Minnesota's 10 guidelines to integrate foreign-trained physicians

An estimated 250 to 400 unlicensed foreign-trained physicians live in Minnesota, according to a Minnesota Department of Health report.

MDH commissioned an advisory task force to develop strategies for integrating the state’s refugee, asylee and other immigrant physicians. The task force reported only 14 percent of the state's physician workforce are physicians of color. This is proportionate to the state’s population — 14.7 percent of the population is of color — but the 14 percent of physicians do not necessarily reflect the precise ethnic makeup of the population, according to the report.

Moreover, most foreign-trained physicians — 87 percent — are interested in working in healthcare in some capacity, which could help address provider shortages, increasing costs and health disparities for the aging, diversifying population. The task force recommended the following guidelines to better integrate this untapped group.

1. Establish a statewide council on immigrant physician integration to implement the following strategies with a focus on increasing the number of primary care physicians in rural and underserved areas of the state.
2. Expand the Foreign Trained Health Care Professionals program to provide foundational support and career guidance.
3. Standardize a process to assess foreign-trained physicians who have lived in the state for a minimum of two years.
4. Develop a certificate of clinical readiness to be awarded when foreign-trained physicians are ready for residency or apprenticeship.
5. Develop a clinical preparation program.
6. Establish dedicated residency programs for foreign-trained physicians. The task force recommended setting aside $2.25 million each year for 15 primary care residency positions.
7. Adjust the “recency” guidelines for residencies, which require physicians to be within a certain number of years from medical school graduation, to instead be recency from completing clinical readiness guidelines.
8. Create a four-year apprenticeship program with a five-year commitment to serving rural or underserved areas for highly skilled physicians with more than seven years of clinical experience. Upon completion, these physicians should be able to apply for a full medical license in the U.S., according to the task force.
9. Offer new licensing options, including limited license options under supervision.
10. Develop pathways to help foreign-trained professionals into non-physician programs. About 64 percent of foreign-trained physicians surveyed by the task force said they would be interested in other healthcare professions, such as physician assistant, nurse practitioner or nursing.

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