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Governor extends moratorium on enforcing USMLE requirement

Gov. Lolo Matalasi Moliga has extended the moratorium on the enforcement of local law pertaining to the licensing of physicians to work at  LBJ Medical Center and the Department of Health, while local officials have identified a U.S. college program to assist with the licensing of non-U.S. certified doctors.


Former Gov. Togiola Tulafono had issued an executive order in August 2011 to waive the the U.S. Medical Licensure Exam (USMLE) requirement for a 12-month period and during this period, non USMLE physicians were to work towards being U.S. certified. It was later extended until the end of 2012.


Last Friday, Lolo’s executive assistant Iulogologo Joseph Pereira said the governor has extended, via an amended executive order, the USLME requirement and details of the order will be released soon.


LBJ chief executive officer Mike Gerstenberger said yesterday that the Governor’s Office had also informed the hospital about this issue and the extension of the moratorium on enforcement of the physician licensing regulations is on its way to LBJ.


“We haven’t seen it yet, but very much appreciate the Administration’s prompt response to our request” for an extension, said Gerstenberger, who was responding to Samoa News questions.


Asked how many LBJ physicians are now US certified, he said there are eleven  physicians on staff who have taken the USMLE — about half that number are “locum” physicians, who visit us on a regular basis.


Asked how many more needed to be certified, Gerstenberger said, “that is the reason we have requested the moratorium” with the former governor and an extension under the new administration.


“We believe that the USMLE, the examination currently required by the American Samoa Health Services Regulatory Board, is not an appropriate measure of how competent a practitioner is,” Gerstenberger explained. “The USMLE measures scientific knowledge, which is only one component of the skill set required of a practicing physician.”


He also says that LBJ board of directors and medical staff, Health Department and the Health Regulatory Board have been working for two years to identify an alternative to this USMLE requirement.


“We believe we have found one – a program of the University of California, San Diego, School of Medicine called PACE  - Physician Assessment and Clinical Education.”


“Three faculty members from UC San Diego were here in early January to introduce the program. It is our intention to revise the language of the licensing regulation to give the Regulatory Board the flexibility to substitute the PACE certification for the USMLE requirement,” explained.


“We are awaiting a final proposal from San Diego and plan to begin to implement the program within the next few months. This will resolve the issue of competence for all of the practitioners who did not attend medical school in the United States,” he added.


In the original executive order, Togiola said “...due to the immediate and significant financial constraints” faced by the hospital and the  licensure requirements listed under local law (ASCA 31.0424), the hospital “has been unable to attract sufficient numbers of healthcare professionals to serve the growing population of American Samoa. (See story in today’s issue about comments in Senate about health regulatory board)


He said the hospital has “an urgent need to have licensure criteria” other than those listed in local statute to evaluate and employ competent healthcare professionals, and the hospital has policies and procedures in place to assess, hire, and supervise competent healthcare providers to ensure high quality healthcare to its patients.


During the moratorium, said Togiola, the health regulatory board shall determine what are acceptable equivalents to the requirements for licensure currently provided by law.


The board shall be allowed to license physicians that have demonstrated clinical competence in manners not listed in local law and said physicians can be employed by the LBJ hospital and Department of Health.


Requirement for licensure of physicians to work in American Samoa are listed in ASCA 31.0424, which states in part that an individual applying for a license to practice medicine or dentistry under this chapter shall establish to the satisfaction of the health regulatory board that the individual is a graduate of an accredited school of medicine or dentistry, and has completed at least one year of post-graduate training in a hospital or other health care or dental facility accredited for post-graduate training.


Graduates from an accredited school of medicine or dentistry located in the United States, Canada, Papua-New Guinea, Australia, New Zealand, Great Britain, Switzerland, France, Belgium, West Germany, Norway, Sweden, or Denmark will be considered as having met standards of education acceptable for licensure in American Samoa, it says.


Full details of ASCA 31.0424 can be read online at: