Doctors trained abroad may have an easier way to medical licenses in several state proposals including Oregon

An increasing number of states have made it easier for doctors who have trained in other countries to obtain medical licenses, exchangers say they could facilitate the lack of doctor in rural areas.

The changes involve residence programs-the survey of supervised training, a practice that the doctors must complete after graduating the medical school. Until recently, each state required doctors who have completed a similar residence or training abroad to repeat the process in the US before obtaining a complete medical license.

From 2023, at least nine states have given up this requirement for some international training doctors, according to Federation of State Medical Councils. More than one dozen of other states consider similar legislation.

A draft law in Oregon legislature would establish a limited license to practice medicine for applicants who have passed certain exams and were certified by the Educational Commission for foreign medical graduates.

About 26% of doctors who practice in the US were born elsewhere, according to Institute of Migration Policy. They need federal visas to live in the US, plus state licenses to practice medicine.

The supporters of the new laws say that qualified doctors should not spend years ending a second training. The opponents worry about the patient’s safety and are doubting that the change of licenses will ease the doctor’s deficit.

The parliamentarians in the states that rely on Republican and Democratic have approved the idea at a time when many other immigration programs are attacked. These include Florida, Iowa, Iidaho, Illinois, Louisiana, Massachusetts, Tennessee, Virginia and Wisconsin.

President Donald Trump has defended A federal visa program on which many foreign doctors are based, but could still be prevented by its wide efforts to strengthen immigration rules.

The supporters of the new licensing laws include Zalmai Afzali, a internal medicine who finished the medical school and a residence program in Afghanistan, before running from the Talibans and coming to the US in 2001.

He said that most doctors trained elsewhere would be happy to work in rural or other underestimated areas.

“I would go anywhere, as long as they let me work,” said Afzali, who now treat patients living in rural areas and small cities in the northern -Virginia. “I missed being a doctor. I missed what I did. “

It took Afzali for 12 years to obtain children of his diploma and transcript, to study exams and to finish a US residence program, before being able to fully authorize as a doctor in his new country.

But a Commission of national health organizations Questions if weakening of residence requirements for trained doctors abroad would ease the deficit. Doctors in these programs could continue to face licensing barriers and employment, wrote in a report that makes recommendations without taking a position on such legislation.

Erin Fraher, professor of health policy at the University of North Carolina who advises the Commission and study the problemThey said that parliamentarians who support changes predict that they will stimulate the labor force in the field of rural health. But it is not clear if this will happen, she said, because the programs are just beginning.

“I think the potential is there, but we have to see how this goes out,” Fraher said.

Afzali has endeavored to support his family as he tried to get his medical license. His jobs included work at a store for $ 7.25 per hour and chemotherapy administration for $ 20 per hour. Afzali said that the nurses from the last job had less training than him, but they won almost four times more.

“I don’t know how I did it,” he said. “I mean, you are truly depressed.”

Many of the state invoices to ease the residence requirements have been based on Model legislation From Cicero Institute, a conservative think tank that sent representatives to testify to the legislats after proposing such programs in 2020.

The new ways are opened only to international trained doctors who meet certain conditions. Common requirements include work as a doctor for several years after graduating a medical school and a residence program, with a rigor similar to those found in the US, they must also pass the standard three -part examination that all doctors take to become authorized in the USA.

Those who qualify are granted a small license to practice, and most states ask them to do so under the supervision of another doctor. They can receive a full license after a few years.

The Oregon Senator, Kayse Jama, is the sponsor of the Senate 476 draft, which would create a license path for international medical professionals.

“The lack of suppliers exists in the whole state,” Jama said. “Providing professionals trained at international level a path to license can help fill labor gaps everywhere: in rural areas, as well as in rural, urban and suburban communities, eager for culturally relevant care and health services in languages that are not English.”

About 10 of laws or invoices also require doctors to work for a few years in a rural or underestimated area, but the proposal in Oregon does not.

“Once we see where the clinicians get to practice after using this option for the license, I am open to adjust the rules of the program on the place where they work around the state,” Jama said. “The draft law requires the Oregon Medical Council to monitor the number and geographical distribution of authorized professionals in this new way.”

But states without this requirement may not see an impact on rural areas, the researchers at Harvard Medical School and Rand Corp have said. New England Journal of Medicine. In addition to including this condition, the states could provide incentives to rural hospitals who agree to hire doctors from the new training paths, they wrote.

MPs, doctors and health organizations opposing changes say that there are better ways to increase the number of doctors in the rural area.

Barbara Parker is a registered assistant and former Republican MP in Arizona, where the legislature considers a draft law for at least the fourth consecutive year.

“It is a truly weak response to the lack of the doctor,” said Parker, who voted against the law last year.

Parker said that facilitating the practice of doctors trained abroad in the US would be a brak in doctors in countries with higher health care needs. And she said she was doubting that all international residences are the same as those in the US and worries that granting licenses to doctors who have trained in them could lead to poor care for patients.

She is also worried about the fact that hospitals are trying to save money by recruiting internationally trained doctors from those trained in the US, the first will often accept lower salaries, said Parker.

“This is led by corporate greed,” she said.

Parker said that better ways to increase the number of doctors in rural areas include increased salaries, extension of loans repayment for those who practice in rural areas and creating accelerated training for nurses and doctor assistants who want to become doctors.

The consultative commission – recently formed by the Federation of State Medical Councils, the accreditation council for graduate medical education, a non -profit that evaluates international medicine schools and their graduates – has published its recommendations to help parliamentarians and medical councils to ensure that these new ways are safe and efficient.

The Commission and Fraher said that state medical councils should collect data on the new rules, such as how many doctors participate, what their specialties are and where they work once they win their complete licenses. Results could be compared to other methods to reduce the rural physician deficit, such as Adding Residence Programs to rural hospitals.

“What is the advantage of this particular path in relation to other levers they have?” Said Frather.

The Commission mentioned that while the state medical councils can rely on an outer organization This evaluates the power of foreign medical schools, there is no similar rating for residence programs. Such an effort is expected to launch in mid -2025, the Commission said.

The group also said that states should ask the supervision of doctors to evaluate the participants before receiving a full license.

Afzali, the doctor in Afghanistan, said that some primary care doctors trained at international level have more training than their US counterparts, because they had to practice procedures that are only done by US specialists

But he agreed with the Commission’s recommendation for the states to ask the doctors who have resided abroad to have supervision while having a provisional license. This would help ensure the patient’s safety, also helping doctors adapt to cultural differences and learn the technical part of the US health system, such as billing and electronic health registers, the Commission wrote.

Fraher mentioned that doctors in programs with surveillance requirements should find an experienced colleague with the time and interest in providing this supervision to a health unit willing to hire them.

The Commission has emphasized other potential obstacles, such as Malpraxis insurers, which could decrease to cover doctors who obtain state licenses without completing a US residence. The Commission and the American Council of Medical Specialties also stressed the problem of specialized certification, which is managed by national organizations that have their own residence requirements.

Doctors who are not eligible to take the on -board exams could lose hiring opportunities, and patients may have concerns about their qualifications, wrote the Council. But he said that most of his member councils will consider the certification of these doctors if the states would add requirements that he recommended.

The plans of the parliamentarians to use these new licensing ways to increase the number of doctors in the rural area will ask the trained doctors abroad to sail on all these obstacles, Fraher said.

“There are a lot of things that have to happen to do this reality,” she said.

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