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J21 Report of Reference Committee C DISCLAIMER The following is a preliminary report of actions taken by the House of Delegates at its June 2021 Special Meeting and should not be considered final. Only the Official Proceedings of the House of Delegates reflect official policy of the Association. AMERICAN MEDICAL ASSOCIATION HOUSE OF DELEGATES (J-21 Special Meeting) Report of Reference Committee [C] Tracey L. Henry, MD, MPH, Chair 1 Your Reference Committee recommends the following consent calendar for acceptance: 2 3 RECOMMENDED FOR ADOPTION 4 5 1. Council on Medical Education Report 1 – Council on Medical Education Sunset 6 Review of 2011 House Policies 7 2. Council on Medical Education Report 3 – Optimizing Match Outcomes 8 (Resolution 304-I-19) 9 3. Council on Medical Education Report 4 – Study Expediting Entry of Qualified 10 IMG Physicians to US Medical Practice 11 12 RECOMMENDED FOR ADOPTION AS AMENDED 13 14 4. Council on Medical Education Report 2 – Licensure for International Medical 15 Graduates Practicing in U.S. Institutions with Restricted Medical Licenses 16 (Resolution 311-A-19) 17 5. Council on Medical Education Report 5 – Promising Practices Among Pathway 18 Programs to Increase Diversity in Medicine 19 6. Resolution 305 – Non-Physician Post-Graduate Medical Training 20 7. Resolution 309 – Supporting GME Program Child Care Consideration During 21 Residency Training 22 8. Resolution 310 – Unreasonable Fees Charged and Inaccuracies by the American 23 Board of Internal Medicine (ABIM) 24 9. Resolution 318 – The Impact of Private Equity on Medical Training 25 10. Resolution 319 – The Effect of the COVID-19 Pandemic on Graduate Medical 26 Education 27 28 RECOMMENDED FOR REFERRAL 29 30 11. Resolution 304 – Decreasing Financial Burdens on Residents and Fellows 31 12. Resolution 314 – Standard Procedure for Accommodations in USMLE and 32 NBME Exams 33 Reference Committee C (J-21) Page 2 of 30 1 RECOMMENDED FOR REAFFIRMATION IN LIEU OF 2 3 13. Resolution 308 – Rescind USMLE Step 2 CS and COMLEX Level 2 PE 4 Examination Requirement for Medical Licensure 5 14. Resolution 311 – Student Loan Forgiveness 6 7 8 Amendments 9 10 If you wish to propose an amendment to an item of business, click here: 11 Submit New Amendment Reference Committee C (J-21) Page 3 of 30 1 RECOMMENDED FOR ADOPTION 2 3 (1) COUNCIL ON MEDICAL EDUCATION REPORT 1 – 4 COUNCIL ON MEDICAL EDUCATION SUNSET REVIEW 5 OF 2011 HOUSE POLICIES 6 7 RECOMMENDATION: 8 9 The Recommendation in Council on Medical Education 10 Report 1 be adopted and the remainder of the report be 11 filed, with the exception of H-260.978, “Salary Equity for 12 Laboratory Personnel,” which is reaffirmed. 13 14 HOD ACTION: Council on Medical Education Report 1 15 adopted and the remainder of the report filed, with the 16 exception of H-260.978, “Salary Equity for Laboratory 17 Personnel,” which is reaffirmed. 18 19 The Council on Medical Education recommends that the House of Delegates policies 20 listed in the appendix to this report be acted upon in the manner indicated and the 21 remainder of this report be filed. (Directive to Take Action) 22 23 Your Reference Committee heard limited, supportive testimony on this item. Testimony 24 from the Pathology Section Council requested that H-260.978, “Salary Equity for 25 Laboratory Personnel,” be reaffirmed rather than rescinded. Particularly during the 26 COVID-19 pandemic, the increased need for laboratory testing underscores the need for 27 highly skilled lab personnel who develop and run these tests is critical to maintaining 28 equitable access to timely, accurate lab results needed both by our care teams and our 29 patients. The Council on Medical Education agreed with the amendment, as does your 30 Reference Committee, which therefore recommends that Council on Medical Education 31 Report 1 be adopted as drafted, with the exception of H-269.978, which is to be reaffirmed. 32 33 (2) COUNCIL ON MEDICAL EDUCATION REPORT 3 – 34 OPTIMIZING MATCH OUTCOMES (RESOLUTION 35 304-I-19) 36 37 RECOMMENDATION: 38 39 Recommendations in Council on Medical Education 40 Report 3 be adopted and the remainder of the report be 41 filed. 42 43 HOD ACTION: Council on Medical Education Report 44 3 adopted and the remainder of the report filed. 