Most people don't realize it, but becoming licensed as a doctor in a foreign country isn't as simple as showing your diploma. I'll speak specifically about veterinary medicine in the US, but I'm sure the principles are applicable to most licensing. The reason for this topic? An email I received over a week ago from Trisha:
I just read your response to the following question on your blog (from April 13, 2009). My husband is ACVIM board certified in internal medicine. He did a residency in Ames, Iowa after receiving his veterinarian degree in France. From what I understand, even though he's board certified, he would still have to go through the ECFVG program in order to work in the U.S. Is this information correct? Can you provide any information of a way he might be able work in the U.S. (besides in a University setting) as an internal medicine veternarian without the ECFVG program?
For those not in the know, Trisha is talking about the Educational Commission for Foreign Veterinary Graduates, a group established by the American Veterinary Medical Association to oversee the licensing of veterinarians in the US who obtained their degree outside of America. The process is complicated and expensive and requires a lot of steps (outlined here). But there is no way to legally practice veterinary medicine in the US without jumping through all of these hoops.
Why? As much as it may sound bad to say, not all veterinary colleges in the world give equivalent training. Some have less focus in companion animal medicine than others, and some just don't have the resources or quality of education you'll find in many first-world, industrialized countries. To ensure that all US veterinarians have a comparable training, there are standards that graduates of other veterinary colleges around the world must meet in order to practice here.
Now the confusion may come in that board certification in a specialty area of medicine (such as the American College of Veterinary Internal Medicine that Trisha mentioned). These specialties are given by boards and groups not directly under the AVMA, and are somewhat outside of standard licensing rules. You can be a practicing veterinarian without a specialization (such as I am), but there are ways to enter in to a given area of specialty such as surgery, dermatology, cardiology, and so on.
What is interesting is that the ACVIM regulations specify that the applicants must be legally licensed to practice veterinary medicine, but does not require this licensing to be in the US. So as best as I can tell you can receive certification by the ACVIM without being able to go and practice in the US. ACVIM accreditation and a license to practice are handled differently and through different organizations and regulatory agencies. Universities and government regulatory agencies have ways to have foreign-licensed vets who can work there but not go into private practice. If anyone knows differently, please feel free to correct me as I've never been through the process myself. And what complicates the situation further, is a vet must obtain a different license in each state! There is no license that will allow a vet (or other medical professional) to automatically practice anywhere in the country. As I've moved around, I've had to obtain a new license in each state (I've held them in six states so far), and each one has different requirements.
So Trisha, your husband will have to go through the ECFVG program if he wants to go outside of a university and work for a privately-owned specialty practice. Good luck!