Medicine: Plight of Foreign Doctors

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Softened Attitude. Top hospitals like New York's Bellevue which has about 100 foreign physicians, can choose the most promising foreign medical school graduates, who have less difficulty getting past the examination hurdle. The pinch comes in hospitals that have no affiliation with a medical school, need A.M.A.A.H.A. accreditation to attract good U.S. graduates. Six of the twelve foreign-trained doctors in Rhode Island's State Hospital for Mental Diseases flunked the exams, and one New York City hospital faces loss of a quarter of its house staff.

Last week, under pressure from Congress and the State Department, the A.M.A. relented a bit on its pass-the-test-or-get-out policy. Foreign doctors who flunked the September exam may remain with their hospitals until next July 1 can take another crack at the qualifying test in April. But they will not be permitted to treat patients until they pass the exam. The A.M.A. and the State Department also agreed that in the future, foreign doctors who want to work in the U.S. must pass the qualifying examinations in their own countries before even applying for exchange-visitor visas.