Many Americans come to Mexico expecting that a dermatologist in Mexico received the same training as a dermatologist in the U.S.
We assume a doctor is a doctor and skin is skin on both sides of the border. That is a big assumption and it is well worth taking the time to get an overview of medical training and qualifying criteria in the U.S. versus Mexico.
Surprisingly there are more similarities than differences but the differences are important and are a reflection of cultural and historical realities in the north versus the south.
Training begins right after high school in Mexico and in the U.S. it is only after completion of a baccalaureate. This means that Mexican medical students are younger throughout all major milestones of medical training.
They are responsible for all aspects of patient care earlier in their life and in training. We have both worked with young graduates in Latin America and older graduates in the United States.
Keeping in mind that this is a limited and biased study of a few American and Mexican students, we find pluses and minuses in both systems.
In broad strokes the Mexican medical students tend to accept criticism and work hard at improving technique and care of their patients. Perhaps because students in the U.S. have more life experience, they may mistake it for medical experience and thus are harder to convince to follow protocol and not question orders.
One of the ways the Mexican government meets the demands for universal health care is to require all medical graduates to serve a year in government-supported networks of clinics serving remote or disadvantaged communities.
After this final year the medical student becomes a doctor and can either do a residency or go straight into practice. Because the residencies are very competitive and represent several more years of low-paying work, a greater percentage of medical school graduates do not pursue specialty training and remain in general practice.
Board certifications across the standard “specialties” are very similar in the U.S. and in Mexico. Specialty training here is at least three years, with many specialties requiring up to eight.
The training and certification processes are becoming more and more uniform in the two countries.
Patient survival is the ultimate measure of the quality of care. In Mexico, as in the U.S., patient survival is directly related to the treating physician’s training and education. This means completing a residency as well as engaging in post-graduate medical education.
Compared to the U.S., quality control of private medical services in Mexico is slack. Once graduated either as a general practitioner or specialist, a doctor can set up office and never again read a medical journal or participate in continuing education.
Indeed some claim to be certified in a specialty when they are not. Poor oversight of private practice makes this more common in Mexico than in the United States.
So how can you make sure your chosen doctor is up to date in his field or truly qualified for the procedures he’s performing? What can you do to ensure that you are in the best possible hands?
The following websites contain information about physician training and certification. If your physician does not appear at these sites you are encouraged to ask them why not. They should always be able to document their training and continuing education.
• At www.cedulaprofesional.sep.gob.mx you can check both the general medical and specialty license. Make sure your provider has a medical license, known as a cédula profesional. Note that the site is in Spanish and requires knowing the doctor’s complete name.
• Board examinations are called Exámenes del Consejo and each specialty has its own website. You can look up consejo mexicano de followed by the name of the specialty and check when a doctor obtained his boards and if he recertified. For example, Cardiology Boards are www.consejomexcardiologia.org.mx.
• Recertification is important because it requires physicians to attend medical meetings, publish and teach, etc. This translates into better, more current practice. Most specialties require recertification every five years.
Also, many doctors are members of the American Academy of their specialty and thus meet the stringent training and education criteria required of their members.
Finally, physicians practicing in government certified hospitals, public or private, are required to have all their certification in order.
Carla Archer is a licensed and board certified (and recertified) dermatologist who lives in San Miguel de Allende.
Deborah Bickel also lives in San Miguel de Allende and is the founder and principal of Be Well San Miguel patient advocacy services. She is an international health worker with a master’s degree in public health from the University of California at Berkeley and is a graduate of the Stanford University Primary Care Associate program. She has practiced medicine in the San Francisco Bay Area, Latin America and Africa.
Do you have a question related to obtaining health care in Mexico? Send them to firstname.lastname@example.org and Deborah will do her best to answer them for you.