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After taking a 10-year break from practicing medicine to raise four sons, Dr. Kate Gibson was ready to go back to work.
The family physician had been reading about a shortage of primary care doctors and knew she could help. But when Dr. Gibson, 51, applied to work at her former hospital near Los Angeles, she was turned away. She’d been out of clinical practice too long.
“I really thought it was not going to be that hard,” she said.
Like many professionals, physicians take time off to raise children, care for sick family members, or recover from their own illnesses. Some want to return from retirement or switch from nonclinical jobs back to seeing patients. But picking up where they left off is more difficult in medicine than in most careers.
In medicine, change occurs quickly. Drugs, devices, and surgical techniques that were standard a decade ago may now be obsolete. Or a returning doctor’s skills may simply be rusty.
“My hands feel like those of an intern,” said Dr. Molly Carey, 36, an Ivy League–educated doctor who recently enrolled in a Texas retraining program after 4 years away from patients.
After extended leaves, doctors must convince medical boards to reissue their licenses, hospitals to grant admitting privileges, and malpractice insurers to provide coverage. Only a handful of programs around the country are set up to help physicians brush up on their skills, and they can cost doctors thousands of dollars.
“Medical schools do a fantastic job graduating brand new medical students,” said Dr. Humayun J. Chaudhry, president of the Federation of State Medical Boards. “But what about people who have already graduated and need to get some retraining? There is clearly a dearth of those kind of training programs.”
Policy makers and professional organizations are pushing to make the process less burdensome and costly – in part because it may help ease shortages of primary care doctors.
Getting experienced doctors to dust off their white coats is cheaper than starting from scratch, said Dr. Robert Steele, director of KSTAR physician programs at Texas A&M Health Science Center, College Station. He oversees a miniresidency program at the University of Texas Medical Branch, Galveston, in which returning doctors divide their time between seeing patients and attending classes. The 3-month training includes the latest on medications, procedures, disease management, and treatment.
“[Returning doctors] just need polishing up to practice safely and competently,” Dr. Steele said.
Patient safety advocates argue that minimum standards should be set to ensure that doctors coming back after a hiatus are providing the best care possible. As it stands, no nationwide standards or requirements exist, and states have different requirements.
“Patients would like to think that any doctor who is seeing them or doing procedures on them is at the height of their career,” said Joe Kiani, founder of the Patient Safety Movement Foundation. “If a doctor has been out for a while, they are not.”
Dr. Carey had a great education, graduating from medical school at the University of Pennsylvania and completing a residency in 2011 in obstetrics and gynecology at Brown University and a Providence hospital. But after taking just 4 years off to care for a sick grandmother and another relative, she felt she needed to freshen her clinical skills. So she moved from Rhode Island to Texas to take part in the KSTAR program, hoping to gain more confidence as a surgeon and become more marketable.
Setting standards and removing obstacles
Reliable numbers of how many doctors suspend their practices aren’t available, but the American Medical Association estimated in 2011 that 10,000 doctors could reenter practice each year.
The Federation of State Medical Boards wants states to create a standard process for physicians to show they have the skills to return to medicine. It is asking licensing agencies to track whether doctors are still practicing and whether they are doing so in their area of training.
The American Academy of Pediatrics and the AMA also are trying to remove obstacles for doctors who want to return to work after taking time off. And Rep. John Sarbanes (D-Md.) has proposed legislation to help expand reentry programs for primary care doctors and help cover physicians’ costs if they agree to practice in high-need areas.
After hitting a wall with her former employer and others, Dr. Gibson enrolled in an online retraining program in San Diego, which cost her $7,000. She spent 4 months completing the courses last year and a week shadowing a family physician. Then she took a written exam and was evaluated during mock visits with “patients” played by actors.
In the end, she received two certificates – one from the program and one from the University of California, San Diego, for 180 hours of continuing medical education.
“I definitely felt more confident,” Dr. Gibson said. But she still wanted more hands-on clinical training. So she recently started a paid family medicine fellowship at the University of Southern California, seeing patients under the oversight of other doctors.
