There is a growing pool of foreign medical school graduates who may be practicing medicine in the United States without having earned a license to do so, according to the national Federation of State Medical Boards.
Typically, the federation says, such people were unable to find post-graduate residency training positions in hospitals--either because they failed the prerequisite certification examination or because no residency positions are available.
These unlicensed doctors may be hired as physicians' assistants or surgical technicians; yet they sometimes find themselves being expected to perform the duties of a licensed physician.
The proliferation of foreign medical schools in recent years is probably enlarging this pool of unlicensed doctors, said Dr. William E. Jacott, federation president.
A 1974 study in the New England Journal of Medicine found that 48% of nearly 4,000 foreign medical school graduates surveyed were already working in the health care field before they took their certification exams, including many who were involved in direct, unsupervised patient care.
The federation has long advocated a new study, and one is now under way by the U.S. General Accounting Office.
"There is nothing that makes me believe that the problem is any less in 1986, and the pool is significantly larger than it was in 1974," said Dr. Bryant Galusha, the federation's executive vice president.
Nearly two years ago, a congressional subcommittee on health and long-term care headed by Rep. Claude Pepper (D-Fla.) estimated that there are more than 10,000 physicians in this country with questionable credentials.
"And we don't think the problem has gone away," Peter Reinecke, a research director in the congressman's office, said in a recent telephone interview.