UK mrcgp to US - help

[mmdpkaaa]

posting for a friend who is interested in moving to the US. Med school complete in the U.K. in 2010 and now working as a family physician in the U.K. for the past few years, having gained the MRCGP qualification. What would be the route to getting licensed in the US. They do also have a Canadian license to practice FM as they accept U.K. training if that makes any difference. There is reciprocity with the ABFM and U.K. royal college but I think a residency in FM still needs to be done. I have heard of getting a credit of a year for the existing training this being able to join a PGY 2 position. Of course USMLE exams will need to be done. Anyone here able to provide guidance on the process or any help in general? Thanks

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[Lucca]

Moving to Gen Res

 

[mvenus929]

1. Take Steps 1-2
2. Apply to residency
3. Get through residency
4. Get licensed

As far as I know, the US does not have any reciprocity agreements with any country other than Canada (as in, if you did training in Canada, you can get a US license). And accredited programs won't take credit from any non-ACGME accredited program, so your friend would have to go through all of residency again.

 

[mmdpkaaa]

Not strictly true as per the abfm website which states reciprocity with the UK royal college.

Need more information though. thanks

 

[rokshana]

Not strictly true as per the abfm website which states reciprocity with the UK royal college.

Need more information though. thanks

doesn't mean you can gain licensure to practice...that requires completion of an ACGME or AOA residency in the US...ABFM has no say in that.

 

[gutonc]

Not strictly true as per the abfm website which states reciprocity with the UK royal college.

Need more information though. thanks

All the information you need is right here:
Royal College of General Practitioners (Great Britain)
Registrants of the Royal College of General Practitioners (Great Britain)—Physicians who have been certified by the Royal College of General Practitioners by examination may apply to sit for the ABFM Family Medicine Certification Examination if they:

• are members in good standing of the Royal College of General Practitioners;
• possess a Certificate of Prescribed/Equivalent Experience issued by the Joint Committee on Post Graduate Training for General Practice;
• reside in the United States;
• hold a valid and unrestricted license to practice medicine in the United States; and,
• are actively involved in Family Medicine in the United States.

The bolded is the key. You need a full/independent license to practice in the US. As a foreign medical graduate, you will need a bare minimum of 1 year of post-graduate (residency) training to get a license (and as near as I can tell from here, only GA and MS allow IMGs to be licensed with only 1 year, all the rest require 2-3 years).

So @mvenus929 is absolutely correct on points 1,2 and 4, and more or less correct on point 3.

One potential "end around" would be to do an FM fellowship that requires 2 years to complete...assuming you can get one to accept you without an FM residency.

 

[mmdpkaaa]

Thanks for the links. So from what I can tell there are multiple states that will give an IMG a license after 2 years of training. I have heard the UK training will give an exemption from the first year of residency and hence able to join as PGY2 - is this accurate? Also once you get a license in one state and then attain ABFM are you able to practice in any state?
Thanks!

 

[gutonc]

Thanks for the links. So from what I can tell there are multiple states that will give an IMG a license after 2 years of training. I have heard the UK training will give an exemption from the first year of residency and hence able to join as PGY2 - is this accurate? Also once you get a license in one state and then attain ABFM are you able to practice in any state?
Thanks!

I don’t know about that particular rule regarding being able to start as a PGY2, but you need to understand that, even if it is true, it will be at the discretion of the individual program director that you work with. So, while it may be allowed, it may not actually be the reality for you. Also, most PDs are going to start you as an intern and consider moving you to PGY2 partway through the year.

As for the licensing issue, you need a state specific license to practice wherever you wind up. So if you decide to only do 2 PGY years, you will only be eligible for licenses in other “2 year states”. Forever.

Finally (and this is something almost nobody thinks about until it’s too late), depending on the type of practice you want to have, particular employers and hospitals may have more stringent rules than the minimum licensing requirements. If you’re planning to go full country doctor, this probably won’t matter. But it might.

