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Policy Issue Brief - Physician Licensure
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Issue

Some Preventive Medicine physicians are experiencing difficulty obtaining medical licenses solely because they do not meet state definitions of having been in "active medical practice.” These physicians fall into at least three groups:

a) New residents in states where Preventive Medicine residency requirements for clinical practice do not meet state minimums

b) Physicians working in non-clinical settings (i.e., non-direct patient care positions in research, public health, academia, or other similar settings) who renew licenses in states where demonstration of active clinical practice is required for license renewal

c) Physicians working in non-clinical settings (i.e., non-direct patient care positions in research, public health, academia or other similar settings) who move to a new state with a licensure requirement where demonstration of active clinical practice and who seek a new license in that state.

Background

This issue arises out of state legislation that defines medical practice or state medical board regulations that define criteria for licensure. Many states are moving forward with "Maintenance of Licensure” requirements that will make this a more common phenomenon. At least 16 states currently have requirements for the active practice of medicine as part of their licensure process.

This practice disproportionately affects Preventive Medicine physicians compared to other physicians because Preventive Medicine physicians tend to practice in settings other than those that involve direct patient care.

The Accreditation Council for Graduate Medical Education (ACGME) defines "clinical” as the practice of medicine in which physicians assess patients (in person or virtually) or populations in order to diagnose, treat, and prevent disease using their expert judgment.

Status

The American College of Preventive Medicine advocates that state medical boards develop licensure policies that recognize the vital impact of well-qualified physicians in settings outside of direct patient care including academic, research, government, public health, and physician leadership roles. Specifically, ACPM strongly recommends that state medical boards adopt the definition of clinical medicine used by ACGME or otherwise include "population-based medicine” in their definition of "active medical practice.”

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