The Federation of State Medical Boards of the United States (FSMB), under contract with the US Department of Health and Human Services, planned and conducted the 1st International Conference on Medical Regulation. Participants met in Washington, DC in May 1994 and included representatives of Australia, Canada, Ireland, New Zealand, South Africa, the United Kingdom and the United States. Observers were sent from Egypt, Israel, Mexico and Taiwan.

Designed to initiate dialogue among the participating nations, the conference focused on the current status of medical regulation in the participating nations, examining current research and identifying future research needs. The conference was successful in stimulating discussion and creating a consensus in favor of continued international dialogue. Conferees concluded that problems faced in the field of medical licensure and discipline are not unique to any one nation, and they decided to hold a second conference in Australia.

The 2nd International Conference on Medical Regulation was held in Melbourne in October 1996 and experienced increased participation, with 20 countries represented. Topics of discussion included disciplinary procedures and practices, registration of medical students, assessment of international medical graduates, impaired physicians, re-certification and maintenance of competence, management of complaints, the international movement of physicians, and issues relative to telemedicine.

In September 1998, the Medical and Dental Professions Board of the Health Professions Council of South Africa hosted the 3rd International Conference on Medical Regulation in Cape Town, with 26 countries represented. The 4th International Conference on Medical Regulation was hosted by the General Medical Council of the United Kingdom in September 2000 in Oxford and attended by 118 medical professionals from 23 countries.

These conferences were successful in providing a forum for the exchange of ideas and discussion of common problems affecting the delivery of health care and the regulation of medical practice, and generated support for establishing an international association. An Interim Governing Committee (IGC) for IAMRA (originally known as the International Association of Medical Licensing Authorities [IAMLA]) was created, composed of a core group of permanent members to provide stability and continuity. Participating countries included Australia, Canada, Ireland, New Zealand, South Africa, Sweden, the United Kingdom, and the United States. The IGC approved a planning document outlining steps that were or would have to be taken to develop a permanent governance structure for the organization.

The following broadly defined goals were identified for the organization.

• Facilitate international cooperation and collaboration among medical regulatory authorities and the exchange of medical regulatory information.

• Encourage and support high standards for medical education, licensure and professional conduct.
  

• Provide a forum for the development of new concepts and approaches in medical regulation and thereby support medical regulatory authorities in protecting the public.

The IGC resolved that two matters be dealt with as priorities: the development of the bylaws of the association and formulation of mechanisms by which information could be exchanged between the members. Working Groups were created to formulate proposals on each of these issues, which were presented for approval by IAMRA membership at the 5th International Conference on Medical Regulation in Toronto, Canada in June 2002. Final membership criteria and a dues structure were included in the bylaws. Additionally, a reference listing of all known medical regulatory authorities was developed to enhance the exchange of information.

A Promising Future

The challenge for medical regulation in the 21st century is to create a relevant, effective medical regulatory system that can address the dynamics of global and rapidly changing medical practice environments, technologies and health care delivery systems. International cooperation is the key to enhancing the role of medical regulatory authorities as the primary vehicle for public protection in health care. IAMRA will help this goal become a reality.