Licensing delays could set back doctors-in-training

SPRINGFIELD — Hundreds of highly qualified medical students could be absent from Illinois teaching hospitals starting in July because of delays in processing their licenses, the result of a dispute between lawmakers and the medical community about how to fund the state office that issues licenses for physicians and doctors-in-training.

Thousands of applications are submitted by medical residents every spring for temporary licenses. But the office that handles those applications, the Department of Financial and Professional Regulation’s medical unit, slashed more than half its employees last month because of financial woes.

The result: Processing times for licenses have increased from 16 days to six months. And it could get worse soon, since the unit is solely funded through license fees but lawmakers and doctors can’t agree on how much those should cost.

Medical students nationwide seeking residency spots for next academic year have until Wednesday to submit a list of their hospital preferences. Yet some highly qualified students may overlook Illinois hospitals out of fears they won’t be licensed by the time they have to start working.

“Students who are quite competitive, who have several options and could have their choice, it could make sense not to take the chance (of not being licensed on time),” said Dr. Karen Broquet, associate dean for graduate medical education at Southern Illinois University.

Senior medical students are interviewed by program directors between fall and winter every year. By February, those students must submit a list with their school preferences in order to a centralized matching service. Similarly, residency programs submit a list of their favored students to the same service. Using a complex algorithm, the service then matches students and programs, and the results are revealed on the third Friday of March each year.

Broquet said medical students have raised concerns about licensing delays during the interviews with program directors. She added that the school is assuring students that they will receive the promised training should they be selected by the school, even if they start later than scheduled.

But promises from medical schools may not be enough for students, since their future careers depend on their residency. By law, doctors cannot practice without a license.

“Illinois is not making its case very well to prospective doctors and prospective residents,” said Marc Lim, a senior medical student at Northwestern University’s Feinberg School of Medicine.

Lim, who is interested in orthopedic surgery, said he interviewed with a dozen programs in and outside Illinois.

“If I have this two choices and the difference is that I can get to start practicing medicine immediately, it’s not a hard choice,” Lim said. “You always go where you can practice medicine right away.”

Discussions between Illinois officials and doctors on how to adequately fund the licensing office began last year. Lawmakers and members of the Illinois State Medical Society have acknowledged that physicians’ license fees should increase, but they cannot agree on how much. The major disagreement resides on whether the department should borrow $6.6 million to rehire the 18 staffers that were let go Jan. 15.

Lawmakers have contemplated two bills this year that could restore the finances of the struggling unit. Both proposals allow the department to borrow money and raise the licensing fees to pay back the loan. The $300 fee physicians currently pay for a three-year license hasn’t increased since 1987.

Under a House proposal, the same license would cost $750. The Senate version puts a $700 price to the permit through June 2018. Payments would then fall to $500, after the office has achieved some financial stability.

But the medical society’s vice president, Jim Tierney, told a Senate committee last week that the department should not borrow any money. Instead, he said, the state should repay the medical unit the money that previous administrations swept from its fund.

The group has previously agreed to raise the fees to $500.

The medical society’s president, Dr. William Werner, has recognized that a lack of action from the legislature could significantly disrupt the training of medical residents. But he also says students focus on the quality of the training they will receive when ranking programs, and he’s confident many will still list Illinois hospitals this year.

“Illinois is well known for the highly regarded training programs we have for residents and fellows,” Werner said. However, he continued, “if this drags on by July 1, when the residents will be starting, then that will be a very serious issue.”

Between 2,300 and 2,800 medical students apply every spring for temporary licenses, Department of Financial and Professional Regulation spokeswoman Sue Hofer said. She said the department starts receiving applications around May 1 and must finish processing them by July 1.

In a public notice posted last week the department’s website, the acting director of financial and professional regulation, Manuel Flores stated that he is confident that the department will have the resources necessary to “effectively facilitate resident-physician `match’ programs for Illinois hospitals.”

The chief government relations officer for the Illinois Hospital Association, A.J. Wilhelmi, said the association’s members are hopeful that the General Assembly will move this week to fund the medical unit.

A bill authorizing the funds could be sent to the governor for approval on Wednesday at the earliest, provided that the House approves the measure that cleared the Senate last week and sets the fee at $700.

But the hopes of the department, hospital administrators and doctors-in-training could easily be crushed. House Speaker Michael Madigan’s spokesman, Steve Brown, said the problem will not be fixed before Wednesday and pinned the blame on the medical society, saying the group has strongly lobbied lawmakers against drastically raising licensing fees.

“You got to overcome the medical society’s opposition,” Brown said. “Maybe hospitals and students have helped overcome it.”