Since arriving at Mayo Clinic last year, fetal surgeon Dr. Rodrigo Ruano has already performed several complex surgeries on fetuses in the womb.
He has removed a mass from a fetus' lung and operated on an unborn baby with severe spinal bifida — a condition in which the bones of the spine fail to form properly around the spinal cord. He has done several other high-stakes procedures, and for many of these tiny patients, the medical outlook would be grim without the surgery.
"Their chance of dying is very high," he said.
But Ruano would not be practicing at Mayo Clinic if it had not been for a law passed last year. The measure established a Medical Faculty License. It allows extraordinarily skilled physicians trained in other countries the opportunity to practice at the state's two academic medical centers — the University of Minnesota and Mayo Clinic. That law expires July 1, 2018. If that happens, Ruano and others would lose their licensure.
Mayo Clinic is urging lawmakers to take action this year and make the law permanent. Sen. Carla Nelson, R-Rochester, is sponsoring a bill in the Senate to do just that. She said it is critical that Mayo Clinic be able to keep recruiting top medical talent from around the world.
"We want to ensure that Minnesota continues to be a world-leading spot for research and be an innovative hub," Nelson said.
The push to make the law permanent enjoys strong bipartisan support. House Health and Human Services Finance Chairman Matt Dean, R-Dellwood, is sponsoring a similar measure in the House. Rochester DFL Rep. Tina Liebling is a co-sponsor of the bill.
"Mayo has a worldwide reach, so it makes sense for Mayo to be able to bring physicians who have unique skills — as long as we're careful that we're upholding our standards and they are properly vetted," she said.
The story behind the law
One Mayo Clinic doctor's determination led to the new law. Dr. Ola Famuyide had spent years trying to find someone who could establish a fetal surgery program at the clinic. After interviewing Ruano, he knew he had found the perfect person for the job. Then he discovered he couldn't hire Ruano because he had done his medical training outside the U.S. — even though the fetal surgeon had been practicing in Texas. So Famuyide begged Mayo Clinic lobbyist Erin Sexton to push to pass a bill in the final days of the session. Despite the steep odds, the measure was approved and the clinic was able to hire Ruano.
"If we couldn't do what we did with the help and assistance of the Legislature and the governor, he simply wouldn't be here," Famuyide said.
Without the law, Ruano would have had to spend up to a year studying to pass the U.S. Medical License Exam to be licensed in Minnesota — something the veteran surgeon said he wouldn't have been interested in doing. The new medical faculty license allows a foreign-trained physician to practice in Minnesota if they are deemed to be a person with "extraordinary ability in the field of science or as an outstanding professor or researcher" as defined under federal regulations. Several other states have similar laws, including Ohio, New York and Texas.
Four licenses already issued
Since the law took effect, the Minnesota Board of Medical Practice has issued four medical faculty licenses. All of them have been for physicians at the Mayo Clinic. They run the gamut from a cardiovascular surgeon trained in Turkey to a South Korean physician who specializes in complex transplant surgeries.
Minnesota Board of Medical Practice Executive Director Ruth Martinez said board members were frustrated last year that the license bill passed so quickly without giving them a chance to weigh in. However, she said the program has worked well so far.
"The board took a neutral position on it because they don't have any opposition to it, "Martinez said. "It's gone extremely smoothly. I can honestly say we have not seen any challenges or difficulties or problems."
While the bill enjoys strong bipartisan support, there is the danger it could get caught up in partisan disputes over funding. The measure is included in a House health and human services budget bill. Liebling said that bill as written faces strong opposition from Democrats and, in its current form, she said would likely be vetoed by the governor. There is the potential the bill could be passed as a stand-alone measure.
If law expires, 'door is closed'
Since Ruano became director of Mayo's Fetal and Diagnostic and Intervention Center, Famuyide said the clinic has been able to recruit other talented professionals eager to work with the surgeon.
"If the law expires, what it means is the door is closed to Mayo or any other entity to hire any other world-class surgeon or physician," Famuyide said.
As for Ruano, he said he was shocked and grateful to learn that a law had been passed to allow him to come to the Mayo Clinic.
"That was amazing. It was impressive. And of course, I was very happy," he said.
The Brazilian native said he is eager to continue building the clinic's fetal surgery program.
He added, "It is important for Mayo Clinic and also for the Midwest because we can bring our experience and combine with the other providers here to get the best quality of health care for the patient."