 

[rokshana]

Thanks for the links. So from what I can tell there are multiple states that will give an IMG a license after 2 years of training. I have heard the UK training will give an exemption from the first year of residency and hence able to join as PGY2 - is this accurate? Also once you get a license in one state and then attain ABFM are you able to practice in any state?
Thanks!

dude, there is no shortcut...don't you think if there was that every FMG that has been practicing in their home countries would have jumped on that option??

 

[mmdpkaaa]

dude, there is no shortcut...don't you think if there was that every FMG that has been practicing in their home countries would have jumped on that option??

This is more to do with ABFM reciprocity with the UK specifically as outlined in the link above - not about other countries.

 

[rokshana]

This is more to do with reciprocity with the UK specifically as outlined in the link above - not about other countries.

FMG is FMG...the UK is treated no differently.

 

[gutonc]

FMG is FMG...the UK is treated no differently.

It is...a little bit.

But not enough that it really matters. The OP is either going to do 3 years of PGY work in the US or won't practice. It really is that simple. The "reciprocity" is kind of a formality between specialty societies that makes everyone feel good but actually does virtually nothing to change the practical calculus for the OP or anyone else in his shoes.

 

[mmdpkaaa]

It is...a little bit.

But not enough that it really matters. The OP is either going to do 3 years of PGY work in the US or won't practice. It really is that simple. The "reciprocity" is kind of a formality between specialty societies that makes everyone feel good but actually does virtually nothing to change the practical calculus for the OP or anyone else in his shoes.

To add to the original post does holding a CCFP from Canada and having completed the MCCQE make a difference to this situation?

 

[gutonc]

To add to the original post does holding a CCFP from Canada and having completed the MCCQE make a difference to this situation?

Pick one. Which do you have?

 

[mmdpkaaa]

Pick one. Which do you have?

Both! Mrcgp from the UK where 3 year family residency was done. Canada accepts UK training entirely and after sitting the MCCQE and working as a family doc in BC for a year full licensure and CCFP was attained with the Canadian Royal college in BC.

 

[gutonc]

Both! Mrcgp from the UK where 3 year family residency was done. Canada accepts UK training entirely and after sitting the MCCQE and working as a family doc in BC for a year full licensure and CCFP was attained with the Canadian Royal college in BC.

You can go to the same link I provided above and find the answer for yourself. It's more or less the same answer you've already been given. You need to have 2y of PG training in Canada AND an unrestricted US license. So, if you want to go this route, you now need 4 years of training (2 in Canuckistan, 2 in Canada's taint) to be BE in the US.

Or...you know, if you're so dead set on practicing in the US...just do what everyone has told you to do so far and complete a US FM residency.

 

[betamale]

posting for a friend who is interested in moving to the US. Med school complete in the U.K. in 2010 and now working as a family physician in the U.K. for the past few years, having gained the MRCGP qualification. What would be the route to getting licensed in the US. They do also have a Canadian license to practice FM as they accept U.K. training if that makes any difference. There is reciprocity with the ABFM and U.K. royal college but I think a residency in FM still needs to be done. I have heard of getting a credit of a year for the existing training this being able to join a PGY 2 position. Of course USMLE exams will need to be done. Anyone here able to provide guidance on the process or any help in general? Thanks

One other loophole is to get your abfm certificate since you are board eligible and work as a faculty member at a medical school. Most states will give you a license to practice as a faculty of a medical school and you can get appointed as a faculty if you are board certified or eligible by an abms board.

First thing you need to do is get ecfmg certified then find a faculty position at a medical school so that they can endorse your for a state license.

I am actually trying to get a certification from UK GMC so that I can take the frcem exam.

 

[Apollyon]

(2 in Canuckistan, 2 in Canada's taint)

You got a "like" just for that. I could give you my credentials why that matters, but just take it like that!

 

[mmdpkaaa]

One other loophole is to get your abfm certificate since you are board eligible and work as a faculty member at a medical school. Most states will give you a license to practice as a faculty of a medical school and you can get appointed as a faculty if you are board certified or eligible by an abms board.