Former medical school professor Dr. Leonard Glass created the San Diego program, called the Physician Retraining and Reentry Program, in 2013. Besides retraining primary care doctors, the online program has attracted specialists who wanted to switch to primary care, as well as some restless retirees.
“Some are simply tired of being retired,” he said. “It’s sort of an itch to go back to taking care of people.”
‘Expensive and time consuming’
Several retraining programs are run by hospitals, including Cedars-Sinai Medical Center in Los Angeles. There, participants spend between 6 weeks and 3 months seeing patients under the supervision of other physicians, then discuss their cases in an exit interview to demonstrate what they learned. They leave with a letter that can be submitted to employers or hospitals.
The Cedars-Sinai program costs $5,000 a month. Dr. Leo A. Gordon, who runs it, said some doctors who call to inquire are angry about having to spend the time and money when they already have so much education and experience. But he said others are simply appreciative that “there is a way to get back in the game.”
One Cedars-Sinai graduate, Dr. Maria DiMeglio decided she wanted to return to practice as an ob.gyn. after taking off almost 6 years to care for her children and her ill mother.
“I thought I was retiring, Dr. DiMeglio said, “but I kept my options open.” She had retained her medical license and kept up with continuing education courses. But she needed to persuade her old hospital, Cedars-Sinai, to give her privileges so she could perform surgeries. The Cedars-Sinai retraining program, she said, “wasn’t difficult, but it was expensive and time consuming. Not everyone can do that.”
Hospitals set their own requirements for doctors to get credentials and privileges, but doctors who have been out of practice for more than 2 years generally must show that they are competent to see patients. Having a certificate from a reentry program helps, said Dr. David Perrott, senior vice president and chief medical officer of the California Hospital Association.
Dr. Jeff Petrozzino, a 50-year old doctor who trained in pediatrics and neonatology, knows all about that. He ran into difficulty returning to clinical practice after spending several years doing health economics research.
“I was a double board–certified physician licensed in several states,” he said. “You would think I would be able to get a job.”
When he finally did get an offer at a medical center in New Jersey, he said both the position and the state medical license were contingent on him getting retrained. He completed a 2-month program at Drexel University in 2013, where he was surprised to discover many other doctors in a similar situation.
Dr. Petrozzino said he was grateful for the program – but given the hassles of reentry, he would advise doctors to plan carefully before taking a break from practice.
“Careers are interrupted or derailed for various reasons,” he said. “The system does not readily allow for reentry.”
Kaiser Health News (KHN) is a nonprofit national health policy news service. Blue Shield of California Foundation helps fund KHN coverage in California.
After taking a 10-year break from practicing medicine to raise four sons, Dr. Kate Gibson was ready to go back to work.
The family physician had been reading about a shortage of primary care doctors and knew she could help. But when Dr. Gibson, 51, applied to work at her former hospital near Los Angeles, she was turned away. She’d been out of clinical practice too long.
“I really thought it was not going to be that hard,” she said.
Like many professionals, physicians take time off to raise children, care for sick family members, or recover from their own illnesses. Some want to return from retirement or switch from nonclinical jobs back to seeing patients. But picking up where they left off is more difficult in medicine than in most careers.
In medicine, change occurs quickly. Drugs, devices, and surgical techniques that were standard a decade ago may now be obsolete. Or a returning doctor’s skills may simply be rusty.
“My hands feel like those of an intern,” said Dr. Molly Carey, 36, an Ivy League–educated doctor who recently enrolled in a Texas retraining program after 4 years away from patients.
After extended leaves, doctors must convince medical boards to reissue their licenses, hospitals to grant admitting privileges, and malpractice insurers to provide coverage. Only a handful of programs around the country are set up to help physicians brush up on their skills, and they can cost doctors thousands of dollars.
“Medical schools do a fantastic job graduating brand new medical students,” said Dr. Humayun J. Chaudhry, president of the Federation of State Medical Boards. “But what about people who have already graduated and need to get some retraining? There is clearly a dearth of those kind of training programs.”
