Can You Do a US Residency After English-Language Italian Med School?

Can I practice and specialize in the States? A hot topic and quite a subject of debate over the years. But sit tight cause we’re here to make your day – big changes are coming ahead!

As an Italian graduate, your degree is automatically recognized just about anywhere in the European Union and affiliated states like Norway or Switzerland. That is because the English-language programs are structured to meet EU-wide requirements. Is this the case for the United States though?

Many fellow students chose (or at least know that they have to opportunity) to do their residency in the United States. In case you’d like to live and practice there, you’d need to complete your practical training (for your specialty or subspecialty) in the US. This means that if you do your residency in, say Italy, and then decide to move to the States, you’d have to repeat your specialty training. Outch.

But right now we’re not concerned with the “HOW” or “WHEN”,  only with the “IF” – If the medical school we pick will be recognized as a valid institution by the US criteria.

Before you even apply for residency, as an International Medical Graduate (IMG), you need to make sure you’re allowed to. The first condition is that the med school you attended has to be recognized as valid medical training by the US authorities. In the past, there have been two issues with this step: whether our English – taught medical courses are individually recognized by the US; and whether they have the almost legendary “California accreditation”.

Let’s dive in and see why this is no longer the case.

Heads up, this is a complicated bureaucratic territory. We tried our best to understand the matter in detail and even contacted Pavia University’s very own Development Officer, Scott Burgess for further clarifications.

Here’s the easily digestible take out of what we gathered:

California accreditation – do we need it?

So, in order to do your residency in the United States, your English-language Italian MD degree must be recognized as a valid medical degree. Up until recently each of the 50 US states had its own requirements as to which medical schools it recognizes. California – the most populous state – wields, however, an enormous amount of influence in this process, and thus the med-school needed to get a California accreditation in order to be recognized in most states.

The problem was that even though most Italian Medical Universities were indeed recognized, the English-thaught programs of these same universities, were not.

But here’s the good news:

Since 2020 the law changed and accreditation by California is no longer required. As result students and graduates of the English-taught medical schools in Italy are now able to apply to California, as long as the university is listed in the World Directory of Medical Schools. Currently, all English-thaught med schools in Italy are listed.

Another big change coming in 2024

Starting from 2024 (previously 2023 but it got extended), international medical schools (IMS) will not be certified by each state and will not apply separately. Instead, the entire country (in this case Italy) will have to apply for accreditation, and once recognized, the accreditation would apply to all the universities in Italy.

How does a country get accredited?

First, an accrediting agency (which is the Government or the Health Ministry of the country) should apply for WFME (World Federation for Medical Education) accreditation. The process is lengthy and takes at least 1-2 years to complete if approved. After the agency is accredited, it means that WFME and Italy (the entire country) have, so to say, aligned standards regarding medical education and so, WFME automatically recognizes any Italian university’s curriculum, be it held in English or in Italian language. 

Exciting right? Even more exciting is the news we get now, in February 2021: Italy has already submitted its application! So in a matter of a year or two, Italy should be recognized. We all hope this will happen before 2024 when the new rules come to effect, but we have no reason to doubt it.

Here’s a map of the current WFME accreditation status (2021):

Time of graduation: which rules apply to me?

Now you may be starting to wonder whether the status of US recognition of a university is relevant when you enter med school or when you graduate. This is a valid question.

The status of a university is relevant at the moment of the student’s individual application for
US residency. This happens through another entity, called ECMFG (Educational Commission for Foreign Medical Graduates) only around the time of the student’s graduation, or at any point after you graduate. This means that students beginning their medical students will have 6 years before they need to apply for ECMFG certification and this is more than enough time for Italy to apply and hopefully, get accredited by WFME.

For a graduate applying any time before December 31st, 2023, the current system applies: English – thaught medical schools in Italy are US recognized.

For a graduate applying from 2024 onwards, Italy has to be approved. And by that time, it most probably will be.

Finally, it is important to keep in mind that recognition of your degree is just one small part of getting a US residency. Non-US medical graduates only have a residency acceptance rate of about 50%, and for certain competitive specialties like dermatology or plastic surgery, it is nearly impossible for a non-US-graduate to find a place. Your chances increase substantially if you do some of your med school education abroad in the US (in part, so you can get letters of recommendation from US doctors), and if you publish scientific research during your time as a med student. You also need to do comparatively awesomely on the United States Medical Licensing Exam, the USMLE.

OK, so that is as far as I have gotten on the question of whether you can do a US residency after studying medicine in English in Italy. Please let me know if you have any further information. As for Canada… well, I have not done much research. However, if you are licensed in the US, it is not hard (and indeed, becoming popular) to cross the border and practice up north.

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