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IMGs in Non-physician Health Care Positions

In the January 2010 issue of the Health Care Careers e-Letter, we asked whether physicians from other countries would be good candidates for nonphysician health care careers.
 
Many international medical graduates (IMGs) come to the U.S. to pursue a career in medicine but are not able to match into a residency program (a requirement to practice medicine in the U.S.). For many of these physicians, a career in a non-physician field may be an viable option.

Would most if not all of these individuals have to start from the very beginning of a given field's educational requirements, or might there be some possibility of advanced standing based on their possessing an MD degree from another country?

Following are the responses received from e-Letter readers.

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Our respiratory therapy program (BS, Biology) fast-tracks foreign physicians and others who already hold a BS degree in a science discipline. They may complete the advanced practice program in 19 months.

We find that the greatest hurdle foreign physicians face is verbal communication. 

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Earning an MD degree from another country does not qualify an individual for advanced standing in any allied health program. Just because the person obtained the MD degree does not mean they have the knowledge or skills to enter, say, a surgical technology, medical assisting, occupational therapy, or physical therapy program. They need to enroll in the desired program.
 
While a non-physician career may be a viable option for an IMG, their prior medical training for the most part would be moot and therefore not applicable to non-physician education and careers.
 
We are in the greatest nation on earth. We can bring these people to our country, enroll them in our schools and colleges, and prepare them for their chosen discipline. Then they can find suitable employment in their field and be part of the health care community providing non-physician care to patients. It’s important to remember that the roles of non-physicians and physicians are quite different, and the education and training process do not prepare students for the same challenges.

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We have had a number of IMGs apply to our sonography program. Based on our experiences, here are a few comments:

Due to the lack of systematic accreditation standards in foreign medical schools, we have found a wide range of academic and technical skills, even in something as standard as anatomy and physiology. We now require any applicant to take examinations for our prerequisite math and science courses if their degree is more than five years old.
The transition from being a physician to being part of the health care team can be a real challenge for these students, and some have not been able to accept the fact that they are in a non-physician role. This can cause serious problems at our clinical sites.
We have had to spend additional time orienting IMGs that the time required to develop clinical scanning skills is not shorter due to any specific background/training, including medicine, but is related to basic hand-eye coordination and pattern recognition skills. Realistic expectations are a critical part of career counseling for all students!

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As manager of an EMT and paramedic program, we have seen a few IMGs in our program. I think this is an excellent track. The down side is that many of the IMG have language difficulties, which is particularly troublesome when trying to communicate by radio.

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It seems that IMGs who have credentials from the Educational Commission for Foreign Medical Graduates (ECFMG) could undertake reduced-length training, which might also include reduced medical training, such as a year of physiology and a year of clinical training in a certificate program (not an MD degree), to better prepare them for residency or training for positions in non-physician fields. In any event, this needs more thought and study.

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In the case of IMG applicants, our diagnostic medical sonography program waives all our prerequisites for entry except for English. We have these applicants submit evaluated transcripts and then award them credit on the basis of their medical education.

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Applicants to our BS degree program in respiratory therapy would need to meet the necessary English language requirement of our institution. The applicant would also need to have transcripts translated and evaluated by a foreign transcript evaluation agency, then evaluated by our registrar's office and by the respiratory care program director. Advanced placement would depend upon these determinations and would likely be clarified by asking the applicant to take a comprehensive examination.