First thing you need to do is get ecfmg certified then find a faculty position at a medical school so that they can endorse your for a state license.

I am actually trying to get a certification from UK GMC so that I can take the frcem exam.

This seems like a good option. I know certain states will accept LMCC/MCCQE in lieu of USMLE -OR/VA/Maine so it could actually be fairly straightforward if there are options for faculty jobs in these states. Are jobs posted in a particular site for faculty positions or directly with the emoloyer/school?
Good luck with the GMC!

 

[gutonc]

One other loophole is to get your abfm certificate since you are board eligible and work as a faculty member at a medical school. Most states will give you a license to practice as a faculty of a medical school and you can get appointed as a faculty if you are board certified or eligible by an abms board.

First thing you need to do is get ecfmg certified then find a faculty position at a medical school so that they can endorse your for a state license.

I am actually trying to get a certification from UK GMC so that I can take the frcem exam.

Those states that still support this option give a limited license that is tied to that institution. So, while you can potentially get a position at a med school, you will be stuck working there, and can not practice elsewhere in that state, or parley that license into a license in a different state.

 

[rokshana]

This seems like a good option. I know certain states will accept LMCC/MCCQE in lieu of USMLE -OR/VA/Maine so it could actually be fairly straightforward if there are options for faculty jobs in these states. Are jobs posted in a particular site for faculty positions or directly with the emoloyer/school?
Good luck with the GMC!

generally that type of limited license is used to bring in rock star foreign physicians to come teach med students and do some research.

there is one DO school in maine...and a pretty prestigious med school in oregon...i doubt that they need someone so separately that they use this loophole...same with Va, though there are more med schools, so possible, but unlikely.

why are you looking so hard to cut corners?

 

[mmdpkaaa]

Not trying to cut corners but explore all avenues available. Already picked up a lot of valuable information so many thanks to all who have contributed. I think first step is to get ECFMG certified, contact ABFM and see if they are willing to offer a credit of a year towards residency as I have heard from a few different sources. Then apply for PGY2 positions if at all possible which upon completion opens up many options.

 

[gutonc]

Not trying to cut corners but explore all avenues available. Already picked up a lot of valuable information so many thanks to all who have contributed. I think first step is to get ECFMG certified, contact ABFM and see if they are willing to offer a credit of a year towards residency as I have heard from a few different sources. Then apply for PGY2 positions if at all possible which upon completion opens up many options.

Again, it doesn't matter if ABFM will give you credit if a PD won't request it.
So, as previously stated:
1. Take and pass Steps 1, 2CK and 2CS
2. Apply to residency
3. Get through (or nearly through) residency

3a. Ask your PD to give you credit for an extra year after proving yourself for at least 6 months as an intern
3b. Petition ABFM for 1y of credit​

4. Get licensed

 

[IMPD]

Again, it doesn't matter if ABFM will give you credit if a PD won't request it.
So, as previously stated:
1. Take and pass Steps 1, 2CK and 2CS
2. Apply to residency
3. Get through (or nearly through) residency

3a. Ask your PD to give you credit for an extra year after proving yourself for at least 6 months as an intern
3b. Petition ABFM for 1y of credit​

4. Get licensed

Here is the ABIM website:
Pathway A: International Medical Graduates who are Full-time US or Canadian FacultyLESS
A full-time faculty member at an LCME- or Canadian-accredited medical school, or at an ACGME- or Canadian-accredited residency or fellowship program, who has successfully completed training in internal medicine and/or a subspecialty abroad, may become eligible to achieve ABIM Board Certification in Internal Medicine and/or a subspecialty as a candidate for special consideration.

The candidate may not propose him/herself for consideration in this pathway, but must be proposed by the Chair of the Department of Medicine, or the internal medicine and/or the subspecialty program director at the institution where the candidate holds a current full-time faculty appointment.

Who is Eligible?

