A new law in the United States is set to allow Nigerian-trained medical doctors, or doctors from any specific country, to bypass US residency requirements. In the United States, medical residency is an essential part of the training process for international medical graduates (IMGs) who wish to practice medicine in the country. IMGs, including doctors trained in Nigeria or any other foreign country, typically need to complete a residency program accredited by the Accreditation Council for Graduate Medical Education (ACGME) or the American Osteopathic Association (AOA) in order to obtain a medical license and practice independently.

Pediatric nephrologist Bryan Carmody, MD, recalls working alongside an extremely experienced neonatologist during his residency. She had managed a neonatal intensive care unit in her home country of Lithuania, but because she wanted to practice in the United States, it took years of repeat training before she was eligible for a medical license.

"She was very accomplished, and she was wonderful to have as a co-resident at the time," Carmody said told Medscape Medical News.

The neonatologist now practices at a US academic medical center, but to obtain that position, she had to complete 3 years of pediatric residency and 3 years of fellowship in the US, Carmody said.

Such training for international medical graduates (IMGs) is a routine part of obtaining a US medical license, but a new Tennessee law bypasses these requirements and creates a quicker pathway for IMGs to secure medical licenses in the US.

The American Medical Association (AMA) took similar measures at its recent annual meeting, making it easier for IMGs to gain licensure. Because the pandemic and Russia's invasion of Ukraine disrupted the process by which some IMGs had their licenses verified, the AMA is now encouraging state licensing boards and other credentialing institutions to accept certification from the Educational Commission for Foreign Medical Graduates as verification, rather than requiring documents directly from international medical schools.

When it comes to Tennessee's new law, signed by Gov. Bill Lee in April, experienced IMGs who have received medical training abroad can skip US residency requirements and obtain a temporary license to practice medicine in Tennessee if they meet certain qualifications.

International doctors must demonstrate competency, as determined by the state medical board. In addition, they must have completed a 3-year postgraduate training program in the graduate's licensing country or otherwise have practiced as a medical professional in which they performed the duties of a physician for at least 3 of the past 5 years outside the US, according to the new law.

To be approved, IMGs must also have received an employment offer from a Tennessee healthcare provider that has a residency program accredited by the Accreditation Council for Graduate Medical Education.

If physicians remain in good standing for 2 years, the board will grant them a full and unrestricted license to practice in Tennessee.

"The new legislation opens up a lot of doors for international medical graduates and is also a lifeline for a lot of underserved areas in Tennessee," said Asim Ansari, MD, a Canadian who attended medical school in the Caribbean and is an advocate for IMGs.

Ansari is participating in a child and adolescent psychiatry fellowship at KU Medical Center in Kansas City until he can apply for the sixth time to a residency program. "This could possibly be a model that other states may want to implement in a few years."

What's Behind the Law?

A predicted physician shortage in Tennessee drove the legislation, said Rep. Sabi "Doc" Kumar, MD, vice chair for the Tennessee House Health Committee and a co-sponsor of the legislation. Legislators hope the law will mitigate that shortage and boost the number of physicians practicing in underserved areas of the state, Kumar said.

"Considering that 1 in 4 physicians in the US are international medical graduates, it was important for us to be able to attract those physicians to Tennessee," he said.

The Tennessee Board of Medical Examiners will develop administrative rules for the law, which may take up to a year, Kumar said. He expects the program to be available to IMGs beginning in mid-2024.

Upon completion of the program, IMGs will be able to practice general medicine in Tennessee, not a specialty. Requirements for specialty certification would have to be met through the specialties' respective boards.

Carmody, who blogs about medical education, including the new legislation, told Medscape the law will greatly benefit experienced IMGs, who often are bypassed as residency candidates because they graduated years ago. Hospitals also win because they can fill positions that otherwise might sit vacant, he said.

Family physician Sahil Bawa, MD, an IMG from India who recently matched into his specialty, said the Tennessee legislation will help fellow IMGs find US medical jobs.

"It's very difficult for IMGs to get into residency in the US," he said. "I've seen people with medical degrees from other countries drive Uber or do odd jobs to sustain themselves here. I've known a few people who have left and gone back to their home country because they were not accepted into a residency."

Who Benefits Most?

Bawa noted that the legislation would not have helped him, as he needed a visa to practice in the US and the law does not include the sponsoring of visas. The legislation requires IMGs to show evidence of citizenship or evidence that they are legally entitled to live or work in the US.

US citizen IMGs who haven't completed a residency or who practiced in another country also are left out of the law, Carmody said.

"This law is designed to take the most accomplished cream of the crop international medical graduates with the most experience and the most sophisticated skill set and send them to Tennessee. I think that's the intent," he said. "But many international medical graduates are US citizens who don't have the opportunity to practice in countries other than United States or do residencies. A lot of these people are sitting on the sidelines, unable to secure residency positions. I'm sure they would be desperate for a program like this."

Questions Remain

"Just because the doctor can get a [temporary] license without the training doesn't mean employers are going to be interested in sponsoring those doctors," said Adam Cohen, an immigration attorney who practices in Memphis. "What is the inclination of these employers to hire these physicians who have undergone training outside the US? And will there be skepticism on the part of employers about the competence of these doctors?"

