license without board certificate

it seems when you say board exams you mean the USMLE, I'm taking about the orthopedic board exams. which is a good point to raise. Suppose the USMLE suddenly says no one except US graduates can take the USMLE!!! you'll have graduates denied the right to enter the competition for "Evaluation" just because they graduated overseas. Wouldn't that be wrong??
Well, the american orthopedic board does the same thing.

you did have a path to board certification by the ABOS. it is quite easy to comprehend really...go to an approved program, complete the residency, pass part 1, start practice, pass part 2...then bingo, you are board certified. the rules didn't all of a sudden change during your lifetime. it's not our fault that you didn't research all of this before starting your training abroad. if you really wanted to be in academics in the US and it meant that much to you, then you would have figured out a way to get into a residency here.

what you're talking about is the conventional pathway. I'm talking about an alternate pathway which the ABOS does have (and this mean they acknowledge the problem) however their requirements are not doable. I'm not asking to sit for all parts of the exams just because I think I'm a good surgeon. What I'm saying is give a chance for those who are fellowship trained in USA (2 years or so) to sit for part 1 only. that way they can merge with the original pathway and not allowed to take part II except after practicing for 5 years as board eligible. Does that make sense?? do you know that current regulations prevents people from sitting for part 1 even if they have 10 years of ACGME accredited fellowships. Don't you think that's irrational!!

Just like the USMLE, if we follow your rhetoric (which is blaming me for not knowing the requirements of the board) then the USMLE should ask all foreign graduates to start med school allover again and not sit for their exams just as ABOS is asking to repeat residency. Whether you admit it or not, there's a shortage in orthopedic surgeons and if having a license guarantees equal employment opportunities, I wouldn't bother about the boards that much.

Finally, even if I don't mind repeating a residency, program directors completely ignore international graduates and I have insider information from many programs that the applications are not even read so that's not fair either.
I know life is not fair but I simply hate to see people protecting wrong regulations. I wouldn't be surprised to see some law suits against the board. I know I will sew them when the time is right!

Your point about comparing to USMLE is really well taken.(Nice analogy)
I agree with you because I am on the same boat. Some guys never put themselves in other's shoes. Well you can find the truth in this article in JBJS:


" Conclusions: Our findings suggest that on a comparative basis, orthopaedic surgery lags behind general surgery and other surgical and nonsurgical fields in terms of the representation of minorities and women. Thus, given similar capabilities and qualifications of applicants, a concerted effort could be made to recruit more diverse residents and faculty."

Charles S. Day, Daniel E. Lage, and Christine S. Ahn
Diversity Based on Race, Ethnicity, and Sex Between Academic Orthopaedic Surgery and Other Specialties: A Comparative Study
J. Bone Joint Surg. Am., Oct 2010; 92: 2328 - 2335.

www.ejbjs.org/cgi/content/abstra ... type=HWCIT

How about I tell you that in Radiology they let you to sit for the radiology board exam after completing 3 radiology fellowships.(NOT in ORTHO)
How about I tell you, I am doing a clinical ACGME accredited fellowship and when I applied for the AAOS membership, they told me you have to pay the whole amount of due(not the fellow's due), because you are an international graduate. That's a true story happened to me this year. I was shocked and asked the are you serious? I am an official legal clinical fellow, how come you are................
Whatever, I believe there is always light at the end of the tunnel
I wanna thank you to bring this point into attention of everybody.

Thanks for sharing this. Yes I know about the radiology board which makes sense.

The orthopedic board is a private lobby of surgeons that care about nothing but protecting their interests. Unfortunately they gained power over the years to monopolize the right to say who is a good surgeon and who's not. Thus reducing the job opportunities for international graduates.

I know they want to keep a high standard but I think if they simply approve three years of fellowships as equivalent to repeating the residency that would be fair. A Fellowship is a more advanced and surgically oriented training so how come they don't approve it??!!

The question is, since their position negatively affects the job opportunities for international surgeons who are licensed by ECFMG as well as their state board, would it be legally sound to sue them for that?? I hope someone with experience shares his opinion with us.

It may be unfortunate for IMGs that it is harder to obtain residency positions, fellowships, board certifications, jobs, etc in the US, but it isn't wrong. Trying to obtain any kind of employment in another country can be met by similar circumstances. Many countries require that there be no current citizens of that country providing a certain service before they allow a non-citizen to come and provide a service in their country. This is not much different. Program directors, fellowship directors and specialty boards should have an interest in offering positions to those who have invested time and/or money into their education and training within this country. If there truly is a shortage of ortho surgeons then residency programs should be given approval to expand their quotas and match more applicants through the NRMP (the same path everyone else takes to eventually get board certified). Just because radiology is doing it doesn't mean that everyone else should. Furthermore, three fellowships in radiology is just one year shy of the full R1-4 radiology residency anyways...