Yes, It Is Time to Rethink Postgraduate Training Requirements for Licensure!

In his Commentary in this issue, Dr. Freeman asks whether it is time to rethink postgraduate training requirements for licensure. The majority of U.S. states require a minimum of one year of postgraduate residency training to qualify for a medical license. The original rationale for requiring just a single year of training dates back over half a century to the era of a general practitioner completing medical school followed by a rotating internship prior to heading out into independent general practice. Today, however, the requirement for a single year of training for licensure is in direct contrast to the more rigorous requirements for specialty certification, the current trend in medical education toward competency-based training, and the unanimous agreement among national organizations that readiness for independent practice usually takes three to five years of progressive training. The complexity of medical practice today, the rising use of technology, and the rapid explosion of the understanding of medical science raise the important question of whether this licensing requirement is out of sync with state medical boards' goal of protecting the public by licensing only qualified physicians. A national discussion should be held to distinguish clear minimal standards for physician training that protect the public by ensuring that practicing physicians are highly qualified through rigorous training.