Tuesday, February 7, 2017

Credentialing for Medical Students? Maybe Not Such a Bad Idea!

This article,  a physician imposter gains access to 5 Brigham and Women's operating rooms, originally appeared in Becker's Hospital Review. Here is a short excerpt:

A 42-year-old woman dressed in scrubs attended patient rounds and observed operations at Brigham and Women's Hospital in Boston even though she wasn't a physician. The woman first gained access to restricted areas at Brigham and Women's Hospital in September by requesting to shadow a surgeon while her application with the National Resident Matching Program was pending.

A surgeon agreed to let the woman shadow him not knowing she had been dismissed from a surgical residency program at Mount Sinai St. Luke's Hospital in New York City in May and reported to the New York Office of Professional Misconduct. It was also later discovered that the woman forged the three letters of recommendation attached to her application with the National Resident Matching Program, according to the report (See the original article for more details).

How Could This Have Been Prevented?

Well, first of all after reading the article it is clear there were quite a few loopholes in the above scenario; not all credentialing related. But as you dig further into the sequence of events, it seems like a more formal credentialing process for soon-to-be medical residents would have been prudent.

As a medical student, when applying for residency you haven't received your medical degree yet or passed any of your board certifications, so how can any of your credentials be verified? First and foremost a simple background check should be conducted for any potential employee and certainly anyone that is given permission to be in or near "critical" patient areas of the hospital. ID badges, visitor badges or other forms of identification should not be issued unless there is a recent record of this person in the hospital database.

If they are a medical student or in this case have applied for residency, this information should be verified. Prior to applying for a resident match, candidates must go through a interview with the respective hospital. This information should be documented within the specific hospital department, for example, orthopedics. For the National Resident Matching Program, hospitals submit to the organization which candidates they have interviewed and want to train. This information could have easily been verified as part of the background check.

Finally, the New York Office of Professional Misconduct is a state office that "investigates complaints about physicians, physician assistants and specialist assistants and monitors practitioners who are subject to Orders of the State Board for Professional Medical Conduct. This section provides a listing of all physicians, physician assistants, specialist assistants, and professional medical corporations who have been disciplined since 1990, or who are subject to a non-disciplinary Board Order, or upon whom charges of misconduct have been served."

This organization is one of many that can be monitored for sanctions or exclusions against providers, and other healthcare professionals. An ongoing monitoring program for all such employees including soon-to-be residents and fully credentialed medical doctors on staff would have potentially raised a red flag for this imposter.

For more information on background checks for your medical staff or sanctions and exclusions monitoring click here or give us a call at 1-800- 733-8737.


  1. The professional residency letter of recommendation is to acknowledge the efforts of a person who has played a substantial role in the smooth operations of a specific institution or department. Thank you for your incredible response.

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