Practicing in the US without US residency

[Keratocyte]

I am just about to complete my ophthalmology residency in the UK but have not completed a fellowship yet. I also have a PhD.

I am about to get married to an American, who is well established in his career in the USA. So, I have to re-locate to the US forever.

I realise I have to complete all USMLE exams in order to practice. That is not a problem.

However, is there any route to board certification without going through residency again? I know how competitive ophthalmology residency is. But I also feel it is not necessary to go through residency again. I would like to do a 2 year fellowship in the US which should make me eligible for licensure in the state I will live in but I would still not be eligible to write the board exams which means my employment prospects are low.

I have been told several times that I am a good surgeon and physician and I love my job. I dread giving up my career even though my partner does not expect me to work.

Does anyone know of people in a similar situation who have succeeded in finding work as an ophthalmologist. I don't mind working n the academic sector but do not know how to find these jobs and also do not know if these jobs require board certification. Also, I do not know if I will be allowed to operate if I am not board certified. I cannot bear the thought of throwing away my surgical skills.

Any advice or info is appreciated.

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[MDEYES]

I am just about to complete my ophthalmology residency in the UK but have not completed a fellowship yet. I also have a PhD.

I am about to get married to an American, who is well established in his career in the USA. So, I have to re-locate to the US forever.

I realise I have to complete all USMLE exams in order to practice. That is not a problem.

However, is there any route to board certification without going through residency again? I know how competitive ophthalmology residency is. But I also feel it is not necessary to go through residency again. I would like to do a 2 year fellowship in the US which should make me eligible for licensure in the state I will live in but I would still not be eligible to write the board exams which means my employment prospects are low.

I have been told several times that I am a good surgeon and physician and I love my job. I dread giving up my career even though my partner does not expect me to work.

Does anyone know of people in a similar situation who have succeeded in finding work as an ophthalmologist. I don't mind working n the academic sector but do not know how to find these jobs and also do not know if these jobs require board certification. Also, I do not know if I will be allowed to operate if I am not board certified. I cannot bear the thought of throwing away my surgical skills.

Any advice or info is appreciated.

Two options for you:

1. get an institutional license in an academic institution after you complete your fellowship (you will need to get the university to do the paperwork for you)

2. Finish fellowship and find a VA hospital that will hire you (don't know the details)

In both scenarios, you will only be able to work under the umbrella of those institutions.

 

[Keratocyte]

Thank you for your response.

I did not know that an institution could get a license for you, so I will look into that. I assume these are academic jobs limiting you to work in that institution alone?

What is a VA hospital ?

Apologise for my ignorance on these matters.

 

[Parinaud]

Thank you for your response.

I did not know that an institution could get a license for you, so I will look into that. I assume these are academic jobs limiting you to work in that institution alone?

What is a VA hospital ?

Apologise for my ignorance on these matters.

VA = Veterans Affairs. VA Hospitals provide health care for US Veterans.

 

[KHE]

VA = Veterans Affairs. VA Hospitals provide health care for US Veterans.

I grew up in Canada and it's been a few years since I became a citizen but my recollection is that working for the federal system like the VA or IHS was not an option unless you were a naturalized US citizen. Non citizens can not work for the federal government in most GS job type classifications. You need to check that out as well.

 

[eye4eye]

Hi 'keratocyte',
There was a guy some time ago named 'hncl'! He used to say that he was from UK etc! He was ECFMG certified though and he said that he had 260 plus in all steps! Why don't you ask him? You two are so similar that it is almost impossible to distinguish between you two!! Incredible!! I'm pretty sure he will be able to help you!! At that time he had 7 PGY 1 interviews, I'm pretty sure he had more than 20 at the end of the season!! He was such a decent, honest, & truthful guy!! He never said anything but truth!! I wonder why doesn't he come here anymore!! Or does he? Do you know?? I miss him!! Good luck

(PS: I really don't post here that frequently; but I am very much here!!)

 

[MR1]

I am pretty sure you can work at a VA if you have your visa and are sponsered by a university associated with the VA

I don't think though without a US residency and the ability to be BE\BC you can practice anywhere. Unless you find a university willing to give you a institutional license and the only time I have heard of this was for big time surgeons from other countries that force retirement at a certain age.

It sucks but I think you have to repeat your residency here. You won't be the first to do this

 

[cme2c]

You can practice in rural areas with a shortage without doing a U.S. Residency. Some of these areas have been looking for docs for years. Malpractice insurance is the biggest hurdle. The small local hospital will credential if they have had trouble getting docs.

 

[eye4eye]

I am curious to know about UK training! Please could you tell me a little bit more? Have you worked in retina clinic? How do they manage extruded buckles? How many bucke extrusions after RD surgery have you seen? Do they put the same buckle in, or get a new one? Do you feel buckle extruders are lousy surgeons? I am so passionate about retina! Will be grateful for your help! Please let me know if I could be of any help to you!? Thank you very much and good luck! Hope you get 260 plus in steps like 'hncl' and may all your dreams come true!
Yours sincerely
eye4eye

 

[Keratocyte]

You can practice in rural areas with a shortage without doing a U.S. Residency. Some of these areas have been looking for docs for years. Malpractice insurance is the biggest hurdle. The small local hospital will credential if they have had trouble getting docs.

