as good as American-trained docs.

I know, I know. FMGs suck, American docs are great. They shouldn't terk, er, take our jobs. This is known and I probably just have sour grapes from never getting the Vandy interviews 😀
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Do we really think physicians trained in other countries are subpar? I think it would be reasonable to make sure they're as up to date as any other somewhat out of date Murican doc.
 
hundreddaysoff said:
Y'know, there's a devil sitting on my shoulder that kinda wants this to happen.

Why? Because if it's allowed to happen for a few years, it should at least be easy to convince the public that our ridiculous healthcare spending is *not* due to providers' 6-figure salaries. We would also have a relatively controlled experiment to inform whether FMGs provide care that is as good as American-trained docs.

I know, I know. FMGs suck, American docs are great. They shouldn't terk, er, take our jobs. This is known and I probably just have sour grapes from never getting the Vandy interviews 😀
Click to expand...
You can't rationalize people out of a position they didn't rationalize themselves into in the first place. Unfortunately the diagnosis is stupid- and stupid is terminal. Palliative care consulted, appreciate recs.
 
I think it's more a matter of workforce protectionism than patient safety protectionism to allow FMGs into the U.S. without fully retraining. Costs a bundle in real dollars, deferred compensation, and life stress to become educated and train as a physician in the U.S. – who wants to have more competition for jobs when they finish?

Very reasonable for a state medical board to establish standards for equivalency in training and experience to obtain a provisional medical license and a pathway to unrestricted licensing. Obviously, we can't have foreign half-wit pseudo-naturopaths practicing voodoo medicine licensed here – we already have an overabundance of those having trained in U.S. medical schools – but there's no sound reason a Fellow of the Royal College from the UK or Australia etc. wouldn't be able to provide safe, modern healthcare in the U.S.
 
Considering all of the corporate hospitals are based in Nashville I have a hard time not seeing this as a ploy used in their favor.

Sure, a UK trained physician is great… Is a Bulgarian trained one great as well? Regardless, flooding the market is not a good thing

Great for the individuals involved and probably these corporate chains, but no way can you convince me it’s good for us docs on this forum…
 
The actual requirements seem pretty restrictive. Have to graduate a medical school the TN Medical Board approves of, be residency trained or have 3 years of experience in practice, speak English, and be able to legally work and live in the US.
 
DeadCactus said:
The actual requirements seem pretty restrictive. Have to graduate a medical school the TN Medical Board approves of, be residency trained or have 3 years of experience in practice, speak English, and be able to legally work and live in the US.
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Legally allowed to work and live in the United States just means visa which tech companies give out like candy. This will be the new thing for HCAs and other for profits to do. Of course the academic medical centers will follow suit
 
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It is also particularly concerning that the bill passed with 95% indicating that such bills would likely garner support in other states. Honestly between midlevels, this, AI, you won’t have many people going to medical school in the future I would guess
 
If an FMG can’t get into any residency, I’ve heard of some DO schools having a foreign doc program, if they can stomach going through med school again of course.
 
interesting program. it's still going to be very limited because they have to be employed in an academic setting which is like having resident that doesnt go through the match. i approve, however, i feel the scope should be limited to nonsurgical/low acuity settings.
 
EMhawkeye said:
Would you rather have a boarded internist from the UK or an app that went to an online school?
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And for a state like tenn, where US grads don’t want to go, this is the crux of the issue… which is a better path? The underserved get care from a physician or from a midlevel?
 
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rokshana said:
And for a state like tenn, where US grads don’t want to go, this is the crux of the issue… which is a better path? The underserved get care from a physician or from a midlevel?
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unpopular view. If you live in a medical desert that’s not societies job to fix.
want to live in the sticks where land is cheap and living costs nothing well guess what buddy. 2-3 hour commute to see a doc. Or the community can opt to figure out how to pay someone great money to bring them in.

middle Tennessee is one of the most desirable places in the Country. Growth has been quite high. Yes there is memphis which sucks and east tn is sort of like personal preference
 
rokshana said:
And for a state like tenn, where US grads don’t want to go, this is the crux of the issue… which is a better path? The underserved get care from a physician or from a midlevel?
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The institutions that are authorized to sponsor these “apprentice doctors” (not sure the correct term under the bill) are in Nashville, Memphis etc. Nothing requires these physicians to go to underserved areas after the 2 year apprenticeship after which they get an unrestricted medical license. This bill is motivated by profit not expanding access
 
xaelia said:
I think it's more a matter of workforce protectionism than patient safety protectionism to allow FMGs into the U.S. without fully retraining. Costs a bundle in real dollars, deferred compensation, and life stress to become educated and train as a physician in the U.S. – who wants to have more competition for jobs when they finish?

