Definition of Physician Reentry
Physician reentry into practice can be defined as returning to professional activity/clinical practice for which one has been trained, certified or licensed after an extended time period. This is an issue that cuts across genders and specialties. However, anecdotal evidence indicates that reentry into the workforce will affect women more often than men. Although there is a paucity of data on this complex topic, many agree that it is an issue that is gaining in prominence.

Project Workgroups
Four topic-specific Workgroups have been established to advance the agenda of the Physician Reentry into the Workforce Project. The workgroups are:

• Assessment and Evaluation Workgroup
• Education Workgroup
• Credentialing, Licensure, and Maintenance of Certification Workgroup
• Workforce Workgroup

These Workgroups continue to meet by conference call and are engaged in activities ranging from developing scenarios to drafting a learner’s bill of rights (i.e. a document that describes what learners should reasonably expect from a ‘reentry program’ that is offered or required by a third party). All Workgroups had an opportunity to respond to a request from the AMA to assist in the development of “overarching guiding principles for developing a well-designed reentry system.”

In 2007, the Co-Chairs of each Workgroup gathered by conference call to share ideas and plans:

Co-Chair Conference Call Summary December 2007 (PDF file)

Assessment and Evaluation
Physicians returning to the workforce will face questions about their competence to resume clinical practice. This workgroup will need to identify appropriate methods for evaluating an individual physician’s competence and need for retraining. Once a physician has undergone retraining, a valid assessment will need to be in place to assure the public that the physician is skilled and competent to resume the practice of clinical medicine.

Assessment and Evaluation Guidelines (PDF file)

Assessment and Evaluation Workgroup Roster (PDF file)

Workgroup Conference Call Summary (September 2007) (PDF file)

Workgroup Conference Call Summary (June 2007) (PDF file)

Workgroup Conference Call Summary (April 2007)(PDF file)

Education
The educational needs of physicians who wish to return to clinical practice are extremely diverse. A “one-size-fits-all” approach is, therefore, unlikely to be effective; and yet the costs of providing customized education to each physician would be prohibitive. This workgroup will be charged with determining how to respond to each physician’s educational needs through Web-based and live CME, shadowing, preceptorships, mini-residencies, and formal reentry programs. This group should also identify strategies to defray the costs of such training opportunities to make them affordable to the individual physician.

Education Guidelines (PDF file)

Education Workgroup Roster (PDF file)

Workgroup Conference Call Summary (September 2007) (PDF file)

Workgroup Conference Call Summary (August 2007) (PDF file)

Workgroup Conference Call Summary (June 2007) (PDF file)


Credentialing, Licensure, and Maintenance of Certification
Physicians who choose to leave the workforce for a period of time risk losing their state licensure, their Board certification and hospital privileges. One of the challenges of this workgroup will be to identify strategies to help physicians maintain their professional standing while they are absent from the workforce. It will also need to propose a process for physicians to regain their professional credentials if they lose them and wish to return to active clinical practice.

Credentialing, Licensure, and Maintenance of Certification Guidelines (PDF file)

Credentialing, Licensure, and Maintenance of Certification Workgroup Roster (PDF file)

Workgroup Conference Call Summary (August 2007) (PDF file)

Workgroup Conference Call Summary (November 2007) (PDF file)

Workgroup Conference Call Summary (June 2007) (PDF file)


Workforce
With the growing proportion of women in pediatrics and other specialties, there will likely be an increase in the number of pediatricians taking an extended leave during their career or returning to medicine after retiring. This has serious implications for the overall supply of the physician workforce. This workgroup will need to determine how the workforce is likely to be affected, and how to mobilize physicians into the workforce once they indicate a wish to return to practice. Additionally, the group should consider how to marshal workforce resources in innovative ways to respond to public health emergencies and emerging models of health care delivery.

Workforce Guidlines (PDF file)

Workforce Workgroup Roster (PDF file)

Workgroup Conference Call Summary (March 2008) (PDF file)

Workgroup Conference Call Summary (May 2007) (PDF file)

The Physician Reentry into the Workforce Project is managed by the AAP Division of Workforce and Medical Education Policy.

Staff Contacts

Holly J. Mulvey, MA
Reentry Project Co-Director
hmulvey@aap.org

Ethan Alexander Jewett, MA
Reentry Project Co-Director
ejewett@aap.org

Diamond Lanier
Department Assistant
dlanier@aap.org

RESOURCES FOR PHYSICIANS

Highlighted Articles and Resources on Physician Reentry Issues: Organized medicine tackles physician reentry issues (PDF file) Posted with permission of American College of Obstetricians and Gynecologists. Reentry problems: returning to practice after a break not easy (PDF file) Posted with permission of Texas Medicine and the Texas Medical Association. Reentry Reading List (PDF file) After a break from practice, returning not easy (PDF file) Posted with permission of American College of Obstetricians and Gynecologists. Physician Reentry Policies: At the American Medical Association's (AMA) Annual Meeting in 2008, the AMA Council on Medical Education presented its report on physician reentry, which was approved by the AMA House of Delegates. The final version of the report can be accessed here. In 2008, the Texas Medical Association also developed a report on physician reentry.

SPOTLIGHT ON

Coalition for Physician Enhancement Resources The Coalition for Physician Enhancement (CPE) is a consortium of professionals with expertise in quality assurance, medical education, and the assessment, licensing, and accreditation of referred physicians seeking higher levels of performance in patient care. The topic of their 2008 spring meeting was physician reentry, and a number of informative presentations were made on topics ranging from the Inter-institutional Physician Retraining Program of the Oregon Health Sciences University to the Importance of Assessment and Enhancement to Physician Re-Entry in the US. To view all Powerpoint presentations, please click here. For more information on CPE and the Guidelines for Physician Enhancement Programs (PDF file), please visit the CPE home page.

REENTRY RESEARCH

Powerpoint on Physician Reentry - April/May 2008 The AAP Division of Workforce and Medical Education Policy delivers many presentations on the Physician Reentry into the Workforce Project at meetings of other medical organizations. The following overview presentation highlights research initiatives, as well as other activities, pertaining to physician reentry.  A copy of the Powerpoint can be accessed here Physician Reentry in Arizona Mary Rimsza, MD, FAAP, a member of the Reentry Project's Assessment and Evaluation Workgroup, and Mark Speicher, PhD Student in Public Administration and Policy, School of Public Affairs, Arizona State University, have studied the data on physicians who reenter the workforce in their home state of Arizona. Using licensure data from the Arizona Medical Board and the Arizona Board of Osteopathic Examiners, they focus on those physicians who not only leave and reenter the workforce, but also change their designated specialty. These findings, posted with the permission of the authors, were originally presented at the Third Annual AAMC Physician Workforce Research Conference, Bethesda , MD , May 2007, and updated in September 2007. Characteristics of Arizona Physicians Reentering Clinical Practice 2003-2006 (PPT file) Reentry and Remediation Resources for Physicians (PPT file) Survey Results on Physician Reentry The American Academy of Pediatrics collaborated with the Association of American Medical Colleges and other medical associations to field a cross-sectional survey focused on work patterns for physicians 50 years and older. The survey generated data on the exiting and reentry patterns of pediatricians over 50. These data were presented at the May 2007 Annual Meeting of the Pediatric Academic Societies (PAS). 2007 PAS Poster on Physician Reentry (PPT file)