Petition for California Governor to approve pilot program as a medical residency for PhA

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The PhA-eAML Physician Associate Project mission is to bring back US citizen foreign-trained MDs to serve California and eventually nationwide. US foreign trained Medical doctors can practice independently with a new license called PhA Physician Associate. The new license is the solution once and forever to indefinitely close the drama of foreign-trained MDs mistreatment since the ECFMG established in 1956! 

The reason for this PhA project is because these foreign-trained MDs, who had attended and graduated from medical schools approved American-Accredited Medical Education Standards from foreign countries from all over the world, though already pass all the USMLEs (step 1, step 2 CK, step 2 CS and obtained the ECFMG certificate) are unable to finalize their MD licenses because they are rejected to work in medical residency programs in which their MD licenses would be granted (the biggest excuse is these doctors have graduated more than three years out of medical schools). This renders thousands and thousands of wasteful MDs talents for the American public while America has been facing serious shortage of physicians in present, near, and far future! It is a stark reality! The whole picture is rather a contradiction of the absurdities of the current licensing system that has become detached from sincerely serving our communities.

The USMLEs are the American standardized quality for practicing medicine. Its importance and influence on international medicine practice is beneficial for both America and the international countries to match themselves to a realistic system for their quality of healthcare services. The pursuing of USMLEs by foreign-trained MDs from all over the world is one of the diversity beacons that continue to refresh the American Dreams and remake America and the world history closer to perfection. We bring on our citizenship duty to succeed the great stories in this professional spectrum of humanity.

To be able to practice medicine in the US, any professional should have a powerful piece of paper called the license.

The current medical residency has been mistreating US citizen foreign-trained MDs in many ways: they practice age discrimination, they sponsor visa for freshly graduated international MDs who are not related to the US to outsource resident jobs that should be placed for US citizen foreign trained MDs besides domestic trained MDs.

This phenomenon has been in the past, present and surely still continuing into the future unless we take some resolute actions. Although there have been many movements trying to solve the problem by expanding more residency slots, opening new medical schools, etc. these kinds of approach only gives more power to residency programs and opening more medical schools only aggravate the burden of the already-sickening system and to continue mistreating US-FMDs.

This phenomenon should be explained as “The Swiss Cheese Effect” in wrong management when one fault from the previous section leads to mistakes in the next and next steps in a process of management. This does not mean to name and/or to accuse any individual. However, it needs to be addressed exactly the problem.

Understanding this painful and intricate problem, we have found the PhA American Physician Associates to carry on the mission as a new license called Physician Associates so that there is an independent pathway for foreign-trained MDs who can work for a few years e.g. three to four years before they eventually finalize their MD licenses.

To be able to realize this ultimate goal, first of all, a pilot program should be sanctioned by the California Governor Office. The governor should approve for The PhA organization or a sponsor entity e.g. the Office of Statewide Health Planning and Development OSHPD ( to be able to carry on the pilot program of PhA Physician Associate residency and placement into jobs in California so that this pilot program would eventually spread out statewide when it works out right.

The description of the pilot program: a six months with possible 3 months extensions of residency for PhA Physician Associates. The residency program is designed according to the standard of any existent primary care residency program in California for MDs with modifications for PhA level of scopes of practice. The levels and scopes of practice of PhA would be higher than PAs as Physician Assistants and NPs Nurse Practitioners, but lower than licensed MD and PhAs are supposed to collaborate with licensed MDs at the ratio of one licensed MD for every ten to fifteen PhAs.

We need the governor to approve for the PhA organization to establish this pilot program to prove that US person foreign-trained MDs with ECFMG certificates can do a good job just like any other licensed MDs to serve the community. From here, the new license PhA will come into sight in the new law.

Once the establishment of the program developed and well organized, there would be open doors for other types of foreign-trained MDs besides US person foreign-trained MDs.

We sincerely ask all and everybody, no matter what, where and who you are, MDs or any professionals or the public, US persons or internationally located, to support this project because of both its short-term and long-term benefits would be tremendous to serve many small and big issues of our current broken healthcare system for the US as nationwide and even internationally when it develops full-fledged.

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Katherine Miller, USFMD-Founder of the American Physician Associates

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