QUESTION:
Like the rest of the country, we are struggling to recruit physicians to our community.  As we expand our efforts, we are seeing more candidates who trained outside the United States.  If they are certified by a foreign board, how should we approach their applications?

ANSWER FROM HORTYSPRINGER ATTORNEY IAN DONALDSON:
Outside of the occasional recognition of the Royal College of Physicians and Surgeons, most Medical Staff Bylaws we see require certification by an American board.  That means applicants with foreign board certification are ineligible for appointment unless a waiver is granted.

This can be a dicey proposition, since waivers generally require a showing of “exceptional” circumstances.  Whether an applicant can demonstrate such circumstances is in the eye of the beholder, so giving your Credentials Committee a set of guidelines for determining waivers related to foreign board certification can help it evaluate candidates in a consistent manner.  We recommend these guidelines walk the Committee through key factors like:  (1) are the foreign board’s certification requirements comparable to certification by an American board, (2) what constitutes “exceptional circumstances” under these circumstances (i.e., is certification by an American board not realistically available to the applicant due to the applicable board’s pathway rules for internationally trained physicians or does the applicant simply prefer not to pursue them), and (3) what information should an applicant who is requesting a waiver provide (e.g., a description of the foreign board’s certification requirements, documentation addressing pathway availability (e.g., relevant ABMS board policy excerpts and/or correspondence confirming eligibility/ineligibility), etc.).

Developing guidelines to address this issue will provide your Credentials Committee with a structured process to review these types of requests, which are likely to become more and more common in the future.

If you have a quick question about this, e-mail us at info@hortyspringer.com.