Policy makers and professional organizations are pushing to make the process less burdensome and costly – in part because it may help ease shortages of primary care doctors.
Getting experienced doctors to dust off their white coats is cheaper than starting from scratch, said Dr. Robert Steele, director of KSTAR physician programs at Texas A&M Health Science Center, College Station. He oversees a miniresidency program at the University of Texas Medical Branch, Galveston, in which returning doctors divide their time between seeing patients and attending classes. The 3-month training includes the latest on medications, procedures, disease management, and treatment.
“[Returning doctors] just need polishing up to practice safely and competently,” Dr. Steele said.
Patient safety advocates argue that minimum standards should be set to ensure that doctors coming back after a hiatus are providing the best care possible. As it stands, no nationwide standards or requirements exist, and states have different requirements.
“Patients would like to think that any doctor who is seeing them or doing procedures on them is at the height of their career,” said Joe Kiani, founder of the Patient Safety Movement Foundation. “If a doctor has been out for a while, they are not.”
Dr. Carey had a great education, graduating from medical school at the University of Pennsylvania and completing a residency in 2011 in obstetrics and gynecology at Brown University and a Providence hospital. But after taking just 4 years off to care for a sick grandmother and another relative, she felt she needed to freshen her clinical skills. So she moved from Rhode Island to Texas to take part in the KSTAR program, hoping to gain more confidence as a surgeon and become more marketable.
Setting standards and removing obstacles
Reliable numbers of how many doctors suspend their practices aren’t available, but the American Medical Association estimated in 2011 that 10,000 doctors could reenter practice each year.
The Federation of State Medical Boards wants states to create a standard process for physicians to show they have the skills to return to medicine. It is asking licensing agencies to track whether doctors are still practicing and whether they are doing so in their area of training.
The American Academy of Pediatrics and the AMA also are trying to remove obstacles for doctors who want to return to work after taking time off. And Rep. John Sarbanes (D-Md.) has proposed legislation to help expand reentry programs for primary care doctors and help cover physicians’ costs if they agree to practice in high-need areas.
After hitting a wall with her former employer and others, Dr. Gibson enrolled in an online retraining program in San Diego, which cost her $7,000. She spent 4 months completing the courses last year and a week shadowing a family physician. Then she took a written exam and was evaluated during mock visits with “patients” played by actors.
In the end, she received two certificates – one from the program and one from the University of California, San Diego, for 180 hours of continuing medical education.
“I definitely felt more confident,” Dr. Gibson said. But she still wanted more hands-on clinical training. So she recently started a paid family medicine fellowship at the University of Southern California, seeing patients under the oversight of other doctors.
Former medical school professor Dr. Leonard Glass created the San Diego program, called the Physician Retraining and Reentry Program, in 2013. Besides retraining primary care doctors, the online program has attracted specialists who wanted to switch to primary care, as well as some restless retirees.
“Some are simply tired of being retired,” he said. “It’s sort of an itch to go back to taking care of people.”
‘Expensive and time consuming’
Several retraining programs are run by hospitals, including Cedars-Sinai Medical Center in Los Angeles. There, participants spend between 6 weeks and 3 months seeing patients under the supervision of other physicians, then discuss their cases in an exit interview to demonstrate what they learned. They leave with a letter that can be submitted to employers or hospitals.
The Cedars-Sinai program costs $5,000 a month. Dr. Leo A. Gordon, who runs it, said some doctors who call to inquire are angry about having to spend the time and money when they already have so much education and experience. But he said others are simply appreciative that “there is a way to get back in the game.”
One Cedars-Sinai graduate, Dr. Maria DiMeglio decided she wanted to return to practice as an ob.gyn. after taking off almost 6 years to care for her children and her ill mother.
