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m →United States: Changed the history of the authority vested in states, not at the federal level, under the Tenth Amendment to the constitution, which is more specific than stating it's authority is set forth in the bill of rights, which is true, but specificity is better. I am reading the book cited under citation 14 which includes a lot of specific information related to this topic both on this page as well as the Federation of State Medical Boards page. |
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==China==
Medical practitioners in China started to be licensed for the first time when Law of the People's Republic of China on Medical Practitioners passed on June 26, 1998.<ref>{{cite web|url=http://www.gov.cn/banshi/2005-08/01/content_18970.htm|title=中华人民共和国执业医师法|website=www.gov.cn|access-date=24 April 2018|url-status=live|archive-url=https://web.archive.org/web/20170925052728/http://www.gov.cn/banshi/2005-08/01/content_18970.htm|archive-date=25 September 2017}}</ref> The law, which came into effect May 1, 1999, requires all newly graduated medical students to sit the National Medical Licensing Examination, regulated by the National Medical Examination Center, and then register with the local regulatory body. The two-part exam includes a Clinical Skill (CS) test and a General Written (GW) test. The candidates must pass the CS test to take the GW test. Each year, the CS is held in July, followed by the GW in September.<ref>{{cite web |url=http://www.nmec.org.cn/EnglishEdition.html |title=Archived copy |access-date=2014-05-27 |url-status=live |archive-url=https://web.archive.org/web/20140528011940/http://www.nmec.org.cn/EnglishEdition.html |archive-date=2014-05-28 }}</ref> The medical practitioners on the job who had obtained a primary medical qualification (i.e., Bachelor of Medicine) prior to law are not required to sit the exam and can directly be licensed.
==Colombia==
{{
The Instituto Colombiano para el Fomento de la Educación Superior (ICFES) and the Ministry of Education regulate the medical schools that are licensed to offer medical degrees. After completing all the schools' requirements to obtain a medical degree, physicians must serve the "obligatory social service" (in rural areas, research, public health or special populations e.g., orphan children), which usually lasts one year. After completing the social service, a doctor obtains a "medical registration" at the governor's office (Gobernación) of the Department (province/state) where they served the obligatory term. This registration is the same as a license in other countries, and authorizes the physician to practice medicine anywhere in the national territory. However, to practice in other departments requires an inscription from that department. Unlike the US, there is no official licensing exam for medical graduates in Colombia, since this responsibility is delegated to medical schools that have permission to confer medical degrees.
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===History===
The [[Tenth Amendment to the United States Constitution|Tenth Amendment to the Constitution]] became the underpinning for the entire medical licensing system. Following several years of discussion and debate, the states' ratification of this amendment as part of the [[United States Bill of Rights|Bill of Rights]] concluded on December 15, 1791.<ref name=":1">{{Cite web |title=ISBN 9780739174395 - Medical Licensing and Discipline in America: A History of the Federation of State Medical Boards |url=https://isbnsearch.org/isbn/0739174398 |access-date=2024-04-28 |website=isbnsearch.org}}</ref> It explicitly avowed that powers not granted to the federal government, nor prohibited to the states by the Constitution. The Tenth Amendment remains a living codification of states rights and is routinely cited by state medical boards today to justify the authority delegated to them by their state legislatures.
The [[American Medical Association]] when formed in 1847, proposed that the state legislate medicine (rather than each of the different medical schools). Horowitz argues that this suggestion was made in order to gain greater control over medical education.<ref name=":0" />{{Rp|page=38}}
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In 1877, the Illinois legislature passed the Illinois medical licensing law, which led to the aggressive prosecution of physicians that were perceived as illegal or unethical.<ref name = PMC2701151/> Medical boards of other states (often composed of both regular and irregular physicians) followed suit.<ref name = PMC2701151/> Some authors claim that these efforts allowed organized regular and irregular physicians to exclude not only fraudulent practitioners, but other groups, including midwives, clairvoyants, osteopaths, Christian Scientists, and magnetic healers.<ref>Sandvick, Clinton. "Enforcing Medical Licensing in Illinois:1877-1890" Yale J. Bio. Med. June 2009, volume 82, issue 2, pages 67.</ref>
In 1889, ''[[Dent v. West Virginia]]'',<ref>{{cite web |title=Dent v. West Virginia, 129 U.S. 114, 9 S. Ct. 231, 32 L. Ed. 623, 1889 U.S. LEXIS 1669 – CourtListener.com |url=https://www.courtlistener.com/opinion/92392/dent-v-west-virginia/?q=%22129%20U.S.%20%22&type=o&order_by=dateFiled%20asc&stat_Precedential=on&filed_after=01%2F01%2F1889&filed_before=01%2F01%2F1890&court=scotus |website=CourtListener |access-date=15 April 2022 |language=en-us}}</ref> the U.S. Supreme Court for the first time upheld a state physician licensing law. A practitioner with insufficient credentials to obtain a medical license sued West Virginia, claiming a violation of his rights under the [[due process clause]] of the [[Fourteenth Amendment to the United States Constitution|14th Amendment]]. The Supreme Court upheld the statute noting that, while each citizen had a right to follow any lawful calling, they were subject to reasonable state restrictions. Because of the nature of medical training, the large amount of knowledge required, and the life-and-death circumstances with which physicians dealt, patients needed to rely on the assurance of a license requiring physicians to meet a minimum set of standards.
