Medical license

A medical license is an occupational license that permits a person to legally practice medicine. Most nations require such a license, bestowed either by a specified government-approved professional association or a government agency. Licenses are not granted automatically to all people with medical degrees. A medical school graduate must receive a license to practice medicine to legally be called a physician. The process typically requires testing by a medical board. The medical license is the documentation of authority to practice medicine within a certain locality.

Canada

Canada requires that applicants have graduated from a school registered in the World Directory of Medical Schools, and apply to sit the Medical Council of Canada Evaluating Examination.[1]

China

China issued the <<Law on Licensed Physician>> in 1995.[2] The law requires all newly graduated medical students to sit the National Medical Licensing Examination (NMLE), regulated by the National Medical Examination Center (NMEC), and then register with the local regulatory body. Eligibility for the exam requires that students complete a one year internship after obtaining a primary medical qualification (i.e., Bachelor of Medicine). The two-part exam includes a Clinical Skill (CS) test and a General Written (GW) test. The CS test consists of many stations, and candidates must pass the CS test to take the GW test. The GW test consists of four papers, and candidates have 2.5 hours to complete each one over two days. The CS is held in July, followed by GW in September each year.[3]

Colombia

The Instituto Colombiano para el Fomento de la Educación Superior (ICFES) and the Ministry of Education regulate the medical schools that are licensed to offer medical degrees. After completing all the schools' requirements to obtain a medical degree, physicians must serve the "obligatory social service" (in rural areas, research, public health or special populations e.g., orphan children), which usually lasts one year. After completing the social service, a doctor obtains a "medical registration" at the governor's office (Gobernación) of the Department (province/state) where they served the obligatory term. This registration is the same as a license in other countries, and authorizes the physician to practice medicine anywhere in the national territory. However, to practice in other departments requires an inscription from that department. Unlike the US, there is no official licensing exam for medical graduates in Colombia, since this responsibility is delegated to medical schools that have permission to confer medical degrees.

Germany

In Germany, licensing of doctors ("Approbation") is the responsibility of the state governments. Licensed doctors are compulsory members of "Ärztekammern" (literally: "Physician chambers"), which are medical associations organized on state level. Criteria for licensing of doctors are regulated in the Approbationsordnung für Ärzte, which is a piece of federal law.[4]

India

In India, certification requires that a medical school graduate pass the final MBBS examination and undergo a one year internship in a hospital recognised by the Medical Council of India. Foreign medical graduates must take the Foreign Medical Graduates Examination (FMGE), conducted by the National Board of Examinations (NBE). They can practise medicine throughout the country after certifying themselves as per Indian Medical Council Act, 1956. Doctors registered with any one state medical council are automatically included in the Indian Medical Register and thereby entitled to practise medicine anywhere in India. The MCI Ethics Committee observed in a meeting held on September 2, 2004 that, "There is no necessity of registration in more than one state medical council because any doctor, who has registered with any state medical council is automatically registered in the Indian Medical Register and also by virtue of Section 27 of the IMC Act, 1956, a person, whose name is included in the IMR, can practise anywhere in India." The Registered Doctors with various State Medical Councils across India up to the year 2015 can be checked in the official website of INDIAN MEDICAL REGISTRY search www.mciindia.org by just typing the name of the doctor.

UK

The term "Medical License" is US-centric terminology. In the UK and in other commonwealth countries the analogous instrument is called registration; i.e., being on the register or being/getting struck off (the register). The General Medical Council is the regulatory body for doctor's licensing in the UK. Currently, there are two types of basic registration: "Provisional Registration" and "Full Registration", and two types of specialty registration: "Specialist Registration" and "GP registration".[5] In November 2009, the GMC introduced the "licence to practise", and it is required by law that to practise medicine in the UK, all doctors must be registered and hold a licence to practise.[6] The registration information for all doctors holding or that have previously held a license in the UK is available online at the GMC website.[7]

United States

In the United States, medical licenses are usually granted by individual states. Only those with medical degrees from schools listed in the AVICENNA Directory for medicine or the FAIMER International Medical Education Directory are permitted to apply for medical licensure.[8]

The federal government does not grant licenses. A physician practicing in a federal facility, federal prison, US Military, and/or an Indian Reservation may have a license from any state, not just the one they are residing in. The practice of "tele-medicine" has made it common for physicians to consult or interpret images and information from a distant location. Some states have special licensure for this. The licensure process for most physicians takes between three and six months, due to the extensive background checks, educational, training, and historical primary source verifications.