“I thought I was retiring, Dr. DiMeglio said, “but I kept my options open.” She had retained her medical license and kept up with continuing education courses. But she needed to persuade her old hospital, Cedars-Sinai, to give her privileges so she could perform surgeries. The Cedars-Sinai retraining program, she said, “wasn’t difficult, but it was expensive and time consuming. Not everyone can do that.”
Hospitals set their own requirements for doctors to get credentials and privileges, but doctors who have been out of practice for more than 2 years generally must show that they are competent to see patients. Having a certificate from a reentry program helps, said Dr. David Perrott, senior vice president and chief medical officer of the California Hospital Association.
Dr. Jeff Petrozzino, a 50-year old doctor who trained in pediatrics and neonatology, knows all about that. He ran into difficulty returning to clinical practice after spending several years doing health economics research.
“I was a double board–certified physician licensed in several states,” he said. “You would think I would be able to get a job.”
When he finally did get an offer at a medical center in New Jersey, he said both the position and the state medical license were contingent on him getting retrained. He completed a 2-month program at Drexel University in 2013, where he was surprised to discover many other doctors in a similar situation.
Dr. Petrozzino said he was grateful for the program – but given the hassles of reentry, he would advise doctors to plan carefully before taking a break from practice.
“Careers are interrupted or derailed for various reasons,” he said. “The system does not readily allow for reentry.”
Kaiser Health News (KHN) is a nonprofit national health policy news service. Blue Shield of California Foundation helps fund KHN coverage in California.
After taking a 10-year break from practicing medicine to raise four sons, Dr. Kate Gibson was ready to go back to work.
The family physician had been reading about a shortage of primary care doctors and knew she could help. But when Dr. Gibson, 51, applied to work at her former hospital near Los Angeles, she was turned away. She’d been out of clinical practice too long.
“I really thought it was not going to be that hard,” she said.
Like many professionals, physicians take time off to raise children, care for sick family members, or recover from their own illnesses. Some want to return from retirement or switch from nonclinical jobs back to seeing patients. But picking up where they left off is more difficult in medicine than in most careers.
In medicine, change occurs quickly. Drugs, devices, and surgical techniques that were standard a decade ago may now be obsolete. Or a returning doctor’s skills may simply be rusty.
“My hands feel like those of an intern,” said Dr. Molly Carey, 36, an Ivy League–educated doctor who recently enrolled in a Texas retraining program after 4 years away from patients.
After extended leaves, doctors must convince medical boards to reissue their licenses, hospitals to grant admitting privileges, and malpractice insurers to provide coverage. Only a handful of programs around the country are set up to help physicians brush up on their skills, and they can cost doctors thousands of dollars.
“Medical schools do a fantastic job graduating brand new medical students,” said Dr. Humayun J. Chaudhry, president of the Federation of State Medical Boards. “But what about people who have already graduated and need to get some retraining? There is clearly a dearth of those kind of training programs.”
Policy makers and professional organizations are pushing to make the process less burdensome and costly – in part because it may help ease shortages of primary care doctors.
Getting experienced doctors to dust off their white coats is cheaper than starting from scratch, said Dr. Robert Steele, director of KSTAR physician programs at Texas A&M Health Science Center, College Station. He oversees a miniresidency program at the University of Texas Medical Branch, Galveston, in which returning doctors divide their time between seeing patients and attending classes. The 3-month training includes the latest on medications, procedures, disease management, and treatment.
“[Returning doctors] just need polishing up to practice safely and competently,” Dr. Steele said.
Patient safety advocates argue that minimum standards should be set to ensure that doctors coming back after a hiatus are providing the best care possible. As it stands, no nationwide standards or requirements exist, and states have different requirements.
“Patients would like to think that any doctor who is seeing them or doing procedures on them is at the height of their career,” said Joe Kiani, founder of the Patient Safety Movement Foundation. “If a doctor has been out for a while, they are not.”
Dr. Carey had a great education, graduating from medical school at the University of Pennsylvania and completing a residency in 2011 in obstetrics and gynecology at Brown University and a Providence hospital. But after taking just 4 years off to care for a sick grandmother and another relative, she felt she needed to freshen her clinical skills. So she moved from Rhode Island to Texas to take part in the KSTAR program, hoping to gain more confidence as a surgeon and become more marketable.
