Licensure of Foreign Medical Graduates: An Historical Perspective

Abstract

Today, one out of five practicing physicians in the U.S. is a graduate of a foreign medical school. The sixfold growth in their number over the past two decades results from national policy; but the place and conditions of practice have been controlled by state governments. The several states have used their jurisdiction over licensure in ways that have often been unfair and irrational. Recent trends toward uniform standards, however, may lead to more equitable assurance of professional competence, and to interstate mobility related to local and national needs.

Primary-Care Physicians' Affective Orientation toward Their Patients

“…Nonetheless, we anticipate that physicians trained in this country will be more likely to define patients in negative terms than their foreign-educated counterparts. We base this hypothesis on the argument that FMGs are less thoroughly trained in the medical sciences and are less familiar with the nuances of American social life (Butter and Sweet, 1977).…”

When “citizenship is indispensable to the practice of a profession”: Citizenship Requirements for Entry to Practise Professions in Canada

“…7 The foreign-born could practice if they had trained provincially, in which case they would have been eligible for naturalization. 8 While Butter and Sweet (1977) argue that many citizenship barriers were erected in the US during the Depression, this appears to be the case only in Nova Scotia. In Quebec most such requirements emerged in the post-WWII era.…”

“…When barriers are placed in regulatory legislation, it is because state actors are willing to accede to professional demands. Although there have been few previous studies of citizenship restrictions for entry to practise professions, both Butter and Sweet () and Fette () document efforts by some professional groups to erect citizenship barriers in the 1930s in response to the economic crisis, in the US and France respectively. In contrast, state‐centred approaches suggest that state actors implement citizenship requirements to facilitate social governance.…”

“…While Butter and Sweet () argue that many citizenship barriers were erected in the US during the Depression, this appears to be the case only in Nova Scotia. In Quebec most such requirements emerged in the post‐WWII era.…”