Very reasonable for a state medical board to establish standards for equivalency in training and experience to obtain a provisional medical license and a pathway to unrestricted licensing. Obviously, we can't have foreign half-wit pseudo-naturopaths practicing voodoo medicine licensed here – we already have an overabundance of those having trained in U.S. medical schools – but there's no sound reason a Fellow of the Royal College from the UK or Australia etc. wouldn't be able to provide safe, modern healthcare in the U.S.
Click to expand...

Why should we allow reciprocity when its essentially impossible for any of us to go to an EU country and practice?

It'd be cool to open up a cash only concierege urgent care type thing catering to tourists in Rome, but Italy makes it essentially unobtainable: take THEIR medical boards...in Italian...**** that.
 
EctopicFetus said:
middle Tennessee is one of the most desirable places in the Country. Growth has been quite high. Yes there is memphis which sucks and east tn is sort of like personal preference
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Well…we will have to agree to disagree there…middle of nowhere fly over states generally don’t appeal to me…and with the governor and legislature thinking they are florida and deciding they know more about how to practice medicine… well, it’s not exactly the best state to practice in…🤷🏽‍♀️
 
GonnaBeADoc2222 said:
Why should we allow reciprocity when its essentially impossible for any of us to go to an EU country and practice?

It'd be cool to open up a cash only concierege urgent care type thing catering to tourists in Rome, but Italy makes it essentially unobtainable: take THEIR medical boards...in Italian...**** that.
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Yet easy enough for US grads to practice in NZ and AUS…
And we do make them take our licensing exams in English…
 
rokshana said:
Well…we will have to agree to disagree there…middle of nowhere fly over states generally don’t appeal to me…and with the governor and legislature thinking they are florida and deciding they know more about how to practice medicine… well, it’s not exactly the best state to practice in…🤷🏽‍♀️
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This isnt about your or my personal preference.

TN was 11th in growth.

Fastest Growing States 2025

worldpopulationreview.com worldpopulationreview.com

It’s not perfect but frankly where is it perfect? Outside of some likely appropriately nervous OB docs this has been not felt in the ED. Meanwhile no State income tax, decent med mal climate and lots of stuff to do, strong schools etc. But it’s cool if you stay away we aren’t hurting. The nashville area has been booMing with Fortune 500 companies and high paying jobs.

tough to find a good EM job though for sure. I would be curious where you live? I can assure you a large majority of folks would also rather not be there but i am glad it works for you.
 
Have any physicians in Tennessee noticed any effects of this bill yet (ie less job recruiting in hopes that there will soon be an influx of cheaper labor)

Assuming this would probably most evident in partnership track jobs due to longer commitment
 
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EctopicFetus said:
unpopular view. If you live in a medical desert that’s not societies job to fix.
want to live in the sticks where land is cheap and living costs nothing well guess what buddy. 2-3 hour commute to see a doc. Or the community can opt to figure out how to pay someone great money to bring them in.
Click to expand...

I don't think you actually want to go down that line of reasoning. One could very well argue that it's also not society's job to guarantee us a high income.
 
Franzd'Epinay said:
I don't think you actually want to go down that line of reasoning. One could very well argue that it's also not society's job to guarantee us a high income.
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Right. Cut the income cut the number of docs. I’m happy to go down this line of thinking.

We spend so much time
And effort to solve for rural issues it is to the detriment of a large number of patients in urban areas. It’s ridiculous.
 
Franzd'Epinay said:
I don't think you actually want to go down that line of reasoning. One could very well argue that it's also not society's job to guarantee us a high income.
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We are paid what the market will bear. Supply and demand. Low supply of doctors in an area, make it worth our while. We are under no obligation to give our services for a discount.
 
EctopicFetus said:
Right. Cut the income cut the number of docs. I’m happy to go down this line of thinking.
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Not if you import the docs, as is the entire point of this thread.

(For what it's worth, I'm also not convinced lower pay will crater the number of American kids who want to go into medicine. Veterinarians exist despite having a similar student loan burden as us with 20-50% of the compensation.)

EMhawkeye said:
We are paid what the market will bear. Supply and demand. Low supply of doctors in an area, make it worth our while. We are under no obligation to give our services for a discount.
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And state governments are under no obligation to go along with the status quo of US-trained physician protectionism.

Anyways, I have mixed feelings on this policy, but if you disagree with it, your line of thinking can't stop at "tough ****, Tennessee; US-trained physicians owe you nothing" because Tennessee can just as well say "tough ****, US-trained physicians; Tennessee owes you nothing".
 
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