Licensure and international medical graduates

Article Abstract:

Graduates of foreign medical schools face numerous problems obtaining licensure in the United States. Since 1988, more than 12 bills have been introduced before Congress to deal with this topic, and some of the more recent bills have focused on discrimination against foreign medical graduates. If foreign graduates were to talk with their US-educated colleagues, they might find that they are not treated so differently after all. Many physicians believe that there is some sort of reciprocity among the states for medical licenses. That is, once licensed in one state they feel it should be easy to obtain a license to practice in another state. This is not the case. Different states have different requirements. Although some of the disparity has been reduced as a result of the Federal Licensing Examination (FLEX), there are still significant differences. For example, in some states scores from different sections of the FLEX may be assembled to produce a passing score, while other states require passing the exam in one sitting. A foreign medical graduate who is licensed in one state on the basis of a passing FLEX score obtained in two sittings may view another state's refusal to license him as discrimination. In some states, however, requirements to produce and verify credentials may create nightmares for some foreign medical graduates. Some are required to produce high school diplomas. Others may have to get a dean to verify the diploma of a student he hardly knew a decade previously. The Educational Commission for Foreign Medical Graduates verifies diplomas from foreign medical schools, yet their verifications are not universally accepted by state licensing boards. Some of the disparity among states may be solved by the new United States Medical Licensing Examination (USMLE). However, this will still not solve the bureaucratic problems facing physicians, regardless of where they were educated, who are licensed in one state and now wish to move to and practice in another. (Consumer Summary produced by Reliance Medical Information, Inc.)

Laws, regulations and rules, Licensing agreements, Health occupations licensing boards

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International medical education: common elements in divergent systems

Article Abstract:

A total of 31 countries responded to a survey of foreign medical education conducted by the American Medical Association. The 1990 International Survey of Medical Education revealed variations which reflect the wide range of cultures, political systems, and stages of economic development found around the globe. The survey revealed concern about the unsatisfactory disparities between medical needs and the availability of services. Concerns were also found about the lack of adequate methods for evaluating competence and about imbalances between specialties and general practice. The survey also revealed increasing focus on the delivery of health care in community-based systems and educational programs tied in with integrated health care strategies. Sixty-three percent of the countries predict a relatively constant supply of graduating medical students over the next five years; of the countries responding to the survey, only Finland, Malaysia, and Malta expect an increase in the number of graduating students in this same period. In most countries, the curriculum is not identical at all medical schools. The overwhelming majority of medical curricula appear to be divided into basic sciences and clinical practice. In two countries, Malaysia and Uruguay, medical education is integrated and presented in a problem-solving approach. In each of three other countries, Israel, Norway, and Sweden, one medical school is organized in a similar integrated problem-solving approach. In over half the responding countries, government financing was the only source of support for medical education. (Consumer Summary produced by Reliance Medical Information, Inc.)

Medical personnel, Foreign

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ECFMG assessment of clinical competence of graduates of foreign medical schools

Article Abstract:

The Educational Commission for Foreign Medical Graduates (ECFMG) has demonstrated it is possible to reliably assess the clinical abilities of graduates of foreign medical schools. The ECFMG developed four testing sites and evaluated the competence of 525 first-year residents who were graduates of foreign medical schools. The residents met with standardized patients and were evaluated on their history-taking ability, their skill at physical examination and communication skills. Their diagnostic knowledge was also tested with a laser videodisk system and a multiple-choice questionnaire. Statistical analysis of responses found them to be highly reliable when compared with external measurements of validation.

Evaluation, Educational Commission for Foreign Medical Graduates

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