Dr. Wright is a family physician and assistant professor of family and commu- nity medicine who supervises residents and directs the UT Southwestern Medi- cal Center’s family medicine clerkship program at Austin’s University Medical Center Brackenridge Hospital. “Students are amazed when they come to my clinic and see all that we do,” he says. “It’s our obligation to expose students to primary care and give them a chance to explore, but we have to get them out of the ter- tiary care setting to do that.”
Walking a fine line At the same time, residency program leaders caution against the pitfall of pushing students into the wrong field for the wrong reasons and say school advi- sors should be attuned to ferreting out those students who are not sincere about pursuing a particular field.
“I hope that students will be inspired to want to be family physicians when they work with me, but it’s not my job to turn all students into family medicine doctors,” said Rodney B. Young, MD, chair of the Department of Family and Community Medicine at TTUHSC in Am- arillo. “As educators, it’s our role to help them find their passion within medicine, where they can have the greatest impact for their patients.” Dr. Berk also acknowledges schools must walk a fine line between maximiz- ing students’ potential for a particular career in medicine and squashing their dreams.
Having walked that tightrope, Dr. Novo says he would have rather had a safety net. “Schools are doing what they can,” he said, but students also have to prepare themselves.
When a former classmate called him for advice about not matching right away, “I told him the conclusion I ar- rived at myself: ‘You are not a failure. It’s a failure of the system.’ Too many medical schools and not enough GME spots does not mean you are a failure. But there are always spots left open,” Dr. Novo said. “If you make it, fantastic. But just in case the worst happens, have a plan B ready that you came up with when you were in a normal mental and emotional state. And be realistic.”
ing series within a maximum period of seven years; and
TMA supports testing limits as part of licensing requirements
The Texas Medical Association House of Delegates (HOD) adopted new policy at TexMed 2014 that supports testing limits as a part of Texas medical licens- ing requirements. The action capped off months of research and deliberation by TMA’s Council on Medical Education on whether TMA should take a position on this issue at all and, if it did, what those limits should be. (See “Testing the Limits,” February 2014 Texas Medicine, pages 27–31.)
Each legislative session, state law-
makers ask TMA for guidance to formu- late their position on bills that often seek to increase or even completely waive testing limits. Until now, however, TMA did not have policy on the matter. Texas law currently sets limits at
three attempts per test and at seven years for completion of the testing series, with some exceptions. TMA’s new policy generally supports
retention of those core limits and estab- lishes three standards:
1. A maximum of three attempts per step or step component and a maxi- mum of seven years for completing the full testing series;
2. In recognition of special circumstanc- es that can adversely impact a physi- cian’s test-taking abilities, support for an exception to the testing attempt limits in cases where a physician has been licensed in another state and in good standing for at least five years, who also has current board certifica- tion by a member board of the Ameri- can Board of Medical Specialties or an osteopathic board approved by the American Osteopathic Associa- tion; and when the physician has also passed the full U.S. Medical Licens- ing Examination or Comprehensive Osteopathic Medical Licensing Ex- amination of the United States test-
Missouri licenses doctors who didn’t finish residency
On July 10, Missouri adopted a new li- censing category — assistant physician — for physicians who have not complet- ed residency training. Typically, physi- cians must complete at least one year of residency to be eligible for a medical license.
The new Missouri law allows a physi- cian who graduated from medical school, passed U.S. Medical Licensing Exam steps 1 and 2 or the osteopathic equiva- lent (passage of Step 3 is not required), and didn’t complete residency training to practice in primary care in an under- served area.
The new license has time limitations.
For instance, the physician must have graduated from medical school no more
September 2014 TEXAS MEDICINE 51
3. Bearing in mind TMA’s vision of “im- proving the health of all Texans,” TMA doesn’t endorse a lower medi- cal licensing standard for medically underserved areas.
In formulating its opinion, the Coun-
cil on Medical Education took into ac- count limits adopted in other states as well as relevant Federation of State Med- ical Boards policies. In its report to the HOD, the council concluded, “There are several factors that support maintaining the current core testing standards, in- cluding exceptionally high passage rates on the first try, the opinions of medical educators, the need to ensure a fair and equitable licensing process, and most importantly, a licensing process that ensures equal access to safe and quality medical care across Texas.” The HOD heard no dissenting testi- mony on the council’s policy proposal. The new policy is effective immediately, and TMA leaders expect it to be useful during the 2015 state legislative session.
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