What's the process for a doctor in Bulgaria getting licensed in the US?
September 10, 2021 9:59 AM   Subscribe

Is it specific to the country? Or, as a member of the EU, does Bulgaria have a process through that? And how long does it take?
posted by rileyray3000 to Law & Government (5 answers total)
There are US-based requirements. A foreign medical graduate must pass the USMLE and then complete a residency training program in their specialty at a US hospital. See information here.
posted by alygator at 10:06 AM on September 10, 2021 [2 favorites]

It's a tough process and generally takes at least a few years. This site aimed at UK medical students gives a more step-by-step overview (I can't speak to all the details but it lines up with what I've heard from acquaintances/coworkers who've taken this path). Note that most of the steps have to be completed even if you're already a qualified and practicing doctor in your home country.

I used to work in a cancer biology research lab and we always had one or two coworkers who were MDs in another country (mostly Israelis - i.e. people from developed countries) who were doing research work while working their way through their USMLEs, etc. These were really smart people but some of them struggled a lot with the USMLEs, partly due to language issues. There's a reason for the old trope about the cab driver who was a neurosurgeon back home.

(And obviously this isn't even getting into visa/immigration issues.)
posted by mskyle at 11:02 AM on September 10, 2021 [1 favorite]

Agreeing with what alygator said, let’s call it 2 years to prepare for and take the 4 board exams and 3-5 years to repeat residency. Add some years for board failures and failure to match into a residency (there’s a complicated system for assigning places).
posted by 8603 at 1:08 PM on September 10, 2021

In addition to the board exams (USMLE = US medical licensing exam; there are 3 of them now because Step 2 Clinical Skills is suspended indefinitely due to covid), the student needs to be certified by the ECFMG, which is its own process. You cannot apply to residency without an ECFMG number.

The system tends to favor US medical graduates; in this last Match, just over half of international medical graduates matched (59% of US citizens; 54% of non-US citizens) compared to ~90% of graduates of US medical schools. As 8603 says, it's wise to build at least one fail-to-match plan into your timeline. Many IMGs also end up in less competitive specialties, or less popular locations, because of that.

At the end of residency, there is another board exam, after which you can practice independently in your primary specialty, or pursue further specialized training in a fellowship.

All told, plan on 8-12 years, depending on the length of residency/fellowship.
posted by basalganglia at 3:07 PM on September 10, 2021 [1 favorite]

My neighbor was a qualified doctor in an EU country and now runs a lab at a prestigious medical center precisely because of this enormous impediment. He was already in his 30s with a family and the many years of prep for the exam and the grueling residency would have been very difficult, as his wife, also a qualified EU doctor, would also not have been able to work here and they had small children.

He continues to oversee his lab, and has grown to really love it. He decided against pursuing medical practice in the US. His wife, though, now in her early 50s, has continued to live and work in the EU. The idea of residency as a specialist requiring at least 3 years of residency, in her 40s, with a couple of really little kids, was just too daunting. Instead they have used their income to spend long periods of time at each location, and as the kids have gotten older they moved to the US for school while the younger ones remained wherever their mother was, traveling to the US for extended visits with her. The plan is for the family to be reunited in the US eventually, when all the kids are at least in high school. All the family members have dual citizenship and have deep ties, and lots of family, in their original country. The oldest is now in college, and the next-oldest is now here in high school.

This might seem like an improbable solution, to live in both countries, but it has worked very well for this family, though I know that the extended European family has helped enormously as the mother continued to work as a physician there. As you can see, though, there are alternatives where deep medical knowledge can be important, fulfilling, and well paid. I might add to academic research labs that you should consider pharmaceutical companies, which are full of people who are medically trained and are not US licensed physicians. I have worked with many of these professionals across many pharmaceutical specialties. As a bonus a number of pharma companies have facilities in many countries across the world and might be easier to access from Bulgaria.
posted by citygirl at 8:46 AM on September 11, 2021

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