45 46 1. That our AMA reaffirm Policies D-310.977, “National Resident Matching Program 47 Reform,” H-200.954, “US Physician Shortage,” and D-305.967, “The Preservation, Reference Committee C (J-21) Page 4 of 30 1 Stability and Expansion of Full Funding for Graduate Medical Education.” (Reaffirm HOD 2 Policy) 3 4 2. That our AMA encourage the Association of American Medical Colleges, American 5 Association of Colleges of Osteopathic Medicine, National Resident Matching Program, 6 and other key stakeholders to jointly create a no-fee, easily accessible clearinghouse of 7 reliable and valid advice and tools for residency program applicants seeking cost-effective 8 methods for applying to and successfully matching into residency. (Directive to Take 9 Action) 10 11 Your Reference Committee received supportive testimony in favor of adoption of this item, 12 including online testimony posted by the Academic Physicians Section, Resident and 13 Fellow Section, and Medical Student Section. As noted in the second recommendation of 14 the report, creation of a clearinghouse to assist applicants applying for residency programs 15 will help transparency and simplicity in the Match process and serve to decrease the 16 financial burden and other barriers to a successful match. This report also highlights our 17 AMA’s advocacy and leadership on this issue (through the Coalition for Physician 18 Accountability and other organizations) and our efforts to continue to change and improve 19 the Match. For these reasons, your Reference Committee recommends adoption of 20 Council on Medical Education Report 3. 21 22 (3) COUNCIL ON MEDICAL EDUCATION REPORT 4 – 23 STUDY EXPEDITING ENTRY OF QUALIFIED IMG 24 PHYSICIANS TO US MEDICAL PRACTICE 25 26 RECOMMENDATION: 27 28 Recommendations in Council on Medical Education 29 Report 4 be adopted and the remainder of the report be 30 filed. 31 32 HOD ACTION: Council on Medical Education Report 4 33 adopted and the remainder of the report filed. 34 35 1. That American Medical Association (AMA) Policy D-255.980 (1), “Impact of Immigration 36 Barriers on the Nation’s Health,” that reads, “Our AMA recognizes the valuable 37 contributions and affirms our support of international medical students and international 38 medical graduates and their participation in U.S. medical schools, residency and 39 fellowship training programs and in the practice of medicine” be reaffirmed. (Reaffirm HOD 40 Policy) 41 42 2. That our AMA encourage states to study existing strategies to improve policies and 43 processes to assist IMGs with credentialing and licensure to enable them to care for 44 patients in underserved areas. (Directive to Take Action) 45 46 3. That our AMA encourage the Federation of State Medical Boards and state medical 47 boards to evaluate the progress of programs aimed at reducing barriers to licensure— 48 including successes, failures, and barriers to implementation. (Directive to Take Action) 49 Reference Committee C (J-21) Page 5 of 30 1 4. That Policy D-255.978, “Study Expediting Entry of Qualified IMG Physicians to US 2 Medical Practice,” be rescinded, as having been fulfilled by this report. (Rescind HOD 3 Policy) 4 5 Your Reference Committee received supportive testimony in favor of adoption of this item, 6 including online testimony posted by the Academic Physicians Section and the 7 International Medical Graduates Section. Proposed and enacted state licensure and 8 credentialing models, such as those described in the report, may enable physicians to be 9 quickly credentialed and licensed so that they may help address national or international 10 pandemics or state/ regional medical emergencies. Additionally, the state models 11 presented may support additional states’ efforts to assist international medical graduates 12 with credentialing and licensure. For these reasons, your Reference Committee 13 recommends adoption of Council on Medical Education Report 4. Reference Committee C (J-21) Page 6 of 30 1 RECOMMENDED FOR ADOPTION AS AMENDED 2 3 (4) COUNCIL ON MEDICAL EDUCATION REPORT 2 – 4 LICENSURE FOR INTERNATIONAL MEDICAL 5 GRADUATES PRACTICING IN U.S. INSTITUTIONS 6 WITH RESTRICTED MEDICAL LICENSES 7 (RESOLUTION 311-A-19) 8 9 RECOMMENDATION A: 10 11 Recommendation 1 in Council on Medical Education 12 Report 2 be amended by addition and deletion, to read 13 as follows: 14 15 1. That our American Medical Association (AMA) 16 advocate that qualified international medical graduates 17 have a pathway for licensure by encouraging 18 encourage state medical licensing boards and the 19 member boards of the American Board of Medical 20 Specialties to develop criteria that allow 1) completion 21 of medical school and residency training outside the 22 U.S., 2) extensive U.S. medical practice, and 3) evidence 23 of good standing within the local medical community to 24 serve as a substitute for U.S. graduate medical 25 education requirement for physicians seeking full 26 unrestricted licensure and board certification. 27 (Directive to Take Action) 28 29 RECOMMENDATION B: 30 31 Recommendations in Council on Medical Education 32 Report 2 be adopted as amended and the remainder of 33 the report be filed. 34 35 HOD ACTION: Council on Medical Education Report 36 2 adopted as amended and the remainder of the 37 report filed. 38 39 1. That our American Medical Association (AMA) encourage state medical licensing 40 boards and the member boards of the American Board of Medical Specialties to develop 41 criteria that allow 1) completion of medical school and residency training outside the 42 U.S., 2) extensive U.S.
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