"Hospital systems will be able to hire experienced practitioners for a very low cost," Ansari said. "So now you have these additional bodies who can do the work of a physician, but you don't have to pay them as much as a physician for 2 years. And because some are desperate to work, they will take lower pay as long as they have a pathway to full licensure in Tennessee. What are the protections for these physicians? Who will cover their insurance? Who will be responsible for them, the attendees? And will the attendees be willing to put their license on the line for them?"

In addition, Carmody questions what, if anything, will encourage IMGs to work in underserved areas in Tennessee after their 2 years are up and whether there will be any incentives to guide them. He wonders, too, whether the physicians will be stuck practicing in Tennessee following completion of the program.

"Will these physicians only be able to work in Tennessee?" he asked. "I think that's probably going to be the case, because they'll be licensed in Tennessee, but to go to another state, they would be missing the required residency training. So it might be these folks are stuck in Tennessee unless other states develop reciprocal arrangements."

Other states would have to decide whether to recognize the Tennessee license acquired through this pathway, Kumar said.

He explained that the sponsoring sites would be responsible for providing work-hour restrictions and liability protections. There are currently no incentives in the legislation for IMGs to practice in rural, underserved areas, but the hospitals and communities there generally offer incentives when recruiting, Kumar said.

"The law definitely has the potential to be helpful," Cohen said, "because there's an ability to place providers in the state without having to go through the bottleneck of limited residency slots. If other states see a positive effect on Tennessee or are exploring ways to alleviate their own shortages, it's possible [they] might follow suit."

Kumar agrees that other states will be watching Tennessee to weigh the law's success.

"I think the law will have to prove itself and show that Tennessee has benefited from it and that the results have been good," he said. "We are providing a pioneering way for attracting medical graduates and making it easier for them to obtain a license. I would think other states would want to do that."

Nigerian doctors have made substantial contributions to the global healthcare industry and are highly regarded for their skills and expertise. Many Nigerian physicians have pursued opportunities abroad due to factors such as professional advancement, access to advanced medical technologies, research opportunities, or better economic prospects.

Source: https://www.publichealth.com.ng/new-law-allows-nigerian-trained-medical-doctors-to-bypass-us-residency/

I hear say na native doctors remain for 9ja.

Any doctor still practicing in Nigeria must be making lots of mistakes. Allow quack nurses to inject agbado mutulas.

This includes Doctors from every part of the world not only Nigeria

All they are doing is making it easier for our medical practitioners to migrate to their country. A time might really come when we will find only quack doctors whenever we go to the hospital.

Okay

More brain drain hitting our health sector. This is best time to japa else to see doctor in Nigeria, it will take a year

Congratulations to Nigeria

Damnnn niggar

Sounds like a good news

After that Unilag professor don start hin residency already

Kudos to the US govt.

Reading...

more japa brewing...

your heroin cocaine sniffing pig goes to France to patch his leaking cracked testicles whereas trying to limit the progress and development of our medical practitioners.

he turned lagos to dubai, didn't build even one pharmacy but the trails of urine keep following him till he reaches France.

Nice one. The brain drain continues.

As long as our elites don't patronise the ones at home, but prefer away doctors, I support all our docs to japa

More brain drain

Ok good can people like Small Dr, Native Dr also perform without Permit

Before now they look down on our education system, but now that their kids have become lazy and leaving the traditional professions, they are now raiding our so called professionals that they had hitherto looked down upon and granting them special privileges to entice them.
The serious ones there just want to do IT stuff like youtube and run online stores leaving very few ready to become doctors, factory workers, engineers and co.

The lazy ones are now into drugs and other unproductive ventures.

Hmmmm ..... brain drain about to shift to overdrive! Residency was a huge stumbling block to most foreign doctors wanting to emigrate. Guess the quacks will troop in when they leave. We need to seriously return to traditional medicines.

That's amazing.

Time to become a quack medical doctor for that green pali

Very Good Development

They understand the rigorous but cheap training that Nigerian trained doctors undergo before certification and after going through residency you expect them to do another internship in America, they simply move on to Arab countries or some European countries which pays better than America without asking them for internship.
America wants to use this measure to grab more doctors from countries like Nigeria

Lol

Good initiative.

Let them all leave... Serious nations deserve serious professionals!

No one should suffer and labor for a nation where semi-literate and morally-bankrupt people reap all the fruits, while idiots who can barely feed themselves support them!

The best brains deserve to work in the best nations that won't take their skills for granted, but remunerate well for their efforts and give them conducive environments to live and thrive with their families!

This is for doctors who have completed residential training and become consultant with minimum of 3 years working experience in Nigeria.

Also, they will have to work for minimum of 2 years with their sponsor in Tennessee, obviously they will be collecting lesser salary, after which the board will award them licence to practice only in Tennessee as at now.

SpecialAdviser:
Any doctor still practicing in Nigeria must be making lots of mistakes. Allow quack nurses to inject agbado mutulas.

So that they won't have the leg to walk to a polling center and vote rubbish

I think only USA requires foreign trained doctors to repeat residency if u are a foreign trained specialist. I'm not sure this makes lots of sense especially if the foreign doctor is coming from a country with advanced healthcare system.
However, the biggest hurdle for most IMG remain USMLE, its a tedious exam that requires at least 2 years of solid preparation and intense hard work, and u still not guaranteed a residency slot.