Do you know of any such rural hospital, so I can contact them directly? Thanks.

 

[Keratocyte]

I grew up in Canada and it's been a few years since I became a citizen but my recollection is that working for the federal system like the VA or IHS was not an option unless you were a naturalized US citizen. Non citizens can not work for the federal government in most GS job type classifications. You need to check that out as well.

Citizenship will not be a problem, in due course, that is.

 

[Keratocyte]

Hi 'keratocyte',
There was a guy some time ago named 'hncl'! He used to say that he was from UK etc! He was ECFMG certified though and he said that he had 260 plus in all steps! Why don't you ask him? You two are so similar that it is almost impossible to distinguish between you two!! Incredible!! I'm pretty sure he will be able to help you!! At that time he had 7 PGY 1 interviews, I'm pretty sure he had more than 20 at the end of the season!! He was such a decent, honest, & truthful guy!! He never said anything but truth!! I wonder why doesn't he come here anymore!! Or does he? Do you know?? I miss him!! Good luck

(PS: I really don't post here that frequently; but I am very much here!!)

No I am not hncl. I am not committed enough to score 260 but will try for 250!! As for truth and honesty, I will save that for the spiritual forums. Thanks for disclosing your feelings on the matter.

 

[Keratocyte]

I am curious to know about UK training! Please could you tell me a little bit more? Have you worked in retina clinic? How do they manage extruded buckles? How many bucke extrusions after RD surgery have you seen? Do they put the same buckle in, or get a new one? Do you feel buckle extruders are lousy surgeons? I am so passionate about retina! Will be grateful for your help! Please let me know if I could be of any help to you!? Thank you very much and good luck! Hope you get 260 plus in steps like 'hncl' and may all your dreams come true!
Yours sincerely
eye4eye

Most buckle extrusions I have seen are long after surgery has been performed - usually many years- and even these are rare. They are usually just removed provided the retina is flat and there is evidence of retinal attachment. I don't think these cases are due to technical / surgical faults. There may be many reasons - location, size of buckle, material, patient related factors, etc.
Consider doing a fellowship in the UK - Travel is the best education I have had. The retinal fellowships over here are divided into medical retina and surgical retina. Bear in mind that the medical retina fellowships do not include training in any vitreoretinal surgical procedures. Good luck with your progress in retinal studies.

 

[eye4eye]

Of course you are not 'hncl'! But then again, I never said you are! Why people are so defensive out here? They take days to answer a simple question, and even that they don't comprehend properly! Match stress, I am sure! My best wishes to your husband; he is a lucky man to have an outstanding life partner like you! Wish you two everlasting happiness!
As for me I am single and unhappy! Some time ago, I fell in love with an English girl..sort of online romance! My mind was full with sweet nothings..and then 'she' actually turned out to be a 'he'..a bearded man from a far away land with multiple identity disorder!! He thought of himself as a woman! Sad and mad guy!! Not that I have anything against people looking like 'bearded man from far away lands', but even for an unassuming man like myself it was difficult to accept a bearded man to be a lady Diana look alike with any significant stretch of imagination!! I know nobody is perfect..but well...a bit on excessive side I suppose!! Sorry to have burdened your heart with my sad story...just match stress! Pardon me!! Good luck

 

[EyeGuy15]

As for me I am single and unhappy! Some time ago, I fell in love with an English girl..sort of online romance! My mind was full with sweet nothings..and then 'she' actually turned out to be a 'he'..a bearded man from a far away land with multiple identity disorder!! He thought of himself as a woman! Sad and mad guy!! Not that I have anything against people looking like 'bearded man from far away lands', but even for an unassuming man like myself it was difficult to accept a bearded man to be a lady Diana look alike with any significant stretch of imagination!! I know nobody is perfect..but well...a bit on excessive side I suppose!! Sorry to have burdened your heart with my sad story...just match stress! Pardon me!! Good luck

You definitely should have told this story at your interviews. You would have had all your programs rank you #1!!!!

 

[eye4eye]

You definitely should have told this story at your interviews. You would have had all your programs rank you #1!!!!

Thanks for the advice! But who are you? I was talking to a coy and genteel English girl! Do you believe that you are 'keratocyte' or what? Is there an epidemic of some sort of confused identity disorder going on these days??

 

[KHE]

Citizenship will not be a problem, in due course, that is.

Well citizenship takes years to obtain. It's not the same as a green card which takes a long time too, even if married to an American.

I'm not suggesting it can't be done... as I do not know for sure. It's just a further wrinkle in your situation beyond the whole IMG thing that you definately want to be aware of because you don't want that to bite you in the rear.

 

[Visionary]

Keratocyte-

Sorry you have to put up with posts from eye4eye. This poster is a disturbed individual who has been prowling our forums for the past few months. Pay him/her no mind. The rest of us are (mostly) sane.

As to your question, I agree with prior posters that your best bet is trying to join a university ophthalmology department. You can practice freely there without repeating a residency in the US. Since you have a PhD, that may make you more attractive to a university, especially if you're interested in doing some research and teaching.

