PROFESSIONAL ISSUES
Most foreign-born doctors flunk Florida test -- againAfter a special licensing exam was revised to make it easier for a small group of foreign-born doctors to pass, 91% failed the second try.By Jay Greene, AMNews staff. April 3, 2000. Taking a second special medical licensure test in Spanish last year didn't seem to make much of a difference for a group of foreign-born physicians in Florida. Despite sitting for a revised test in their native language that emphasized clinical skills over textbook knowledge of basic science, 79 of 87 of the doctors failed the test. Florida is the only state that offers an alternative to the U.S. Medical Licensing Examination. But that alternative, the Florida Medical Licensure Examination, is offered only to some 400 doctors, mostly from Cuba and Nicaragua, who immigrated to Florida during the 1980s and took a special course at the University of Miami from 1990 to 1992. Supporters of the doctors claim the revised test still discriminates against them. Opponents of the special test, including L. Thomas Bowles, MD, executive director of the National Board of Medical Examiners, say the low pass rate indicates Florida should eliminate the special test. "We don't think a tailor-made case for anybody is the best way to test medical competence," Dr. Bowles said. "Florida did everything that was asked of them. They offered a special test, then revised the test to stress daily-practice-type questions and downplay basic science that the doctors said they are rusty in. Yet we still see a 90% failure rate." Dr. Bowles said only 10% of U.S. medical school graduates fail the USMLE, which is required of all U.S.-trained physicians. About 40% of the international medical school graduates who take the USMLE fail the first time around. "Most of these doctors taking the Florida test failed the old Federation Licensing Examination" (replaced by the USMLE), Dr. Bowles said. Some 95% of those physicians failed FLEX, he said. "The high failure rate for all these tests says something." But Frank Cuneo, a Miami attorney for the Florida International Medical Assn., which represents the 400 foreign-trained doctors, claims state officials have purposely crafted an exam that guarantees failure. Although the physicians had pushed for the special test, Cuneo said most did not take the exam because they believed it was biased. In May 1999, when the special test was first offered, 260 doctors took it in English and 4% passed. Complaints of unfairness from South Florida legislators prompted the state to revise the test, translate it into Spanish and offer it again in November 1999. "A significant number of doctors have flunked," said Bernd Wollschlaeger, MD, a member of the Florida Medical Assn.'s IMG section and a family physician in Miami. "This has nothing to do with language and everything to do with the quality of the candidates." Copyright 2000 American Medical Association. All rights reserved. |