Advisory Commission Releases Recommendations and Toolkit to Inform Assessment and Supervision of Internationally Trained Physicians
Guidance for state medical boards and potential employers on assessment and supervision requirements for internationally trained physicians during periods of provisional licensure
WASHINGTON, D.C.- The Advisory Commission on Additional Licensing Models (ACALM), co-chaired by the Federation of State Medical Boards (FSMB), the Accreditation Council for Graduate Medical Education (ACGME), and Intealth™, today released its latest guidance aimed at supporting state medical boards, legislators, and employers as they implement new licensure pathways for physicians who have already trained and practiced medicine outside the United States. Accompanying the recommendations is a toolkit that provides information and guidance to help implement these recommendations and ensure that ITPs are prepared and supported to deliver high-quality care.
ACALM was formed in December 2023 in response to increasing interest among state policy makers to improve patient access and reduce workforce shortages by changing licensure requirements for internationally trained physicians (ITPs). Some of these proposals bypass certain requirements, including requirements related to U.S. postgraduate training, that are designed to ensure physicians have acquired the necessary knowledge, skills, abilities, and attitudes to provide safe and competent patient care.
ACALM’s newest guidance and recommendations, which are not intended as an endorsement of pathways legislation, focus on assessment and supervision requirements for ITPs during provisional licensure—prior to eligibility for a full, unrestricted license. The recommendations were developed through a rigorous, multi-step process that combined expert consensus with a careful review of medical education literature and relevant legislation. In addition, they reflect feedback gathered during a months-long public comment period, which engaged nearly 100 individuals and organizations from across the healthcare community.
Key Recommendations
Comprehensive Assessment: ITPs should be evaluated during the supervisory period on six core competencies: patient care, medical knowledge, practice-based learning, interpersonal and communication skills, professionalism, and systems-based practice.
Initial Assessment to Understand Current Strengths and Areas for Development: Individualized assessment at the start of supervision should be conducted to identify strengths and address areas needing support.
Specialty-Specific Examinations: Use of specialty exams should be used to inform learning plans that are developed with the ITP’s scope of practice in mind.
Regular, Multi-Modal Evaluation: Standardized knowledge assessments, direct observation, multi-source feedback, and medical record audits should occur periodically throughout supervision.
Supervisor Qualifications: Supervisors must be board-certified, fully licensed physicians in the same specialty, with state medical boards establishing criteria for supervisors and supervisory sites.
Protection of ITP Employee Rights: Institutions must ensure fair treatment, access to resources, and employee rights of ITPs during supervision.
The full guidance document and recommendations can be viewed here.
The toolkit for institutions and supervisors can be viewed here.
About FSMB
The Federation of State Medical Boards (FSMB) is a national non-profit organization representing the medical boards within the United States and its territories that license and discipline allopathic and osteopathic physicians and, in some jurisdictions, other health care professionals. The FSMB serves as the voice for state medical boards, supporting them through education, assessment, research and advocacy while providing services and initiatives that promote patient safety, quality health care and regulatory best practices. The FSMB serves the public through Docinfo.org, a free physician search tool which provides background information on the more than 1 million doctors in the United States. To learn more about the FSMB, visit www.fsmb.org.
About Intealth
Intealth is a private, nonprofit organization that brings together the expertise and resources for advancing quality in health care education worldwide in order to improve health care for all. Through strategic integration of its divisions, ECFMG® and FAIMER®, Intealth offers a flexible and multi‐layered portfolio of services. These services enhance and support the education and training of health care professionals, verify their qualifications required to practice, and inform the development of health workforce policies around the world. By leveraging these combined competencies, Intealth powers innovation in areas critical to the health professions. Learn more at www.intealth.org.
About ACGME
The Accreditation Council for Graduate Medical Education (ACGME) is an independent, 501(c)(3), not-for-profit organization that sets and monitors voluntary professional educational standards essential in preparing physicians to deliver safe, high-quality medical care to all Americans. Graduate medical education (GME) refers to the period of education in a particular specialty (residency) or subspecialty (fellowship) following medical school; the ACGME oversees the accreditation of residency and fellowship programs in the US.