Activists want to streamline licensing
D. Aileen Dodd - Staff
Atlanta Journal Constitution
Tuesday, November 5, 2002
In Colombia, Lina Montana was a surgical nurse, a profession that earned her respect and a comfortable living. But when she left her civil war-torn homeland for the land of opportunity, she was given a broom and a mop at a Buford golf resort.
Despite a national nursing shortage, Montana found it would not be easy to return to her career under Georgia law. So, in September 2000, she turned to blue-collar labor instead to pay the rent.
Out of necessity, many dozens of unlicensed Latino doctors and nurses across the state take odd jobs as they wait for U.S. visas and transcripts from international universities to start the medical licensing process in Georgia.
For them, the road to licensure is paved with months of red tape.
They must provide documentation of their medical training, be certified by the Educational Commission for Foreign Medical Graduates, speak English and pass state board examinations.
It can take foreign-trained nurses one to three years to get licensed. Immigrant doctors trained outside the United States can toil for more than seven years before they qualify to be licensed.
Now, Latino activists are lobbying the state to speed up the licensing process for immigrants to make it easier for Latinos to fill the health care void in the Hispanic community.
The Hispanic population grew 300 percent in Georgia during the past decade, from 109,000 in 1990 to 435,000 in 2000, census figures show. That accounts for 5.3 percent of the population, compared with 1.68 percent in 1990.
"Many nurses and doctors do other work for several years until they can get a license," said Montana, now a medical assistant in a pediatric office working toward her professional license.
Pierluigi Mancini, founder of the Clinic for Education, Treatment and Prevention of Addiction, is working to provide more medical help by practitioners who can speak Spanish and understand the culture.
In October, Mancini asked the state's Professional Licensing Boards Division to consider a plan to allow foreign medical professionals to work as apprentices alongside licensed doctors and nurses on a "limited license" until they learn English, receive credential reviews, and complete follow-up classes or tests required for formal licenses.
He also urged the state agency to provide application instructions in Spanish.
Latino nurses are among 170 immigrants who have applications pending for state licenses. No data is kept on the number of immigrant doctors who are working toward their licenses.
Foreign-trained doctors must pass three versions of the U.S. medical licensing exam in English in seven years before they can qualify for a license. The license is granted after three years of medical residency. U.S. and Canadian graduates can be licensed after one year of residency.
"The state could allow people to provide service in their language while they become proficient in English. It could be an answer to many levels of need in Georgia," said Mancini, who initially asked the state to consider the option for mental health care providers.
Shortages fuel support
Mollie Fleeman, Professional Licensing Boards Division director, said she is considering the license suggestion.
"We are open to it. It would require legislation," Fleeman said. "All of our license boards are set up by statute."
Officials at the Medical Association of Georgia do not share the state's optimism. Its leaders maintain that only licensed doctors should work in Georgia.
The Georgia Nurses Association president, however, was supportive of the notion.
"We need to try to get these people into the field as soon as we can. Our shortages are fairly severe," said Myra Carmon, head of the association and a Georgia State University professor. "We don't want our patients to be jeopardized, but if [the immigrant nurses] are working with other nurses, I don't think there would be danger to patients. At Grady . . . we have such a difficult time communicating with a large percentage of our popu- lation."
Hispanic Health Coalition President Cecilia Galvis sees the licensing idea as a first step to improving access to health care for Latinos. So far, California has been the front-runner in finding ways to streamline the licensing process for immigrants. A new law that will go into effect in January grants three-year licenses to 30 graduates of a Mexico City medical school who want to work in California clinics. Another law will make it easier for doctors trained outside the United States to take clinical rotations in California and get licensed.
"We want clients to receive service in their own language," said Galvis. "It is a big concern for our organization."
Dr. Eduardo Montana, a pediatrician at La Clinica Del Nino in Norcross, says he sees some former doctors waiting tables at a Mexican restaurant.
"Every week, I get a call from a Colombian doctor looking to get into the mainstream, but they don't have a license or speak English," said Montana, who was licensed in 1968 after working as an Army physician.
One of those colleagues, Juan Alvarez, went from patching up gunshot wounds as a doctor in a Colombian emergency room to tending bar in Georgia. Alvarez said he passed the first round of board exams but failed the second. He is saving to take the test again and complete a clinical skills assessment.
"It is so frustrating," said Alvarez, now a health educator for Healthy Mothers, Healthy Babies. "You start making some money, you have bills and you don't have time to go back and study all the stuff again. Working as a physician is the only thing I miss from my country."
A growing need
Hundreds of Latinos have made the transition from being foreign-trained to state-licensed. Officials with the State Board of Medical Examiners said it has been licensing foreign-trained doctors for decades.
Because of the state's growing Hispanic population, Mancini stresses Latino medical professionals ought to be able to obtain licensing credentials more quickly.
"I don't want to give a license to someone who is not qualified, but if we facilitate the process for a foreign-trained professional, we will be meeting a human resource crisis."