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USMLES AND MEDICAL LICENSING IN THE UNITED STATES SURVIVAL SKILLS Paperback – October 10, 2016
Katherine T Miller is a medical doctor graduated in 1996 from The University of Medicine of Hochiminh City, Saigon, Vietnam. The primary reason for her immigration to the US is in search of personal freedom and social justice. She does not want to live in a communism that has mutated into a muddle of “red capitalism” that even worsens human rights in Vietnam. With the clear perspective of a medical doctor, she has soon found out she does not belong there. She came to the US and proud to become US citizen 2007. She is an American at heart; however, her previous country and its Vietnamese people are still in her heart.
Since there are no medical licensing examinations in Vietnam for practicing medicine, all new medical graduates start working as physicians after they receive their MD diplomas, same story for Katherine Miller. She entered eighteen (18) months of OBGYN training at the biggest OBGYN hospital in Saigon and graduated with a certificate of preliminary OBGYN specialist. Then, she had practiced medicine as primary care physician at multiple general hospitals and OBGYN hospitals and medical facilities, clinics in Saigon, Vietnam. She then also attended nine (9) months training of general and OBGYN sonogram that added into her rich skills in serving the patients and earned her a great deal of clinical experiences for the last seven (7) years practicing medicine in Saigon, Vietnam before she immigrated to the US at the end of 2002.
Since her move to the US in 2002, she has stayed at the same town, San Leandro, The East Bay of the San Francisco Bay Area, Northern California. Living in the underserved area of the East Bay, she has experienced and sensed the shortage of primary care physicians. Although she has entered public schools such as CSU East Bay, Chabot College, and City College of San Francisco (Stem Cell Technician Certificate earned) to enjoy learning about the American and Californian diversity culture, never strayed away from her ultimate goals, has Katherine always yearned to return practice medicine; she eventually found out the challenging path of medical licensing. For the primary reason of why she came to the US, she was not initially informed about this. In her book, “Survival Skills for USMLEs and Medical Licensing in the United States”, she explained the most disadvantageous group of foreign-trained US doctors that has known zero information about the intricate and puzzling medical licensing.
From meticulous work and tremendous devotion, she passed all the USMLEs (United States Medical Licensing Examinations), the same licensing examination for domestic-trained MDs including USMLE step 1 as basic medical sciences, USMLE step 2 CK clinical knowledge, and USMLE step 2 CS clinical skills with verification of medical school transcripts and diploma from Saigon Vietnam. She was granted the ECFMG certificate in 2011. Her medical school from my previous country, Vietnam, has forced her to pay them $2,500 for just sending the official transcript to the ECFMG (The Educational Commission for Foreign Medical Graduates). It was the price of freedom!
Then, the worst has yet to come, she found out about the huge blockade to finalize MD licenses because of the cumbersome licensing system that lead to the discrepancy of the waste of foreign-trained MDs versus the serious shortage of MDs to provide care for the increasingly demands of physicians in near and far future. The absurdity of the current medical licensing is here. Passing all the USMLEs does not help to make a MD ready to practice medicine. The ECFMG certificate is only used for applying into medical residency while medical residency has become the big roadblock for finalizing medical doctor licenses. According to an AAMC study in early 2018, there would be at least 200,000 MDs shortage projected in twenty (20) years!
She has been volunteered as a medical interpreter and clinical assistant for over ten (10) private practices of local physicians with various specialties: three primary care offices (3) in San Leandro, Hayward, three OBGYN offices (3) in Castro Valley and Hayward and NAPA, one pediatrician office (1) in San Leandro, one ophthalmology office (San Jose), one urology surgery office (1) in Napa, two internal medicine offices (2) in San Leandro and Castro Valley. She has been a visiting physician observed at Saint Rose OBGYN hospital, NAPA Valley Hospital, Stanford Hospital, Eden Hospital and Emergency Room. Indulging herself into these clinical activities yet with minimum permission of hands-on experiences, Katherine Miller could still learn a lot of clinical experiences and how the medical and healthcare system in America operate via her critical thinking capability. She has deeply understood the intricate healthcare system and how the business built on the for-profit foundation, a huge change from a non-profit charity purpose on healthcare system before the 1950s.
Hindsight is 20/20 as the saying goes. Thousands of foreign-trained medical doctors and even about a few hundreds of domestic-trained doctor annually are unable to “secure” a residency slot. (Sarcastically, it is said “secure a residency slot”). They are totally blinded about this huge barricade until getting too close! The frustration only worsens. She had applied for medical residency all over the US for four (4) continuous years without success, wasting thousands of dollars annually. The same disturbing stories are like thousands of other doctors, both foreign-trained and domestic-trained!
Since 2011, Katherine Miller has been studiously researching about the medical licensing system in the US via local libraries, university especially medical school libraries, and talking with people in related fields. She wrote the book based on what she has found and wanted a better change for the current cumbersome licensing system. She has delineated the PhA Physician Associate Project as the solution to bring back foreign-trained MDs who live in American soil to be able to practice medicine in a new pathway with a new license PhA Physician Associates, a mid-level provider that is higher than PA physician assistant and NP nurse practitioner, but still a little lower than licensed MD. These Physician Associates PhA would work in the real medical settings (instead of the restrained boundaries of teaching hospitals) for three (3) to four (4) years with meticulous online and onsite credentialing (based on the evaluation system of our current residency systems) to validate their clinical work and CME participants. These PhAs are eventually able to finalize their MD licenses. This approach is much more realistic and practical that directly meets with the demand of physician shortage as the endemic near and far future.
Since 2014, she has researched and understood the basics American political system for legislation changes. She has been in contact with more than ten (10) government offices including local (district 13 and surrounding districts) assembly members and senator offices and Sacramento Offices of the Governor, Office of Professional and Business Development (She submitted to the office chief consultant and manager the SUNRISE BOOK answering over seventy (70) questions on how a new medical license established to the safety of the public), etc. in the effort to promote her PhA Project. She also initiated the online campaign for the Pilot medical residency program for Physician Associate PhA. (https://www.change.org/p/california-governor-petition-for-california-governor-to-approve-pilot-program-as-a-medical-residency-for-pha)
The majority of these government offices have approved the idea to be able to promote into a new legislation and encouraged her trying to work on the PhA Organization growth so the entities can take on the wheel to launch the project successfully.
She has also struggled to survive a normal life. She had previously experienced as a tutor for Vietnamese language, mathematics and life sciences and social sciences for junior high school students in Saigon, Vietnam previously and Northern California in 2006 to 2011. She is currently working as a caregiver nurse and a medical interpreter, working fifty (50) to seventy (70) hours a week with minimum wages to make my end-meet.
At the moment, with the success of the online petition on change.org (please see the link above), the legislative Counsel Office has accepted into drafting the PhA Project idea into an initiative for The State of California official election. Dr. Miller has been working with a deputy legislative counsel since March 2018.
As busy as a bee, she has officially found The American Physician Associates, Inc. short form as The PhA Organization in September 2017. She has been still running the organization as its very early stage with very limited modalities and trying to search for sponsors, donators, etc. to help its growth. The PhA Organization has obtained its 501(c) (3) as nonprofit tax exempt status last February 2018.