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Re-Entry to Clinical Practice

The Oregon Medical Board (“OMB” or “Board”) has the mission to protect the health, safety, and wellbeing of the citizens of Oregon and must protect the public from the practice of medicine by unqualified, incompetent or impaired physicians.  Consistent with this directive, the Board has adopted a policy regarding provider re-entry to clinical practice following a period of clinical inactivity.

In general, the Board requires any licensed physician with more than a 24-month hiatus from practice to design a re-entry plan that includes an assessment and possible supplemental training or mentorship.  Requirements for assessment and supplemental training vary depending on individual circumstances.  Factors the Board uses in determining the appropriate plan include the number of years in practice before the physician’s hiatus, the number of years out of practice, the type of licensure requested, and the physician’s intended practice and specialty.

Competency assessments include the Special Purpose Examination (SPEX), Comprehensive Osteopathic Medical Variable-Purpose Examination (COMVEX), self-assessment exercises, computer-based simulations and direct evaluation by a board-approved clinician.  Assessments should be standardized and validated.

Following the initial evaluation, a detailed re-entry plan is constructed, which may consist of mentoring, supplemental training, passing the SPEX or COMVEX exam, or other activities pertinent to the clinician’s needs.  Supplemental training should focus on the intended area of practice and cover a broad scope, including areas such as managing and assessing information.  The duration of participation in a re-entry program is dependent upon individual circumstances, and completion requires a letter from the program verifying fitness to return to clinical practice.  In cases where clinicians are found sufficiently competent during an initial assessment, supplemental training may be deemed unnecessary.  The re-entry program is not a mechanism for switching specialties.

Providers who are re-entering clinical practice after a prolonged absence may also be required to restrict the scope or volume of practice, work with a mentor, or participate in regular re-assessment of competency.  Mentors participating in physician re-entry programs must be board certified, have no public record and be Board approved.  Decisions to allow physician re-entry will be significantly influenced by mentor opinion and achievement of goals established at the outset of the mentorship.

Currently, there are national discussions about standardization of re-entry programs.  Common objectives of a standardized re-entry program include helping providers return to practice, assuring licensure boards of competency, promoting quality care, enhancing physician supply, and re-assessment of competency at the completion of the program.  The Board supports initiatives to standardize re-entry programs and establish accreditation.  Furthermore, the Board recognizes that re-entry programs may be expensive and that much of the financial burden will be borne by the clinician seeking re-entry.  In some circumstances, admission to a re-entry program will be influenced by State need for clinicians in that specialty.

The Oregon Medical Board is firmly invested in ensuring provider competency to deliver safe health care to Oregonians, and every effort will be made to maintain balance between provider supply and the demand for safe, competent health care. 

-Adopted April 2011