Criticism

The enactment of U.S. state medical licensing laws in the late 1800s was for the primary purpose of reducing competition and allowing physicians to make more money.[9] The added benefit of public safety made restrictive licensure laws more appealing to both physicians and legislators. Infrequently mentioned in the literature, is that the “public safety” that is created by reducing the number of practitioners only extends to the patients who receive medical care. Thus, the overall effect is more expensive and higher-quality medical care for fewer patients.[10]

An article from 2013 says of the road to licensing in Canada, "The path through immigration, residency training, licensure and employment promises to remain a difficult road to navigate," and emphasizes that the current and future demand for healthcare.[11] This emphasizes that there are a number of barriers that doctors face when it comes to practicing, yet there is a very high demand for doctors.

Beyond the more general criticisms of occupational licensing that licensing increases costs and fails to improve quality, licensing in the medical profession specifically has been criticized as failing to enforce the standard practices they are charged with enforcing. In 1986, Inspector General at the US Health Department said that medical boards took "strikingly few disciplinary actions" for physician misconduct.[12] There have been a number of cases involving patient deaths where physicians only had their licenses removed years after multiple wrongful patient deaths had happened.[12] [13]

Also, it has been said that because hospitals have had more legal burden placed on them in recent decades, they have more of an incentive to require that their physicians be competent. Thus, the process whereby physicians are reviewed and licensed by the State medical board results in some duplicate evaluations. The physician is evaluated both in the licensure process and then again by the hospital for the purpose of credentialing and granting hospital privileges.[14] State medical boards have increased the number of disciplinary actions against physicians since the 1980s.[15]

References

  1. ^ "Archived copy". Archived from the original on 2017-03-21. Retrieved 2017-03-15. retrieved 15/03/2017
  2. ^ "中华人民共和国执业医师法". www.gov.cn. Archived from the original on 25 September 2017. Retrieved 24 April 2018.
  3. ^ "Archived copy". Archived from the original on 2014-05-28. Retrieved 2014-05-27.
  4. ^ "Approbationsordnung für Ärzte (Licensing regulation for physicians)". www.gesetze-im-internet.de (in German). Archived from the original on 20 February 2017. Retrieved 19 February 2017.
  5. ^ "General information about registration and licensing". General Medical Council. Archived from the original on 24 April 2018. Retrieved 29 October 2017.
  6. ^ "The licence to practise". www.gmc-uk.org. Archived from the original on 2018-04-24. Retrieved 2018-01-04.
  7. ^ "List of Registered Medical Practitioners". www.gmc-uk.org. Archived from the original on 2018-04-24. Retrieved 2018-01-04.
  8. ^ "ECFMG 2009 Information Booklet - ECFMG Certification". Ecfmg.org. Archived from the original on October 13, 2008. Retrieved 2008-11-08.
  9. ^ Hamowy, R. (1979). "The early development of medical licensing laws in the United States, 1875-1900". The Journal of Libertarian Studies. 3 (1): 73–119. ISSN 0363-2873. PMID 11614768.
  10. ^ Camenisch, Paul F. (NaN). "On the matter of good moral character". The Linacre Quarterly. 45 (3): 273–283. ISSN 0024-3639. PMID 11661606. Check date values in: |date= (help)
  11. ^ Campbell–Page, R. M., Tepper, J., Klei, A. G., Hodges, B., Alsuwaidan, M., Bayoumy, D. H., … Cole, D. C. (2013). Foreign–trained medical professionals: Wanted or not?A case study of Canada. Journal of Global Health, 3(2), 020304. http://doi.org/10.7189/jogh.03.020304
  12. ^ a b "Thousands of doctors practicing despite errors, misconduct". USA TODAY. Archived from the original on 2017-09-09. Retrieved 2018-01-04.
  13. ^ "Archived copy". Archived from the original on 2015-07-22. Retrieved 2015-07-18.
  14. ^ "Does Physician Licensing Serve a Useful Purpose? | Shirley V. Svorny". The Independent Institute. Archived from the original on 2018-01-04. Retrieved 2018-01-04.
  15. ^ Feinstein, Richard Jay (21 March 1985). "The ethics of professional regulation". New England Journal of Medicine. 312 (12): 801–804. doi:10.1056/NEJM198503213121231.

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