THE BAKER ADMINISTRATION on Thursday announced several executive orders to support the health care workforce and expand its capacity, including easing licensing restrictions for foreign-educated doctors.
One order allows graduates of international medical schools who have successfully completed at least two years of postgraduate resident medical training to be eligible for licensure in the Commonwealth. The postgraduate programs have to be approved by the Accreditation Council for Graduate Medical Education, the American Osteopathic Association. Canadian programs also qualify. The Board of Registration in Medicine is directed to review and approve applications on an expedited basis.
Immigration advocates welcomed the order, but said it will limit how many medical professionals can participate in the fight against COVID-19.
Eva Millona, the executive director of the Massachusetts Immigrant and Refugee Advocacy Coalition, said the order is good news for international medical school graduates who are well into their residencies. “Sadly, many foreign-trained doctors, nurses, and other medical professionals in Massachusetts don’t fit that profile, even though they have very robust skills and experience. We had hoped for a policy like the ones adopted in New Jersey or Nevada, which invite a broader range of internationally trained medical professionals to become part of the COVID-19 response,” she said in a statement.
“I don’t think any of us have graduated from such programs. That’s disappointing and I hope we can continue to work on it to make it not limited to those programs,” said Laith Almatwari, a Revere resident who is licensed in Iraq and Egypt as a doctor, and also helped the US Army as a medic.
“The ACGME accredits certain programs, but usually most of the international residency programs are not accredited, and that’s why we need to have more US experience before applying to residency programs here, which is a requirement to get accepted into any program,” he said.
In March, Baker asked medical schools to graduate their students early and approved 90-day provisional licenses for them so more students would be freed up. But health care professionals think that foreign trained doctors and nurses can also help, especially if they’ve had years of previous experience.
Other states have put in place more liberal policies. At the end of March, New York Gov. Andrew Cuomo said he would allow graduates of foreign medical schools who are not licensed in New York but have completed at least a year of US-based medical graduate education to practice. In New Jersey, Gov. Phil Murphy ordered his Division of Consumer Affairs to issue temporary licenses to doctors certified and in good standing in other countries
According to a recent Migration Policy Institute analysis, there are 263,000 immigrants and refugees who have a four-year degree in a health-related field who are either confined to low-paying jobs that require at most a high school degree (such as home health or personal care aides) or are out of work.
The Massachusetts Immigrant and Refugee Coalition said 20 percent of the state’s foreign-trained medical professionals are unable to practice.
On Friday, Amherst Rep. Mindy Domb and Northampton Sen. Jo Comerford sent a letter to Baker calling for temporary medical licenses to be granted to “members of our Commonwealth’s communities who are health care personnel and licensed in good standing in foreign countries.” They feel like today’s order barely addresses the issue. “This EO only refers to people right out of medical school, not immigrant and refugee physicians and other healthcare professionals with years of practice and experience,” said Domb.
“The Governor’s Executive Order issued today recognizes that the training and skills gained in other countries can benefit our healthcare workforce,” she and Comerford said in a statement. “We welcome extending this to immigrants in MA, whose deep experience will also be invaluable to our efforts. In addition, we seek assurances that health care providers licensed and in good standing from Puerto Rico will be covered by previous executive orders. Given projections of an imminent Massachusetts surge, we eagerly await a response from Governor Baker.”
At a press conference Thursday, Baker unveiled a second order to allow nursing school graduates and students in their final semesters of nursing programs to practice nursing in advance of receiving a license, provided that they are supervised by other licensed medical professionals.
Another order mandates that insurers cover all medically required costs of COVID-19 treatment in out-of-network hospitals or other medical facilities with no charge to the patient, including co-pays, deductibles, or co-insurance payments.
Insurers will have to agree to a contracted rate even if the patient is not in a network that covers the provider or facility, and it will be at 135 percent of the applicable Medicare rate.