Foreign-Trained Docs Eyed To Plug Workforce Gaps

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BOSTON (State House News Service) - As the health care workforce shortage causes continued difficulties in meeting patient needs, an advocacy group is renewing calls to allow internationally-trained physicians to practice in Massachusetts.

Sen. Jason Lewis of Winchester and Reps. Jack Patrick Lewis of Framingham and Mindy Domb of Amherst filed legislation with the Massachusetts Immigrant and Refugee Advocacy Coalition to "ease pathways" for those who were trained outside the U.S. to continue practicing medicine after they've immigrated, without having to go back to school through a traditional American medical school program.

The petition (SD 1823 / HD 3112) would allow these doctors who have been licensed or authorized to practice outside of the U.S. to be issued a one-year limited license under the mentorship of a federally-qualified or other community health center or hospital.

The legislation also focuses on expanding care into underserved areas of Massachusetts, especially in central and western Massachusetts.

"Here in Massachusetts, unfortunately, we have areas where individuals don't have access to the kind of primary care and other medical services that they need," said Elizabeth Sweet, executive director of the MIRA Coalition. "In Suffolk County, there are 670 patients for every one physician. But in counties such as Bristol, Franklin and Plymouth there are well over a thousand -- over 1,480 patients for every one physician."

Challenges in accessing health care have grown over the past few years, as the COVID-19 pandemic has strained the industry, Sweet said.

In 2021, 33.9 percent of Bay Staters reported challenges obtaining "necessary health care," an increase of 1.5 points over the rate two years earlier, according to the Center for Health Information and Analysis' primary care dashboard.

The CHIA dashboard also shows that fewer medical professionals are offering primary care in the state than before the pandemic. In 2018, about 30.4 percent of Massachusetts physicians practiced in primary care, and that rate dipped to 29.8 percent in 2019 and 2020. Meanwhile, the rate of physicians who left primary care in Massachusetts grew from 3 percent in 2018 to 3.6 percent in 2020 -- in both cases higher than the national rate.

"Creating these pathways for individuals to go through a process of mentorship with a limited credential to serve those in underserved areas gives them the opportunity to practice their profession and also ensures that more Massachusetts residents have the kind of medical care that everyone should have access to," Sweet said.

The new legislation was modeled using recommendations made last summer by the state's Special Commission on Foreign Trained Medical Professionals.

The commission's report recommended creating a pathway that included one to two years of mentored limited licensure, followed by two to four years of a license restricted to practice in an underserved region as a primary care physician, psychiatrist, or other specialist impacted by the shortage, resulting in eligibility for a full, unrestricted license.

The pathway to full licensure is only one of the 13 recommendations the commission made to fill the Bay State's health care gaps with foreign-trained physicians.

In the near term, they suggested health profession boards revise and reorganize licensing information available online to be more clear, and that health profession board staff receive culturally appropriate training to better support professionals trained in other countries.

Other medium- to long-term recommendations included eliminating redundant English proficiency testing and replacing it with other testing options; re-establishing two years of postgraduate residency training, rather than three, for full licensure eligibility of international medicine graduates; establishing a state-supported program for these doctors to do residency training; and creating a revolving loan program that would provide interest-free loans for the licensure process and related costs.

Though the bill focuses on the recommendation to create a pathway for full licensure through a mentored limited licensure, Sweet said this legislation is the "first step" in implementing the recommendations made by the commission.

Written By Sam Drysdale/SHNS

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