February 21, 2014

Foreign doctors retrain to become U.S. nurse practitioners

Daily Briefing

Florida International University (FIU) in Miami is helping many foreign-educated doctors living in the United States retrain as nurse practitioners (NPs), adding more expertise and diversity to the health care workforce, National Journal's Sophie Quinton reports.

Why doctors don't like their jobs—and why NPs do

Could foreign docs fill the physician shortage?

Federal statistics suggest that the United States in 2025 will encounter a shortage of 20,400 primary care physicians. At the same time, the Association of American Medical Colleges anticipates a shortfall of surgeons and other specialists. Currently, medical schools and residency programs are unable to train enough new physicians to meet growing demand.

However, there are thousands of foreign-trained physicians living in the United States who are able to fill the gap, Quinton writes. Between 5,000 and 12,000 foreign-trained physicians who have passed their licensing exams apply for residency positions each year—but only half succeed. (By comparison, over 90% of U.S. medical school seniors who apply are accepted, according to the National Resident Matching Program.)

Foreign physicians who do obtain a residency typically go on to treat minority populations. According to a 2009 CDC study, graduates of international medical schools are more likely to treat minority patients, foreign-born patients, individuals who speak little English and Medicaid beneficiaries.

At the same time, demand for NPs and other non-physician providers, like physician assistants (PAs), is growing, particular those who speak more than one language. If highly trained NPs and PAs were to shoulder more primary care responsibilities, the physician shortage could be reduced by more than two-thirds, according to the Health Resources and Services Administration.

Details of FIU program

For the thousands of foreign doctors who do not secure a residency position, FIU offers an alternative route: accelerated programs leading to a bachelors or masters of science in nursing which train foreign-trained doctors to be NPs.

The program is tailored to international physicians—lasting four years instead of the typical six—by moving quickly through undergraduate material. English learners receive help with reading and writing essays, and courses are held either at night or compressed to one day a week to accommodate the schedules of working students.

For the past few years, the program has boasted a nearly 100% graduation rate and attracted foreign-trained physicians from around the country. "They choose to come here because they know that there are other people in same situation," says program director Maria Olenick.

And while some foreign doctors are reluctant to enter the field of nursing, those feelings generally fade with time. Olenick says that students generally "enjoy the role of [NP] in the United States, because it's more like the way they practiced in their home countries."

However, Carlos Arias, COO of Access Healthcare, says it's not always easy for graduates of the accelerated degree program to find a position they want. Often, they are offered entry-level positions with low salaries, despite their extensive medical knowledge.

Doctor-turned-patient: I 'never before understood how much' nurses matter

Olenick notes that many students do not enter the workforce right away. Of the 55 graduates in FIU's first class of NPs, 12 returned to school to enroll in a doctoral program. "We're looking now at making the program a BSN to DNP program, because we have so many that are interested," she says (Quinton, National Journal, 2/20).

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