Anesthesiology & Pain Medicine >> Administration >> Tips for New Staff: >> Practice Requirements: Medical License and Insurance

Tips for New Staff:
Practice Requirements:
Medical License and Insurance

The entire medical faculty of the University of Washington self insures as a group. The premium for this is part of your package and is not taken out of your salary. The University does this because it is able to pay less than outside arrangements and still provide complete coverage. This coverage only covers you if you are working in the department.

Medical Staff Privileges

This refers to the procedure of getting credentialing papers signed at each of the hospitals where you work. This ensures that you have had the requisite training and skills to function as an attending (=consultant). It is important to get your credentialing papers signed a minimum of four months before you arrive. You will be steered in the right direction by the administrative staff.

Medical License

This, in the end, will be given to you by the licensing authority in the Washington State capitol of Olympia. A U.S. social security number is required for issuance of a Washington State medical license. You will need to apply early in the whole process. After you have completed your application the departmental office will submit it to Olympia. The address of the licensing authority is:

Washington State Department of Health
Health Professions Quality Assurance
310 Israel Rd
Tumwater WA 98501
Email: hpqa.csc@doh.wa.gov
Phone: (360) 236 - 4700
Fax: (360) 236 - 4818

The Medicolegal Environment And Malpractice Insurance

This area is often a cause of anxiety with new overseas staff. The insurance arrangements are as follows. The entire medical faculty of the University of Washington self insures as a group. The premium for this is part of your package and is not taken out of your salary. The University does this because it is able to pay less than outside arrangements and still provide complete coverage. This coverage only covers you if you are working in the department. It does not cover outside work at all and definitely does not provide coverage in other U.S. states. If you consider providing some care and you are uncertain about the coverage (e.g., providing medical assistance for an athletic event for free or working on the ski patrol), please talk to the department's clinical director at (206) 543-2470, before doing anything.

The practical day to day medico legal situation is different in some aspects. Each hospital has a risk management department which likes to hear about any mishaps early so that they can intervene and try to minimize the damage. This can be as minor as dental mishaps during intubation (where risk management will supervise the free dental service that will follow) or as major as dealing with the family after an unexpected severe complication (which will involve consideration of adjustment of billing, paying for all other medical care, dealing with any explanations to the family, and dealing with a lawsuit). Please get risk management involved early if a mishap occurs.

This department is very sensitive with respect to new staff in terms of trying to prevent mishaps. You will not be placed in cases which are unfamiliar to you without appropriate orientation. This especially applies to taking call. We encourage new staff to discuss any concerns about any particular case with one of the permanent staff. We encourage this collegial attitude among staff, rather than having staff get into a situation they are uncomfortable with.

Overall the medico legal "stress" is less than might be expected from all the publicity which goes overseas.

Educational Commission for
Foreign Medical Graduates (ECFMG)

The Educational Commission for Foreign Medical Graduates or ECFMG (www.ecfmg.org) has two possible roles in your trip to the US. One role is in regulating which exams, if any, you have to pass to be allowed to come here. This sort of thing changes about every three years and the Chair, will be able to find out if you need to take any such exam to get here. ECFMG is required for most fellowship (trainee) positions. ECFMG is not required for most visiting faculty positions.

The other role has to do with sponsoring your trip here. It may be that the ECFMG in fact is the outfit which sponsors your trip, in which case they have to process all sorts of papers as well. This step was added a few years ago to stop local abuses of the rules. ECFMG is a part of the federal government and can be quite slow at times. If you are processed this way, do not despair, as most of your predecessors have traveled this path. It works out in the end.

Working With Residents

During the course of their training, residents in the USA do fewer cases compared to their cohorts in Australia, or New Zealand or the UK or most other places. Consequently, the residents expect to derive more experience and benefit from each case in terms of practical procedures and teaching by attending anesthesiologists. They are prepared to work a lot harder to get the experience, teaching and benefits, and genuinely appreciate any effort you make to teach. In fact, compared to many other residency programs, the program at the University of Washington has somewhat of a good reputation for teaching by overseas faculty. If you have a teaching point to make, it really helps to explain the point or to give references. The residents are likely to be very appreciative of such efforts.

Although it is a small point: please get the residents out early for their lunch and dinner breaks, because you will be likely running two rooms and it is all too easy to get distracted and in the end everybody eats late.

One last note: The US is fairly well advanced in the area of regulations governing relationships at work and how you should behave. Specifically, with respect to reacting to people of different race or sexuality, we are all expected to behave in an unprejudiced manner. This is almost certainly the case in many overseas countries and this comment is not meant to offend, rather, it is to confirm the ground rules as they exist.




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