Eligible faculty will have:

• Completed three or more years of verified graduate medical education training in internal medicine and/or a subspecialty abroad.
• Certification in Internal Medicine from ABIM for certification in a subspecialty.
• An academic rank of Assistant Professor or higher.
• A full-time faculty appointment for a minimum of three (3) immediately prior and consecutive years at the same institution.
• Full-time faculty members are those who supervise and teach trainees (students, residents or fellows) in clinical settings that include direct patient care.
• The appointment must be at an LCME- or Canadian-accredited medical school or at an ACGME- or Canadian-accredited internal medicine residency or subspecialty fellowship training program

 

[IMPD]

Again, it doesn't matter if ABFM will give you credit if a PD won't request it.
So, as previously stated:
1. Take and pass Steps 1, 2CK and 2CS
2. Apply to residency
3. Get through (or nearly through) residency

3a. Ask your PD to give you credit for an extra year after proving yourself for at least 6 months as an intern
3b. Petition ABFM for 1y of credit​

4. Get licensed

Probably what's missing here is the understanding that it is PDs who sign off on "ready to practice" documents and not any Board or whatever. That's why it's PDs who have to request the waivers and verify that the trainee is, in fact, ready.

 

[LucidSplash]

Also seems that OP is missing that state licenses are predicated on completion of training in acceptable programs, not achievement of board-certification.

 

[Winged Scapula]

Also seems that OP is missing that state licenses are predicated on completion of training in acceptable programs, not achievement of board-certification.

Yes a common misunderstanding.

In the US, board certification and state licensure are 2 separate entities managed by 2 separate boards. In this case, the American Board of Family Medicine and relevant state Medical Board (for all specialties).

What I believe the OP is also missing is that you don’t “start” as a PGY2 exemption or not. You apply for and match to a PGY1 position and the PD applies for the exemption if they feel your friend is capable of acting as a senior FM resident. This would be unlikely without a period of observation given the presumed lack of knowledge about how US medicine works, insurance issues, practice guidelines etc that your friend would need to learn. IIRC you have to work for at least 6 months before exemption is usually applied for, so you’re not saving much time

Lastly why doesn’t your friend make an account here? It’s free and easy and looks a lot better to Americans who value independence and doing things on your own.

 

[NotAProgDirector]

I know certain states will accept LMCC/MCCQE in lieu of USMLE -OR/VA/Maine

This was news to me, so I googled all three states.

The VT Medical Board website is not easy to navigate. Using google, I found a "track changes" version of their rules / laws. According to it, only Canadian MD Grads are allowed to use LMCC/MCCQE. IMG's must use USMLE.

In Maine, LMCC is allowed as an exam option but is clearly marked as "Subject to board approval". I worry that "board approval" = Canadian grad.

In OR, it appears to be fine. LMCC is listed as an equivalent option to USMLE. That said, the board might decide to reject it anyway. You would be free to take them to court.

... contact ABFM and see if they are willing to offer a credit of a year towards residency as I have heard from a few different sources. Then apply for PGY2 positions if at all possible which upon completion opens up many options.

Again, it doesn't matter if ABFM will give you credit if a PD won't request it.
So, as previously stated:
1. Take and pass Steps 1, 2CK and 2CS
2. Apply to residency
3. Get through (or nearly through) residency

3a. Ask your PD to give you credit for an extra year after proving yourself for at least 6 months as an intern
3b. Petition ABFM for 1y of credit​

4. Get licensed

Already commented on above (and by IMPD, for IM). You usually can't petition a board, the PD needs to do it.

Getting a US license the way you're suggesting is close to impossible. Medical schools are not going to just hire someone as faculty, esp if it requires a special request to the medical board. And if the license is limited in any way, then you don't meet the definitions of the Royal College.

 

[LondonT]

I'm bumping this thread because I want to see how the OP's friend got on?

Not able to directly message the OP

 

[Apollyon]

Not able to directly message the OP

I think that's because you have less than 10 posts. But, I'm no mod or admin.