Not All Is Well in Paradise
Earning a medical degree from a Caribbean medical school can be a great way to enter medical practice in the United States. The education can be rigorous and cost-effective, and the ocean environment is conducive. A Caribbean medical school may also be the candidate's only available route into a highly desirable US medical practice. About one-quarter of U.S.-licensed physicians graduated from international medical schools, many of them from Caribbean schools. But getting through a rigorous and rewarding Caribbean medical school is not the candidate's only challenge. Caribbean medical school graduates can face extra challenges that graduates of US medical schools do not face. Caribbean medical school graduates can even face biases from licensing officials, making for an unfair and even discriminatory licensing process. Retain medical school defense attorney advisor Joseph D. Lento if you face obstacles getting your US medical license after earning your Caribbean medical school degree. Skilled and experienced help is available for international medical students. Attorney advisor Lento knows both medical education issues and international student issues.
Beyond ECFMG Certification
Graduates of Caribbean medical schools are already well familiar with ECFMG certification. The Educational Commission for Foreign Medical Graduates (ECFMG) certifies international medical graduates to enter US medical residency programs and sit for the Step 3 US Medical Licensing Exam. The Educational Commission also helps Caribbean medical graduates apply for US medical residencies and obtain J-1 visas if the graduate is not already a US citizen. The Educational Commission also conducts a verification service for those residency programs and for state medical boards as to the Caribbean medical graduate's credentials. The Educational Commission's Electronic Portfolio of International Credentials (EPIC) enables Caribbean medical graduates to prove their qualifications not only to residency programs and employers but also to state medical licensing boards. And therein lies the Caribbean medical graduate's extra challenge. Obtaining ECFMG certification and entering and completing a US medical residency doesn't qualify the Caribbean medical graduate for licensure. The graduate must also obtain a license from a state medical board.
State Medical Licensure
Government regulation of medical practice, like the regulation of other professions, is primarily a state, not a federal issue. Caribbean medical graduates pass the US Medical Licensing Exam and satisfy other national medical standards. Medical practice standards are largely national, not local. But US states, not a federal authority, ensure that individual physicians meet those national standards. State legislatures enact laws that require physicians practicing within the state to obtain and maintain a state medical license. New York's medical practice act is an example stating, "Only a person licensed or otherwise authorized under this article shall practice medicine or use the title 'physician.'" Practicing without a medical license is professional misconduct subject to declaratory ruling, cease and desist order, and severe sanction, including the inability to later obtain a license. State medical boards like the one in New York's Office of the Professions issue medical licenses, take public complaints against licensees, and provide license verification services. You don't have to attend a medical school within the state to get the state's medical license. Your Caribbean medical school degree may be a perfectly appropriate credential. But only expect to practice medicine in the US with a state license.
Resolving ECFMG Issues
A Caribbean medical graduate's ability to resolve any ECFMG certification issues can go a long way toward obtaining a US state medical license. The candidate for ECFMG certification must show graduation from a Caribbean medical school listed in the World Directory of Medical Schools with a special ECFMG-approved notation at the time of the candidate's graduation. That's one resolvable issue. ECFMG certification also requires an accurate online application. If your application has irregularities, that's another resolvable issue. ECFMG certification also requires passing the US Medical Licensing Examination's Step 1 exam, Step 2 clinical knowledge exam, and the Occupational English Test (OET) for medicine or the USMLE's former Step 2 communication skills (CS) component. That's another resolvable issue. Finally, the candidate must also avoid committing irregular behavior and subverting the ECFMG certification process. Irregular behavior can include: submitting falsified or altered documents; violating test-taking rules, policies, or procedures; false or misleading representations of online information; taking ECFMG exams when ineligible to do so; or falsifying ECFMG status to other entities. The ECFMG's policies and procedures on irregular behavior include procedures for resolving these issues. Retain medical school defense attorney advisor Joseph D. Lento to help you resolve any ECFMG issue delaying your US state medical licensure.
State Medical Board Issues
While state medical boards may rely heavily on ECFMG certification, they still make their own decisions on medical licensure. As a Caribbean medical school graduate, your ECFMG certification may be in good order, and you may have even completed your US medical residency, but you can still face state medical board licensing issues. Here are some of the potential state medical board issues that Caribbean medical school graduates may face.
Caribbean Medical School Not on a State-Approved List
Your Caribbean medical school may not be on your state's approved list for various required components of your medical education. Just because the ECFMG recognizes your Caribbean medical school as approved in the World Directory of Medical Schools doesn't mean your state licensing board also recognizes your school as authorized to supervise your New York clinical medical education training. Each state board can make its own list of approved schools. New York, for example, approves fourteen international medical schools, many of them in the Caribbean, to offer clinical training at hospitals in New York for medical graduates seeking the state's licensure. But New York also maintains a process for qualifying for licensure through the Bureau of Comparative Education in its Office of Professions, even if you graduated from a Caribbean medical school not on New York's list. You just have to navigate that process. Retain medical school defense attorney advisor Joseph D. Lento to help you do so.
