By Valerie Davis Benton
Dr. Gary Swartzentruber is a second-year family medicine resident at the Southwest Georgia Family Medicine Residency Program at Phoebe Putney Memorial Hospital. Like most residents, he is eager to begin his career as a physician immediately after completing his training.
Swartzentruber is also an international medical graduate. When applying to U.S. medical schools, which are highly competitive and have a limited number of openings, he did not make the cut.
Until February, the international medical school grad ran up against some hurdles that would delay the issuance of his medical license in Georgia.
He discovered that graduates of approved medical schools in the United States and Canada could apply for their license after completing 12 months of post-graduate medical training. That was not the case for Swartzentruber and others like him.
As an international medical graduate, he would have to complete 36 months of post-graduate training before he could begin the application for his medical license and securing provider numbers from insurance companies, including Medicare and Medicaid – a process that can take up to seven months.
The process, which includes applying for a Drug Enforcement Administration (DEA) number and a National Provider Identification Number, would have to be completed before he could begin earning wages as a licensed physician.
In the meantime, Swartzentruber has been offered a job on the medical staff at the Kirk Clinic at Colquitt Regional Medical Center in Moultrie, starting Aug. 1, 2011.
Thanks to recent changes made by the Georgia Composite Medical Board, Swartzentruber no longer faces delays in starting his career.
With the help of healthcare leaders in the state, Swartzentruber is now among the first international medical graduates (IMGs) in Georgia to be licensed under a new definition adopted by the state Board.
The Georgia Composite Medical Board has oversight for licensing qualified applicants as physicians, physician assistants, physician residents in training, perfusionists, respiratory care professionals, acupuncturists, orthotists, prosthetists and auricular detoxification technicians.
Robert Jeffrey, director of operations with the Georgia Composite Medical Board, said the delays in licensing IMGs occur in part from the longer length of time it takes medical schools abroad to send transcripts.
But the biggest stumbling block, Jeffrey says, involves determining which medical schools should be on the approved ACGME list.
To eliminate that barrier for many International medical grads, the Composite Board voted in February to broaden its definition for licensing international medical grads. The Board decided to use of a list of approved medical schools recognized by the Medical Board of California – a list that includes approved international medical schools.
Jeffrey explained that California had the resources to make site evaluations and, therefore, expand its list beyond the United States and Canada. By adopting the California list, the Composite Board was “attempting to make sure there was no gap,” he said.
Graduates of the schools on this list are required to complete one year of post-graduate training in a program accredited by the Accreditation Council for Graduate Medical Education. Graduates of schools not listed on the California list are still required to complete three years of post-grad training.
Jim Lowry, President/CEO at Colquitt Regional and vice chairman of the Georgia Physician Workforce Board of Directors, said the issue of delaying licensing international medical graduates has been the subject of ongoing discussions and the impact of the problem had escalated to the point of financially impacting recruiting hospitals in the state.
The Georgia Board for Physician Workforce is a state agency responsible for advising the governor and the General Assembly on physician workforce and medical education policy and issues. The 15-member Board works to identify the physician workforce needs of Georgia communities and to meet those needs through support and development of medical education programs.
The Physician Workforce Board recognized that the problem had begun costing hospitals a bundle to carry new physicians until they became licensed. For smaller rural hospitals experiencing a greater need for qualified physicians, the rule was creating a significant financial hardship.
Lowry said that during the four-to-five month waiting period, Colquitt Regional incurred between $25-40,000 in expenditures for a family physician and up to $100,000 for a specialist like an orthopedist.
One physician, who had practiced medicine at the former Sumter Regional Medical Center for 12 years, had to wait five months for a new billing number to be able to practice medicine at Colquitt Regional. Adding insult to injury, Lowry said, the physician was unable to bill for retroactive patients.
Lowry explained that a person who graduates from medical school with high honors has a value of $0 without a provider ID number because they are unable to bill for physician’s services. “To earn money, you have to have billing numbers,” he said.
“There’s a huge primary care need,” Swartzentruber said. “Why shoot yourself in the foot? Let’s make it easier for these people who stay in the state.”
Swartzentruber, who is a member of the Georgia Academy of Family Physicians and has an interest in health policy and legislation, said he played a small role in getting the definition changed.
Because of his efforts to bring the matter into the light, Swartzentruber is among the first five international medical graduates to be licensed in Georgia under the broader definition of approved schools, said Jeffrey.
“I’m very honored to be licensed under the new guidelines,” said Swartzentruber, who received his medical license March 4. He plans to graduate on June 30, 2011 from the Southwest Georgia Family Medicine Residency Program.
“Now that’s done, I don’t have to wait,” Swartzentruber said. “We can hit the ground running the day after we graduate from residency.”
CAPTION: Gary Swartzentruber, M.D., a family medicine resident with the Southwest Georgia Family Medicine Residency, (left) is presented his license by the Residency Program Director George Fredrick, M.D. Swartzentruber was among the first students to be licensed in Georgia under the new state definition for licensing international medical school graduates.