Physician re-entry refers to a return to clinical medical practice in the specialty in which the returning physician was trained or certified, after a prolonged absence from clinical work which was not the result of impairment or discipline. The requirements for a physician to return to practice are often a function of the state rules and regulations in the state in which you want to return to clinical care.
The fastest way for retired physicians to help is to volunteer. In the current pandemic you might be a gift to the systems which are imploding and to healthcare workers desperate for relief. There are many other opportunities for physicians to volunteer as well. However, the following information about physician re-entry is intended for those planning for paid employment and/or a return to their specialty of training or experience, not the current crisis.
The American Medical Association (AMA), along with leaders in licensure, board certification, and education, and directors of re-entry programs worked together to establish recommendations for re-entry. In particular, the American Academy of Pediatrics, and the Federation of State Medical Boards made some of the greatest contributions.
These recommendations include:
Regulatory policies: Develop a comprehensive, transparent, reasonable, regulatory process for physicians to return to clinical practice.
- Develop understanding of expectations and needs of relevant stakeholders.
- Develop re-entry guidelines across state medical licensing jurisdictions, which clarify:
- Length of time away from practice allowed before retraining is necessary
- How much involvement in clinical care constitutes active practice
- Clinical practice requirements for maintaining licensure
- Impact of loss of specialty board certification
- Establish ways for a returning physician to work with supervision
- A site (medical school, graduate medical education program, teaching hospital and medical home, as well as non-traditional sites such as mental health hospitals and nursing homes)
- Hospital credentialing committees that allow re-entry program participants to work under supervision
- State medical licensing boards should establish a non-disciplinary licensure status option for reentering physicians during their re-entry education and training
- Development and validation of a process for previously board-certified physicians not eligible for maintenance of certification to participate in re-entry training necessary to return to their field and original scope of practice
Physician re-entry program policies: Develop policies that assure the quality and consistency of re-entry programs.
Research and Evaluation: Create an evidence base used to study re-entry programs and physicians.
Program Funding: Develop means to ensure that a physician re-entry system is financially feasible.
A table of some physician re-entry regulations by state is available at on the AMA’s website. You’ll find some of these areas regulated:
- Board policy on reentry
- Allowable length of time out of practice
- Length of time out of practice before additional training is require.
- Use of a case-by-case basis for re-entry
- Special examination requirements
- CME requirements
A detailed presentation of all the factors used to determine policy and eligibility for re-entry is beyond the scope of this article. You will find state requirements and elaboration on the American Medical Association recommendations for re-entry in the PDF linked above.