Verification Documentation Unavailable
Your state licensing board may require additional documentation verifying various components of your Caribbean medical school education. For example, your Caribbean medical school transcript may list your medical rotations satisfying your state licensing board's clinical requirements. You completed those rotations, and you and your Caribbean medical school know it. But your state's licensing board may demand documentation from the particular hospital, site, or other medical provider where you did those rotations. That demand may mean that you have to locate hospital or clinic officials who have the time, means, and inclination to assist you with available documentation. That documentation may not exist, or you may not find a willing hospital or clinic official. Medical school defense attorney advisor Joseph D. Lento and the Lento Law Firm's student defense team can help you both with obtaining alternative documentation and with preparing alternative verification that state licensing officials will accept.
Affiliated Clinical Training
Your state licensing board may also reject your application on the basis that you did not complete one or more components of your clinical training at an approved site or under the approved site's own physicians. You may indeed have had a non-employed, but affiliated physician supervise one of your dozen or more clinical rotations. Or you may have completed all or part of a required rotation outside of the approved facility at an affiliated facility that you thought or assumed was part of the approved site. While your state licensing board may have delayed or rejected your application on that rational basis, medical school defense attorney advisor Joseph D. Lento may be able to help you obtain documentation showing the board the reliability and appropriateness of the affiliation. Affiliated clinical training can raise a red flag with state licensing officials, who must check protocol boxes against approved lists. But the lists are always changing or subject to modification with appropriate documentation.
State Licensing Board Bias and Discrimination
You may also find your state licensing board requiring you to get original documents, get copies of documents notarized, authenticated, or attested documents, and jump through other proverbial hoops that you know other candidates are not facing. As credible, rigorous, and regulated as Caribbean medical schools are, individual licensing officials in various states may nonetheless hold biases against certain schools or against Caribbean medical schools generally. State medical licensing boards in California, Arkansas, Vermont, Alaska, and New Mexico, and other states' medical licensing boards, may even list disapproved Caribbean medical schools that licensing officials believe do not provide a quality education. Whether your Caribbean medical school is clearly approved or instead suspect among some state licensing officials, it only takes one licensing official one bad decision on one bad day to derail or significantly delay your licensing application. You may receive a request or response that isn't clear, isn't fair, or is outright contradicted by the materials you submitted. You may even find your licensing application delayed without response or even seemingly ignored as if acting on it was simply an afterthought. While bias and discrimination can be difficult to discern and prove, they do exist. Retain medical school defense attorney advisor Joseph D. Lento to help you address suspected bias and discrimination issues.
The Nature and Value of Attorney Advisor Services
You know the huge investment you've made in time, trouble, and tuition to earn your Caribbean medical degree. You also know the challenges you've overcome to pursue and complete your clinical rotations and residency training. You also rightly anticipate substantial job, career, and collateral rewards for your future medical practice. A study published in the National Library of Medicine reports that "Caribbean graduates contribute significantly to the US healthcare workforce." You have no reason to be troubled by your Caribbean medical education. You should also not let state medical licensing board officials unduly delay or unfairly reject your license application. Medical school defense attorney advisor Joseph D. Lento and the Lento Law Firm's student defense team provide a wide range of skilled and effective services for Caribbean medical school graduates facing state licensing issues. Those services include:
- evaluating your license application to confirm its accuracy and completeness;
- researching and confirming state law, rule, regulations, and procedures on medical licensure;
- communicating timely, clearly, and firmly with state licensing officials to determine the status of license application;
- obtaining, authenticating, and verifying additional documentation to supplement the license application;
- advocating and negotiating with state licensing officials for prompt early resolution of licensing disputes;
- invoking state licensing dispute resolution procedures for formal hearings and appeals of license denials; and
- evaluating and pursuing litigation or other alternative special relief through oversight channels.
Alternative Available Special Relief
The last attorney advisor service mentioned just above bears special mention. Your state medical licensing board has protocols and procedures that it must follow to process and approve or deny multiple license applications. But your state medical licensing board is also accountable to oversight bodies. The licensing officials are accountable to the licensing board, and the board is accountable to higher offices and officials. Medical school defense attorney advisor Joseph D. Lento has such substantial experience with medical licensing and other professional licensing issues that he has a national reputation and network of professional contacts inside and outside of licensing offices. Attorney advisor Lento may be able to negotiate alternative special relief through these channels to obtain your medical license.
Premier Medical School Defense Attorney Advisor
Your prospects for state medical board licensure as a Caribbean medical school graduate should be good with your ECFMG certification. If instead, your state medical board has delayed or rejected your application, then retain premier medical school defense attorney advisor Joseph D. Lento to help you qualify for licensure. Call 888.535.3686 or go online now to retain attorney advisor Lento and the Lento Law Firm's student defense team.
