Medicine: Qualified Welcome

The inflow of doctors who have been poorly trained in foreign countries is threatening to undermine the standards of U.S. medical care, Columbia University's Dean of Medicine warned last week. Unless something is done about it, Dr. Willard C. Rappleye told a Chicago conference on medical education, the U.S. will lose the benefits of a 40-year effort to raise its standards.

Dr. Rappleye was not opposing the admission of all doctors trained abroad,-nor was he assailing their professional standards or ideals. But, he said, the simple fact is that many have had poor training in the basic sciences, and many more have not had enough experience in bedside care. When they reach the U.S., there is no nationwide program for checking on their qualifications or for plugging gaps in their education. An internship in a U.S. hospital is no guarantee of the additional training they need, said Dr. Rappleye, because too many internships are in small or municipal hospitals that are strapped for funds and understaffed. So they use these doctors as cheap labor and give them no training.

The A.M.A.'s Dr. Edward L. Turner had a suggestion: let the National Board of Medical Examiners act for the 48 states in passing on the qualifications of foreign-trained doctors. With a single nationwide standard, he said, it would be easier to license those who are already qualified, and to find out what additional training the others need..