Can I go to the US and work as a doctor?

European English Medical Universities (EEMU)

ECFMG will certify students of Hungary and Italy

From 2020, California changes its accreditation policies, which subsequently affect WFME accreditation procedure

ECFMG (Educational Commission for Foreign Medical Graduates) has announced that effective in 2023, the eligibility for USMLE (United States Medical Licensing Examination) and employment as a medical doctor in the United States will be restricted to graduates from medical schools/programs accredited by an agency officially recognized by the WFME Recognition Program (*WFME – World Federation for Medical Education) or to an equivalent standard.

Therefore, it IS CRITICAL to verify the current status of accreditation and predict possible change in the status of European medical universities (*especially, European English Medical Universities, EEMU). For the majority of (future) medical students at EEMU, the US accreditation, as well as Californian accreditation more specifically, status is one of the most popular topics to discuss before their entry/graduation level. 

The following is the simplified flow of the international medical graduates (IMG), who pursuit their residency matching for a relevant teaching hospitals within the US.

  1. ECFMG certification
  2. USMLE application (*through ECFMG, for Step 1 and Step 2 CK and CS only)
  3. USMLE tests (*during and after graduation; must be completed within 7 years from the first exam)
  4. Residency Matching

In order to be “personally certified” by ECFMG, the individual IMG (*including the students from EEMU, including Germany, Hungary, and Italy) must attend/graduate from those “accredited” medial schools. From 2023 and on, this “accreditation” will be performed only by the official agencies that are endorsed by WFME (*later, ECFMG only certifies this applicant/IMG has successfully attended one of the accredited medical schools overseas.)

■ Countries with WFME-authorized agencies:

  1. United States of America
  2. Canada
  3. Aruba, Cayman Islands, Curacao, Dominica, Nevis, Saint Kitts, Sint Marteen
  4. Australia and New Zealand
  5. Korea
  6. Japan
  7. Turkey
  8. Kazakhstan
  9. Sudan
  10. Georgia
  11. Thailand
  12. Indonesia
  13. Netherlands and Flanders
  14. Mexico
  15. Egypt
  16. Brazil
  17. Taiwan
  18. Iran
  19. UAE

■ Countries currently “applying” but not yet finalized:

  1. Cameroon
  2. Morocco
  3. Tunisia
  4. Colombia
  5. Israel
  6. Cyprus
  7. Panama
  8. Venezuela
  9. Ireland
  10. Saudi Arabia
  11. Pakistan
  12. the Philippines
  13. China

From the countries listed above, we can figure out there are only Netherlands (and Flanders) and Irelands among the European countries. Rather, quite many of countries listed are from South Asia, Middle East, Africa, and South America. This, accordingly, may indicate the majority of European countries are either currently “under discussion” to adopt their EU-centered accreditation agencies soon to be endorsed by WFME or simply another “set of rules” to govern the accreditation procedure/status of European Union.

Apparently, this kind of “estimation” seems to be more plausible, especially when considering “the majority of EEMU are already confirmed (*not accredited) by WDOMS, or World Directory of Medical Schools, and this will naturally qualify these medical schools for the new accreditation rules (*effective from Jan 2020) of Medical Board of California.

As of January 1, 2020, the Medical Board of California (MBC) shall determine a foreign medical school to be a recognized medical school if the foreign medical school meets any of the following requirements:

  1. The foreign medical school has been evaluated by the Educational Commission for Foreign Medical Graduates (ECFMG) or one of the ECFMG-authorized foreign medical school accreditation agencies (*mostly “governmental/national organizations) and deemed to meet the minimum requirements substantially equivalent to the requirements of medical schools accredited by the Liaison Committee on Medical Education, the Committee on Accreditation of Canadian Medical Schools, or the Commission on Osteopathic College Accreditation.
  2. The foreign medical school is listed on the World Federation for Medical Education (WFME) and the Foundation for Advancement of International Medical Education and Research (FAIMER) World Directory of Medical Schools (WDOMS) joint directory or the World Directory of Medical Schools.

Naturally, the majority of EEMU will satisfy these requirements and should qualify for recognition in January 2020, at least for the state of California. Once they are “newly accredited by California,” quite a few of the other states will follow this accreditation policy/status within upcoming years as seen from the previous pathways.

Specifically speaking, the (English) medical universities of France, Germany, Hungary, and Italy are “currently certified and registered” on WDOMS as below.

WDOMS-France-2019
WDOMS-Germany-2019
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Once approved and recognized, all current and future students of those listed EEMU will possibly qualify for clinical rotations, residencies and licensure in California, which is one of the most popular “American (*rare) opportunities” with its clinical centers with multiple (future) affiliations offering a full complement of core and elective rotations.

Another important fact is “UNTIL NOW,” the (future) graduates from EEMU must complete 10 years of practice outside of California to qualify for licensure. However, this regulation will also be repealed in 2020 from the state of California. As a result, our understanding is that there will no longer be a waiting period imposed for licensure, allowing those “resident doctors” coming from EEMU (*be it they are European nationals or not) to have faster and more chances to legally qualify for the medical license of California.

Once “accredited by California,” there is supposed to be little or less chance for the EEMU to disqualify from WFME-authorized “agency accreditation qualification,” subsequently. Of course, this remains valid only if these EEMU still successfully maintain their curriculums, clinical practice opportunities, and non-discrimination policy at the level of entry/graduation, not to mention their “teaching quality” as accredited medical schools. However, it is highly unlikely that (any of) the EEMU will lose their currently well-established medical education (*we call this as MEDUCATION) quality.

As a result, apart from the “current/old” accreditation status of the ENGLISH medical schools in Hungary and Italy, this NEW Californian accreditation will possibly allow these EEMU to practically approach the nation-wide accreditation within the US (and Canada).

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Applying for USMLE with Accreditation and Certification is one thing.

Residency matching is ANOTHER.

In practice, the success rate of Residency Matching for IMG is known/assumed around 8% for the entire “spots.”

■ Number of operational medical schools worldwide

  • Africa – 154
  • Americas – 825
  • Europe – 587
  • Mediterranean – 354
  • South East Asia – 590
  • Western Pacific – 408

updated August 2017 from www.wdoms.org

■ Countries with the most operational medical schools

  1. India – 392
  2. Brazil – 242
  3. USA – 184
  4. China – 158
  5. Pakistan – 96
  6. Mexico – 92
  7. Japan – 80
  8. Russian Federation – 78
  9. Indonesia – 74
  10. Turkey – 73

updated August 2017 from www.wdoms.org

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