Setting standards and removing obstacles
Reliable numbers of how many doctors suspend their practices aren’t available, but the American Medical Association estimated in 2011 that 10,000 doctors could reenter practice each year.
The Federation of State Medical Boards wants states to create a standard process for physicians to show they have the skills to return to medicine. It is asking licensing agencies to track whether doctors are still practicing and whether they are doing so in their area of training.
The American Academy of Pediatrics and the AMA also are trying to remove obstacles for doctors who want to return to work after taking time off. And Rep. John Sarbanes (D-Md.) has proposed legislation to help expand reentry programs for primary care doctors and help cover physicians’ costs if they agree to practice in high-need areas.
After hitting a wall with her former employer and others, Dr. Gibson enrolled in an online retraining program in San Diego, which cost her $7,000. She spent 4 months completing the courses last year and a week shadowing a family physician. Then she took a written exam and was evaluated during mock visits with “patients” played by actors.
In the end, she received two certificates – one from the program and one from the University of California, San Diego, for 180 hours of continuing medical education.
“I definitely felt more confident,” Dr. Gibson said. But she still wanted more hands-on clinical training. So she recently started a paid family medicine fellowship at the University of Southern California, seeing patients under the oversight of other doctors.
Former medical school professor Dr. Leonard Glass created the San Diego program, called the Physician Retraining and Reentry Program, in 2013. Besides retraining primary care doctors, the online program has attracted specialists who wanted to switch to primary care, as well as some restless retirees.
“Some are simply tired of being retired,” he said. “It’s sort of an itch to go back to taking care of people.”
‘Expensive and time consuming’
Several retraining programs are run by hospitals, including Cedars-Sinai Medical Center in Los Angeles. There, participants spend between 6 weeks and 3 months seeing patients under the supervision of other physicians, then discuss their cases in an exit interview to demonstrate what they learned. They leave with a letter that can be submitted to employers or hospitals.
The Cedars-Sinai program costs $5,000 a month. Dr. Leo A. Gordon, who runs it, said some doctors who call to inquire are angry about having to spend the time and money when they already have so much education and experience. But he said others are simply appreciative that “there is a way to get back in the game.”
One Cedars-Sinai graduate, Dr. Maria DiMeglio decided she wanted to return to practice as an ob.gyn. after taking off almost 6 years to care for her children and her ill mother.
“I thought I was retiring, Dr. DiMeglio said, “but I kept my options open.” She had retained her medical license and kept up with continuing education courses. But she needed to persuade her old hospital, Cedars-Sinai, to give her privileges so she could perform surgeries. The Cedars-Sinai retraining program, she said, “wasn’t difficult, but it was expensive and time consuming. Not everyone can do that.”
Hospitals set their own requirements for doctors to get credentials and privileges, but doctors who have been out of practice for more than 2 years generally must show that they are competent to see patients. Having a certificate from a reentry program helps, said Dr. David Perrott, senior vice president and chief medical officer of the California Hospital Association.
Dr. Jeff Petrozzino, a 50-year old doctor who trained in pediatrics and neonatology, knows all about that. He ran into difficulty returning to clinical practice after spending several years doing health economics research.
“I was a double board–certified physician licensed in several states,” he said. “You would think I would be able to get a job.”
When he finally did get an offer at a medical center in New Jersey, he said both the position and the state medical license were contingent on him getting retrained. He completed a 2-month program at Drexel University in 2013, where he was surprised to discover many other doctors in a similar situation.
Dr. Petrozzino said he was grateful for the program – but given the hassles of reentry, he would advise doctors to plan carefully before taking a break from practice.
“Careers are interrupted or derailed for various reasons,” he said. “The system does not readily allow for reentry.”
Kaiser Health News (KHN) is a nonprofit national health policy news service. Blue Shield of California Foundation helps fund KHN coverage in California.
