Texas is a big state, comprising 268,581 square miles of territory. It also has a big shortage of doctors. Fifteen percent of Texas’ 254 counties (i.e., 37) lack a single primary care physician. The physician shortage could reach 10,000 by 2032, just seven years from now. While no one method will alleviate the entire shortage, Texas has a plan that makes a lot of sense. Here it is: Let physicians who have trained and worked abroad come work in Texas without insurmountable barriers to entry. That means allowing foreign-trained physicians to practice in Texas without forcing them to repeat a 3-to-7-year residency program that they may have already completed abroad. The new law takes effect September 1.
For the most part Doctors of Medicine (and Doctors of Osteopathy) must complete graduate medical training before practicing in the United States. After completing medical school graduates must complete a medical residency program lasting three to seven years. Medical residencies are in short supply and highly competitive. For instance, Texas has more medical school graduates each year than residency slots to complete their training. That means Texas educates and then exports doctors, who ultimately work in other states. In some years up to 10,000 medical school graduates nationwide apply but fail to obtain a residency program and are turned away. They can try again the following year or give up and never practice medicine. While some medical school graduates do not match each year because their choices are too narrow, most who do not match will never be accepted to a residency program. The reasons are varied: most went to medical schools abroad and residency committees think they have better candidates. Some graduates have educational experience unlike that found in the United States. Whatever the reason, the result is thousands of would-be doctors who cannot practice medicine in the United States.
Residency programs are difficult and stressful. Having to repeat residency is a nearly insurmountable barrier for foreign medical graduates who have already practiced abroad for a few years. It is like starting over. Residents must often work 80 hours a week at an average pay per year of about $55,000. That’s less than $13 an hour compared to $250,000 in student debt.
To qualify for the Doctor Act, international medical graduates must have at least five years of experience practicing medicine abroad. There are a few more provisions you can read about here. Physicians who meet the requirements will get a provisional license to practice in Texas.
According to the Dallas Morning News, Texas joins 12 other states that have approved an alternative licensure pathway for foreign-trained physicians with work experience abroad. The Federation of State Medical Board puts the number of states with some type of alternative provisions at 18. A similar number of states have proposals or pending legislation to gain limited or full licensure for foreign medical graduates. Some states are creating other ways to allow medical school graduates who have not completed a residency to get on-the-job training by working with participating licensed physicians.
Thousands of Americans attend medical schools abroad, while an untold number of foreign-born medical graduates would like to migrate to the United States but are unlikely to match to a residency. Anything states can do to put these doctors to work treating patients will increase access to care.
Read more at:
- Dallas Morning News: To Address Doctor Shortage Texas Launches New Pathway for Foreign Trained Physicians
- Beckers Hospital Review: Another State Offers Alternative Licensure Pathway for Foreign Physicians