人家没有board certification，moonlighting总可以吧。在移民病人很多的地区，一口家乡话胜过所有的paperwork：）））
我知道的这四位医师，只有一位是某院ERgroup的长期雇员，其他理论上都是短期的。 我还没算内科， 小儿科fellow 偶尔在 ER moonlighting 的呢：））） At any given time, ER里有board certified的ER doctors，有PA，还有这些医生。ER以前普遍亏空，再说病人也有季节性，如每个ER医生都必须是board certified的ER doctors，那恐怕更多的ER要关门了。但是对每一个病人来说，碰到谁就难讲了。我知道moonlighting的医师里有非常优秀的， 当然也会有。。。
“这些没有完成住院医培训，但拥有行医执照的医生，理论上可以自行开业。但是没有相关认证，很难吸引到病人。”对美国训练的，外语不够硬的医师来说，that is very true。 但在移民病人很多的地区，医师的一口家乡话往往胜过所有的paperwork：）））我只能这么说了。
对于政治势力特别强大的某些移民团体和他们中的医师，ECFMG都得让路。
http://www.nytimes.com/1989/05/31/us/immigrants-seek-to-be-doctors-again.html
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Last week the Florida House of Representatives took the doctors' side; by a vote of 105 to 4 it passed a measure that would enable them to obtain a license after a period of training in this country. The State Senate is expected to take up the issue this week. Only Fair, Nicaraguans Say
The bill applies mainly to physicians who came here from Nicaragua. The 400 doctors say it is only fair to give them special treatment because 6,000 immigrant Cuban physicians received such treatment from 1961 through 1986. And they point out that in Nicaragua they had seven years of university courses and one year of residency. With the extra training that would be required in Florida, they say, they would be well qualified to practice here.
If the proposal is adopted, Nicaraguans would not have to take the test for foreigners. Using state loans, they could enroll in a yearlong course at the University of Miami Medical School to prepare them for the Federal Licensure Examination. They would have to take the test in English; once they passed, they would spend one year working with a physician in a hospital associated with a medical school. Residency, Then Public Service
The work in the hospital would not be as extensive or rigorous as a resident's. Officials at the University of Miami say there are too few residency positions to accommodate the Nicaraguans.
To win political support for the plan, its backers added one more hurdle before the Nicaraguans could win a permanent license: they would have to practice for a year in areas where medical care is deemed insufficient, like migrant farm workers' camps or prisons.
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