Boundary Problems

As I was browsing past issues of Psychiatric News on the Internet, I read with interest the letter by Dr. Rick Strassman in the February 6, 1998, issue about his problems in achieving licensure in Canada, specifically British Columbia. He noted the fact that he was a fully trained psychiatrist and should have been recognized as such in Canada.

May I mention that his experience is identical to the experience of other physicians trying to practice in the United States. I am a fully trained—some may say highly trained—psychiatrist who has worked in the United Kingdom for 14 years. I teach psychiatry to undergraduates and postgraduates. I am on the faculty of a university and chief of psychiatry for a county and have all the European degrees that an English-speaking psychiatrist can acquire, but I can neither practice nor contemplate work in psychiatry in the United States without taking what is equivalent to basic medical examinations and other licensing exams.

This is something that APA and regulatory bodies need to review. Psychiatrists who have been trained in such countries as the United Kingdom, United States, Canada, France, and Germany should be able to have their qualifications and experience accredited and recognized mutually.

In this way, we would be able to have the varied experiences we wish to have, do sabbaticals, and travel throughout the world of psychiatry without unreasonable restrictions, which are bureaucratic at best and discriminatory at worst.

I chair one of the largest associations of psychiatrists in the United Kingdom and would be interested in furthering this discussion with your readers and associations.