Good luck!

 

[orbitsurgMD]

I am just about to complete my ophthalmology residency in the UK but have not completed a fellowship yet. I also have a PhD.

I am about to get married to an American, who is well established in his career in the USA. So, I have to re-locate to the US forever.

I realise I have to complete all USMLE exams in order to practice. That is not a problem.

However, is there any route to board certification without going through residency again? I know how competitive ophthalmology residency is. But I also feel it is not necessary to go through residency again. I would like to do a 2 year fellowship in the US which should make me eligible for licensure in the state I will live in but I would still not be eligible to write the board exams which means my employment prospects are low.

I have been told several times that I am a good surgeon and physician and I love my job. I dread giving up my career even though my partner does not expect me to work.

Does anyone know of people in a similar situation who have succeeded in finding work as an ophthalmologist. I don't mind working n the academic sector but do not know how to find these jobs and also do not know if these jobs require board certification. Also, I do not know if I will be allowed to operate if I am not board certified. I cannot bear the thought of throwing away my surgical skills.

Any advice or info is appreciated.

You might explore reciprocity with the Royal College of Physicians and Surgeons of Canada and see whether you could be eligible to sit the Canadian ophthalmology board examination with your UK training. Were that possible, there is in turn reciprocity between RCPSC and the American Board of Ophthalmology whereby you might be then considered qualified to sit the ABO examinations.

 

[studentjerry]

You cannot be board certified in the US without having completed a US residency. This regulation has been in effect for many years. Why not practice in the UK? There are many ppl in this world who wish they could move to Britain. Your American wife should have no problem adjusting to life in the UK. Most of the food is familiar and language should be no problem.

In the US, most ophthalmologists depend heavily on Medicare reimbursement and every year, there are moves to cut payments by 5% or more. Many ophthalmologists here envy the family practitioners who can see more patients and bill private insurance. The reimbursement for cataract surgery continues to fall. But the liability stays the same. And the malpractice insurance rates keep climbing.

 

[StupidWikipedia]

Marriage is supposed to be love but there are practical things to take into consideration. A British trained ophthalmologist cannot practice in the U.S. There are a few academic exceptions, like if you show you are a distinguished professor, some states will let you practice in a university. However, the university will know you are their slave and the chair may exploit you. In any case, a British trained person cannot be board certified. There is no reciprocity between Canadian and American board certification.

 

[theretinageek]

You might explore reciprocity with the Royal College of Physicians and Surgeons of Canada and see whether you could be eligible to sit the Canadian ophthalmology board examination with your UK training. Were that possible, there is in turn reciprocity between RCPSC and the American Board of Ophthalmology whereby you might be then considered qualified to sit the ABO examinations.[/QU

 

[RGRGRGRG]

I am just about to complete my ophthalmology residency in the UK but have not completed a fellowship yet. I also have a PhD.

I am about to get married to an American, who is well established in his career in the USA. So, I have to re-locate to the US forever.

I realise I have to complete all USMLE exams in order to practice. That is not a problem.

However, is there any route to board certification without going through residency again? I know how competitive ophthalmology residency is. But I also feel it is not necessary to go through residency again. I would like to do a 2 year fellowship in the US which should make me eligible for licensure in the state I will live in but I would still not be eligible to write the board exams which means my employment prospects are low.

I have been told several times that I am a good surgeon and physician and I love my job. I dread giving up my career even though my partner does not expect me to work.

Does anyone know of people in a similar situation who have succeeded in finding work as an ophthalmologist. I don't mind working n the academic sector but do not know how to find these jobs and also do not know if these jobs require board certification. Also, I do not know if I will be allowed to operate if I am not board certified. I cannot bear the thought of throwing away my surgical skills.

Any advice or info is appreciated.

Hi Keratocyte,
Thanks for your post. I find myself in a similar position. Would appreciate any advice, guidance or help you can provide. Thank you

 

[Helpful Troll]

Hi Keratocyte,
Thanks for your post. I find myself in a similar position. Would appreciate any advice, guidance or help you can provide. Thank you

Keratocyte hasn't been active since September 2012....... This thread is >10 years old.

 

[mjohnsonets]

Keratocyte hasn't been active since September 2012....... This thread is >10 years old.

This is the only way to become board certified without completing a US based residency currently:

Certification for Internationally Trained Ophthalmologists (ITO) | American Board of Ophthalmology

The American Board of Ophthalmology is now accepting applications from qualified internationally trained ophthalmologists (ITOs) who are currently practicing ophthalmology in the United States and wish to become board certified.

abop.org

We should lock this thread because of its age until something changes.

 

[Gonio5]

Ophthamologists trained in other countries can practice in the US. Several ways are possible:

1. American Board of Ophthalmology ITO program to become board certified.
2. Be a faculty member of a university
3. Practice only office visits, possibly in the office of a spouse who is an ophthalmologist. Would not be board certified. Some insurance companies would refuse to let the person be in network. Others would allow it.
4. Get into optometry school. Practice a combination of optometry and ophthalmology.