The way Dr. Ola Famuyide saw it, his toughest challenge in getting a world renowned fetal surgeon to practice at Mayo Clinic would simply be convincing him to come to Rochester. He was wrong.
"He came. We liked him. He loved the practice, and I thought everything was hunky dory," said Famuyide, chairman of the clinic's Obstetrics and Gynecology Department.
Then came the bad news. The accomplished fetal surgeon — Dr. Rodrigo Ruano — had done his medical training outside of the United States. Even though he had been practicing in Texas, he was ineligible to be licensed in Minnesota. To get licensed, he would have to dedicate up to a year studying to pass the U.S. Medical License Exam — a tough sell for an experienced surgeon.
But Famuyide wasn't satisfied. Several other states, including Texas, Ohio and New York, have provisions in law that allow extraordinarily skilled physicians who were trained abroad the chance to practice at academic health centers. So Famuyide asked Mayo Clinic lobbyist Erin Sexton what could be done.
She didn't sugar coat things. With only 10 days left in the 2016 Minnesota legislative session, the prospects of getting a bill passed changing the state's physician laws seemed slim to none. But Famuyide was not deterred.
"I said, 'I love playing long odds. Let's do it,'" he said.
To the astonishment of Famuyide and others, lawmakers embraced the proposal. The bill sped through the Legislature and won DFL Gov. Mark Dayton's support. As of today, Ruano and other physicians like him can apply to the Minnesota Board of Medical Practice for a license to practice in the state. Ruano has accepted an offer to be director of Mayo Clinic's Fetal Diagnostic and Intervention Center. His job will be to help establish a fetal surgery program at the clinic. Only five or six such clinics exist in the United States, Famuyide said.
"It's important work because it offers hope to mothers whose babies otherwise have serious and awful, lethal malformations," he said.
A closer look at the new law
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. The physician must also be a faculty member at one of the state's two academic health centers — Mayo Clinic and the University of Minnesota — to be eligible for licensure. The law is set to automatically expire July 1, 2018.
Dr. Taylor Hays, chairman of Mayo Clinic's Personnel Committee, said the new law is a welcome change that will enable the clinic to compete for international talent. In the past, Hays said he has had to tell colleagues they can't pursue renowned surgeons who have done their training outside the U.S.
"We've had a number of situations where I would have loved to have had this," he said.
Hays said attempts to convince the Minnesota Board of Medical Practice to support an exemption went nowhere. No one had really thought to push it at the Legislature.
"We would just throw up our hands and say, 'We can't do it,'" Hays said.
He said he expects the clinic would rarely tap into the new law. But he said having it available means that Mayo Clinic will have the chance to pursue extraordinarily talented physicians.
"It's a win win," Hays said. "I don't think there are any losers in this. And as much as I feel cynical about the Legislature, they did a good job with this."
Not everyone pleased
Not everyone was thrilled with the lightening fast passage of the bill. Ruth Martinez, executive director of the Minnesota Board of Medical Practice, said she first learned about the bill on May 16 — two days after the board's last meeting. Six days later, the bill had cleared both the House and Senate and was on its way to to the governor's desk. Board members never got a chance to weigh in on the proposal.
Martinez said she isn't necessarily opposed to the proposal, but she's frustrated by how it got done.
"This went through without a hitch. (Mayo Clinic) is well connected and they had paved the way so that when it was introduced on the floor, it was a love fest," she said.
But lawmakers who backed the change say the new law will in no way lower licensing standards. Instead, it provides a very narrow exception for extremely talented physicians.
"We wanted to try to balance moving really quickly with trying to build in safeguards, which I think we did a good job of," said House Health and Human Services Finance Committee Chairman Matt Dean, R-Dellwood.
Senate Health, Human Services and Housing Chairwoman Kathy Sheran said she supported the provision because other states already have similar laws in place. She said it's important that Mayo Clinic and the University of Minnesota are able to compete.
"We needed to untie those handcuffs that we have placed on the systems, at least for awhile, to take advantage of this opportunity, and then have a more measured conversation," said Sheran, DFL-Mankato.
Building a fetal surgery program
Ruano is expected to be the first physician to take advantage of the new faculty medical license. A native of Brazil, Ruano earned his medical degree and did his residency in his home country. He also completed a fellowship in maternal-fetal medicine in Paris. In 2012, he began practicing at Texas Children's Hospital and Baylor College of Medicine.
Famuyide said that while fetal surgery remains a relatively new field, it can help improve outcomes for babies facing potentially life-threatening illnesses. He expects there will be challenges. Expectant mothers undergoing these procedures will likely have to stay in Rochester for months until the birth. But Famuyide said Mayo Clinic patients will benefit from being able to access this cutting-edge treatment.
"What Mayo Clinic is known for is providing solutions, offering solutions for patients with complex problems," he said. "This is as complex as a problems get for expectant pregnant mothers."