In 1956, the [[Federation of State Medical Boards]] released "A Guide to the Essentials of a Modern Medical Practice Act."<ref>https://medicallicensedirect.com/files/A_Guide_to_the_Essentials_of_a_Modern_Medical_Practice_Act.pdf</ref> The report distilled a series of recommendations that addressed five core areas: the definition of the practice of medicine; eligibility standards for licensure; licensing examinations; licensure endorsement; and the bases for probation, suspension, or revocation of a license.<ref name=":1" /> Since its initial publication in 1956, the Essentials of a Modern Medical Practice Act has passed through thirteen updated editions, with the most recent in 2012.<ref name=":1" />
By the beginning of the 20th century most states had implemented licensing laws.<ref name=":0" />{{Rp|page=44}}During the 20th century, medical boards sought to eliminate diploma mills by expanding their requirements for medical schools.<ref name = PMC2701151/> They started to dictate the length and type of education required for licensing.<ref name = PMC2701151/> As early as 1910, all but 12 states excluded physicians from medical practice if their schools were not found to be in "good standing".<ref name = PMC2701151/> Between 1910 and 1935, more than half of all American medical schools merged or closed, in some part due to all state medical boards gradually adopting and enforcing the [[Flexner Report]]'s recommendations on having all schools connected to universities.<ref>{{cite journal|last=McAlister|first=Vivian|author2=Claydon, Emily|title=The Life of John Wishart (1850–1926): Study of an Academic Surgical Career Prior to the Flexner Report|journal=World Journal of Surgery|year=2012|pages=684–8|url=https://tspace.library.utoronto.ca/handle/1807/32172|doi=10.1007/s00268-011-1407-x|pmid=22270978|pmc=3279636|volume=36|issue=3}}</ref>▼
▲By the beginning of the 20th century most states had implemented licensing laws.<ref name=":0" />{{Rp|page=44}}During the 20th century, medical boards sought to eliminate diploma mills by expanding their requirements for medical schools.<ref name
Today, physicians are amongst the most highly regulated professionals with detailed criteria for licensing established by medical boards in each state, however, lack of discretionary action against physician misconduct by state medical boards has been criticized in recent years for their failure to discipline physicians, despite several consumer concerns and complaints.<ref name="PMC2701151" /><ref>{{cite web |access-date = 31 May 2021 |website = FSMB.org |publisher = [[Federation of State Medical Boards]] |url = https://www.fsmb.org/step-3/state-licensure/|title = State Specific Requirements for Initial Medical Licensure}}</ref><ref>{{Cite web |date=2023-07-26 |title=Doctors who put lives at risk with covid misinformation rarely punished |url=https://www.washingtonpost.com/health/2023/07/26/covid-misinformation-doctor-discipline/ |access-date=2024-04-28 |website=Washington Post |language=en}}</ref><ref>{{Cite web |last=Staff |first=Los Angeles Times |date=2022-01-14 |title=California Medical Board and troubled doctors: What you need to know |url=https://www.latimes.com/california/story/2021-12-10/full-coverage-california-medical-board-and-troubled-doctors |access-date=2024-04-28 |website=Los Angeles Times |language=en-US}}</ref>
{{Further|Federation of State Medical Boards}}
===Criticism===
{{POV|date=May 2021}}
According to a 1979 article in the ''[[Journal of Libertarian Studies
The added benefit of public safety made restrictive licensure laws more appealing to both physicians and legislators. Infrequently mentioned in the literature, is that the "public safety" that is created by reducing the number of practitioners only extends to the patients who receive medical care. Thus, the overall effect is more expensive and higher-quality medical care for fewer patients.<ref>{{cite journal|last1=Camenisch|first1=Paul F.|date=August 1978|title=On the matter of good moral character|journal=The Linacre Quarterly|volume=45|issue=3|pages=273–283|issn=0024-3639|pmid=11661606}}</ref>
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