Shift supporters say it can alleviate the shortage of rural doctors, as it has made it easier for trained doctors in other countries to obtain medical licenses.

Changes include the Residence Program. This is a monitored, practical training experience that your doctor must complete after graduation. Until recently, all states required doctors who have resided overseas or completed similar training abroad to repeat the process in the United States before obtaining a full medical license.

Since 2023, at least nine states have removed this requirement for some internationally trained physicians. State Medical Board Federation. More than a dozen other states are considering similar laws.

Approximately 26% of doctors practicing in the United States were born elsewhere. Immigration Policy Research Institute. They require a federal visa to live in the United States and a state license to practice medicine.

Advocates of the new law say that qualified doctors do not need to spend years completing their second residential training. Opponents worry about patient safety and doubt that changes in licenses will alleviate the shortage of doctors.

Republicans and democratic state lawmakers approved the idea when many other immigration-related programs were under attack. It includes Florida, Iowa, Idaho, Illinois, Louisiana, Massachusetts, Tennessee, Virginia and Wisconsin.

President Donald Trump defended it The federal visa program that many foreign doctors rely on, but it could still be hampered by his widespread efforts to strengthen immigration rules.

Supporters of the new licensing law include Zarmai Afzari, an internist who graduated from medical school and completed a residency program in Afghanistan before fleeing the Taliban and coming to the US in 2001.

He said most doctors trained elsewhere are happy to work in rural areas and other underserved areas.

“As long as they let me work, I’ll go anywhere,” said Afzari, who treats patients living in rural and small cities in northeastern Virginia. “I missed being a doctor. I missed what I did.”

It took him 12 years to obtain a copy of his diploma and transcript, study for the exam, and finish a three-year US-based residency program before being fully permitted to practice as a doctor in his new country.

But a National Health Committee We ask whether relaxing the residency requirements for foreign-trained physicians will ease the shortage. Physicians in these programs still could face licensing and employment barriers, they wrote in a report that they made recommendations without taking any stance on such laws.

Erin Flaher, professor of health policy at the University of North Carolina, advised the committee. Research the problemlawmakers who support change said they predicted they would boost the rural health workforce. But it’s unclear whether that will happen, she said.

“I think the possibilities are there, but we need to see how this sounds,” Flaher said.

Afzari struggled to support his family while trying to obtain a medical license. His job included working at a department store for $7.25 an hour and administering chemotherapy at $20 an hour. Afzari said the nurse practitioner in the latter job had less training than he had earned almost four times more money.

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

Many of the state’s bills to facilitate residence requirements are based on Model method From the Cicero Institute, a conservative think tank that sent representatives to testify to Congress. I propose such a program 2020.

The new routes are only open to internationally trained physicians who meet certain conditions. General requirements include working as a physician for several years after graduating from a rigorous residency program similar to those found in medical schools and the United States.

Qualified individuals are granted a limited license to practice, and most states require them to do so under the supervision of other physicians. They will receive a full license in a few years.

Around ten laws or bills also require doctors to work for several years in rural or unserved areas.

However, there is no requirement, Tennessee etc.may not affect rural areas, says researchers at Harvard Medical School and Land Corporation. New England Journal of Medicine. In addition to including that condition, they wrote, the state could provide incentives to rural hospitals who agree to hire doctors from new training routes.

Lawmakers, doctors and health groups opposed to the change say there are better ways to safely increase the number of rural doctors.

Barbara Parker is an Arizona registered nurse and former Republican lawmaker, and Congress has been considering the bill for at least four years in a row.

“That’s a really bad answer to the shortage of doctors,” said Parker, who voted against the legislation last year.

Parker said it would unethically poach doctors from countries with high medical needs, making it easier for foreign-trained doctors to practice in the United States. And she said she suspects that all international residents are on par with people in the US and that they are worried that granting licenses to the doctors who trained them could lead to inadequate care for their patients.

She is also concerned that hospitals are trying to save money by recruiting internationally trained doctors over those trained in the US, the former would often accept low wages, Parker said.

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

Parker, according to better ways to increase the number of rural doctors, includes raising wages, expanding loan repayment programs for people practicing in rural areas, and creating accelerated training for nurse practitioners and physician assistants who want to become doctors.

Advisory Committee – Recently established by the state Federation of Medical Boards, the Graduate Medical Education Accreditation Council, and Intellectual, a nonprofit organization that evaluates international medical schools and their graduates, have released recommendations for lawmakers and medical boards to ensure these new pathways are safe and effective.

The committee and Fraher said the state health boards should gather data on new regulations, including the number of physicians participating, what their specialties are and where they will work once they have a full license. The results can be compared with other methods of alleviating the shortage of rural physicians. Adding a Residency Program At a rural hospital.

“What is the advantage of this particular path compared to other levers?” Flaher said.

The committee can rely on state medical boards; External organization It assesses the strength of foreign medical schools, but there is no similar rating in the residency program. Such efforts are expected to begin in mid-2025, the committee said.

The group also said the state should require physicians to oversee participants before they are granted a full license.

Afzari, a physician from Afghanistan, said internationally trained primary care physicians received more training than their US counterparts as they had to practice procedures only performed by US experts.

However, he agreed to the committee’s recommendation that supervision be required by doctors resident overseas while the state holds a provisional license. It helps ensure patient safety, while also helping physicians adapt to cultural differences and learn technical aspects of the US health system, such as claims and electronic health records, the committee wrote.

Fraher pointed out that doctors in programs with supervision requirements should find experienced colleagues who have time and interest in providing this oversight in medical facilities that are willing to hire them.

The committee pointed to other potential hurdles, such as fraudulent insurance companies that could refuse to cover physicians who obtain state licenses without completing their US residence. The Committee and the US Medical Specialist Committee pointed to the issue of specialized certifications managed by national organizations with their own residency requirements.

Physicians who are not eligible for the board exam may lose employment opportunities and patients may be concerned about their qualifications. The board wrote. However, the majority of its member committees said they would consider accreditation of these physicians if the state adds recommended requirements.

The lawmaker’s plan to use these new licensing pathways to increase the number of rural doctors requires foreign trained physicians to navigate all of these obstacles and unknown physicians, Fraher said.

“There’s a lot that needs to happen to make this happen,” she said.

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