How to work as a surgeon at a clinic without residency training in the US

[bestpacifist]

Hello, everyone. Thank you for reading my thread.

I'm an aesthetic plastic surgeon working in Tokyo in Japan. I belong to a huge company that has more than 50 aesthetic clinics and some hospitals in Japan and the company is going to expand to the US. The company is first going to open a clinic in Beverly Hills in California. And I will need to work as a surgeon at the clinic in Beverly Hills (most likely in other states too in the future when my company opens clinics in other states).
I've passed USMLE until step3 but haven't done any residency. In most states, 1 to 3 year-accredited residency training is required (2 years in CA) but I would like to start working without residency training, if possible. I don't have high scores of USMLE and I'm in 7th year from graduation, so it is almost impossible to get a surgery residency.

I've heard it's possible to work as an "assistant physician" under supervision by a collaborator (attending) in Missouri (and NY?).
I think there should be some ways and there must have been some doctors like me before.

In summary, my questions are:

1. Is there any way to get a license and work as a surgeon at the clinic in CA or other states without residency training.
2. If I do a residency of other speciality (e.g. Family Medicine) for only 1 to 2 years, can I get a license?
3. I would like to know more about NY's law.

I would very much appreciate if you gave me advice. Any advice or information is appreciated.
Thank you.

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[NotAProgDirector]

1. No
2. Mostly no. Most states require that IMG's have 3 years of GME training. There are a few that require less. Cali requires 2. The entire list is here: https://www.fsmb.org/licensure/usmle-step-3/state_specific
3. Not sure what law you're talking about. Missouri is the only state that has passed an "assistant physician" law. To my knowledge, it hasn't been done in NY. It's still being worked out, no one has been licensed this way yet. Even if you found a way to do this, it doesn't give you the GME experience you would need for a license in another state (although perhaps in the future they might consider such experience equivalent, but I wouldn't count on it).

Bottom line: There is no pathway that you are describing, unless the Missouri process gets started and you can make that work. And that won't work for you, because it only allows assistant physicians in primary care in underserved parts of the state. Also you should know that legally you'll be held to the same standard as a US trained plastic surgeon. Without training, you may not be able to get medical malpractice insurance. Not sure how things work in Japan, but here in the US if you perform an aesthetic procedure on a patient and it doesn't go according to plan, you can get sued for millions of dollars.

 

[bestpacifist]

Thank you so much for your reply. I appreciate.
In terms of question 2, it seems to be possible to get a license and operate a surgery after doing other speciality for required years.
Thank you.

 

[NotAProgDirector]

No. No hospital will give you surgical privileges without completing a US residency. Theoretically, they could (i.e. there's no law against it). Realistically, it won't happen.

 

[ElCucuy]

From what I understand, with private practice cosmetic surgery all you need is a valid medical license in the US to operate legally.

So yes, you can get 2-3 years of necessary post graduate training to qualify under the states requirements and then practice legally. In real life, this is unfeasible and extremely unusual circumstance for anyone since hospitals will not credential you for said atheistic procedures and malpractice insurance will not likely cover your group. Not to even mention ones ability to perform.

With that said, your situation might be the perfect storm to expose the legal minimums to practice aesthetics in the US. If all is done properly, your practice may be able to work independently with an insurance company and they may be willing to work something out with you.


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[Medstart108]

No. No hospital will give you surgical privileges without completing a US residency. Theoretically, they could (i.e. there's no law against it). Realistically, it won't happen.

Or Canadian residency assuming it is considered equivalent by the specialty board or accepted by the state medical board as equivalent.