I am a British family physician trained in London and married to an
American. We want to emigrate to the USA and I need to know what
professional examinations or requirements are needed to practice as a
family physician in Florida.

Dear huwdoc,

I have searched the websites of the relevant medical organizations and
found information regarding the question: What must a foreign
physician do to get a license to practice in the United States?

The brief answer consists of these steps:

1. Pass the tests to get an Educational Commission for Foreign Medical
Graduates (ECFMG) certification.

2. Undertake residency training.

3. Pass the 3rd and final exam of the United States Medical Licensing
Examination (USMLE).

4. Apply for a license to practice in a particular state.


The complete process is a bit complex. I tried to summarize its most
important points in words as plain as possible:

International Medical School Graduates (IMGs) who wish to be certified
as physicians in the USA must pass a program of evaluation,
examination, and certification of the Educational Commission for
Foreign Medical Graduates (ECFMG). ECFMG certification provides an
assurance that IMGs have met the minimum standards required to enter
the following residency training programs.

To be certified by ECFMG, IMGs must pass a series of exams; they must
also provide copies of their medical diplomas, which ECFMG will verify
directly with their medical schools. The certification process begins
when they submit their first application for examination to ECFMG.

Once they have achieved ECFMG certification, IMGs can enter training
programs accredited by the Accreditation Council for Graduate Medical
Education (ACGME). All IMGs must undertake residency training in the
United States before they can obtain a license to practice medicine in
the United States even if they were fully trained, licensed, and
practicing in another country.

IMGs must also be certified by ECFMG if they wish to take Step 3 of
the three-step United States Medical Licensing Examination (USMLE).
Passing this examination is required to obtain a license to practice
medicine in a US state. In the United States the individual medical
licensing authorities of the various states grant a license to
practice medicine. Each medical licensing authority sets its own rules
and regulations and requires passing an examination that demonstrates
qualification for licensure. In Florida, the competent authority is
the Florida Department of Health, Board of Medicine. Results of the
USMLE are reported to these authorities for use in granting the
initial license to practice medicine. Because the individual medical
licensing authorities make decisions regarding use of USMLE results,
IMGs should contact the jurisdiction where they intend to apply for
licensure to obtain complete information.


Step-by-step information and instructions on how to apply for and
obtain ECFMG certification, as well as important additional materials
and forms, can be found on the ECFMG website:
http://www.ecfmg.org/cert/index.html


In case you have specific questions not covered or not explained
clearly on their website, here is contact information for the ECFMG:

Educational Commission for Foreign Medical Graduates
Applicant Information Services
3624 Market Street
Philadelphia, PA 19104-2685
--
Phone: (215) 386-5900
Fax: (215) 386-9196
E-Mail: info@ecfmg.org
Website: http://www.ecfmg.org/


Information on the ACGME-accredited residency training programs
necessary for obtaining a license to practice medicine is available on
the ACGME website:
http://www.acgme.org/adspublic/

Here is full contact information for the ACGME:

Accreditation Council for Graduate Medical Education
Suite 2000
515 North State Street
Chicago, IL 60610-4322 
--
Phone: (312) 755-5000 
Fax: (312) 755-7498
Website: http://www.acgme.org/


The USMLE, whose examination for medical licensure is necessary for
obtaining a license to practice medicine, also offer information on
their website:
http://www.usmle.org/bulletin/2004/TOC.htm

Here is full contact information for the USLME:

USMLE Secretariat
3750 Market Street
Philadelphia, PA 19104-3190
--
Phone: (215) 590-9700
E-Mail: webmail@nbme.org
Website: http://www.usmle.org/


Finally, here is information provided by the Floria Medical Quality
Assurance (MQA) on how to apply for a Medical License for practising
in the State of Florida:
http://www.doh.state.fl.us/mqa/medical/me_lic-process.html
http://www.doh.state.fl.us/mqa/medical/me_applicant.html

Here is full contact information for Florida MQA:

Florida Board of Medicine
Medical Quality Assurance
4052 Bald Cypress Way
Tallahassee, Florida 32399
USA
--
Phone: 850-245-4131 -and- 850-488-0595
Fax: 850-488-9325
E-Mail: MQA_Medicine@doh.state.fl.us
Website: http://ww2.doh.state.fl.us/mqaservices/


For basic instructions on how to get a license to practice medicine in
a state of the USA, please read this introduction provided by the
American Medical Association (AMA):
http://www.ama-assn.org/ama/pub/category/2644.html

The AMA also provides an overview of the steps foreign physicians have
to take if they wish to be allowed to practice in the United States:
http://www.ama-assn.org/aps/physcred.html#foreign


I hope that this is what you needed to know!
Best regards,
Scriptor

thank you. All my questions answered succinctly. Very pleased with
detail and speed of response

For practising in US, you need to pass the USMLE step 1, step 2 ck,
step 2 cs and step 3 examinations. All the doctors are then required
to undergo a residency program from a college. Family Practice needs 3
years of training under residency.  After this period, you can go
ahead and start your medical practice in US.

STEP 1 assesses whether you understand and can apply important
concepts of the sciences basic to the practice of medicine, with
special emphasis on principles and mechanisms underlying health,
disease, and modes of therapy. Step 1 ensures mastery of not only the
sciences that provide a foundation for the safe and competent practice
of medicine in the present, but also the scientific principles
required for maintenance of competence through lifelong learning. It
is a computerized test of the basic medical sciences consisting of 350
multiple choice questions. For IMGs, Step 1 is required for ECFMG
certificate as well as for registration for Step 2 CS. Since most US
graduates apply to Residency with their Step 1 scores only, it maybe
the only objective tool available with which to compare IMGs with US
graduates.
http://www.usmleweb.com/usmle_step1.html

STEP 2 CK ( Step 2 Clinical Knowledge) assesses whether you can apply
medical knowledge, skills, and understanding of clinical science
essential for the provision of patient care under supervision and
includes emphasis on health promotion and disease prevention. Step 2
ensures that due attention is devoted to principles of clinical
sciences and basic patient-centered skills that provide the foundation
for the safe and competent practice of medicine. It is a computerized
test of the clinical sciences consisting of 370 multiple-choice
questions. Step 2 is required for ECFMG certificate. It reflects the
level of clinical knowledge of the applicant.
http://www.usmleweb.com/usmle_step2_ck.html

STEP 2 CS ( Step 2 Clinical Skills): uses standardized patients to
test medical students and graduates on their ability to gather
information from patients, perform physical examinations, and
communicate their findings to patients and colleagues. The patients
you will see are lay people trained to portray a clinical problem.
This method of assessment is referred to as a standardized patient
examination. Step 2 CS is required for ECFMG certification.
http://www.usmleweb.com/usmle_step2_cs.html

STEP 3 assesses whether you can apply medical knowledge and
understanding of biomedical and clinical science essential for the
unsupervised practice of medicine, with emphasis on patient management
in ambulatory settings. Step 3 provides a final assessment of
physicians assuming independent responsibility for delivering general
medical care. Step 3 emphasizes selected physician tasks, namely,
evaluating severity of patient problems and managing therapy.
Assessment of clinical judgment will be prominent.
http://www.usmleweb.com/usmle_step3.html