I was thinking about this as people were discussing how the hierarchy at the ER works. First, what exactly is Luka's title? How is it that he has enough senority that he and Mark trade off being in charge when Kerry is not there? And why was Luka (being a foreigner, as I don't remember mention of his becoming a citizen) able to immediately become a full-fledged doctor when Elizabeth (also a foreigner) had to intern for awhile and THEN got a rather prestigious job? I guess I missed the explanations on this one.

Is there a double standard here? And not just in the gender department, but also within specific countries? In reality do hospitals (and states, I guess) require different credentials, experience, etc. from each foreign country before they allow you to be a practicing physician? I know this is how it operates in the educational system, so I thought maybe it was the same within medicine.

Laura

-- Laura (alulak@earthlink.net), April 25, 2000

Answers

I'm not sure exactly how it works when doctors come from another country, but in regards to Elizabeth, I do know that she choose to be an intern again because her fellowship was over and Romano didn't renew it. She didn't want to go back to England so it was her choice to start again until another fellowship was available. Kristine

-- Kristine (kriskazias@hotmail.com), April 25, 2000.

I asked my mum about this cos she's a doctor and she told me that in order to be able to practise medicine in the USA coming from a foreign country a doctor must have already done 1 yr of intern, then has to sit an exam to be able to practise in a hospitable.

Is it possible that Luka in fact came to USA a yr before joining County, then came to County after doing 1 yr of intern at another hospital in another hospital, whereas Lizzie had come straight from England and therefore still had to do a year of intern in the USA.

Because it's not said how long ago he left Croatia after the death of his family we don't know if he came straight to County or other places before that. My guess is that, because it would probably have been hard to attain a year of proper experience as a hospital dr in Croatia during the war etc that he came to USA one or two years before joining County in order to be able to practise as a dr - therefore he spent one yr doing intern some place, maybe another gaining experience then could come to County and qualify for quite an important job, because of his experience in the USA. This would also mean he'd already be a citizen of US, probably, having gained his citizenship before coming to County - thus we woiuld not hear of it.

I also think that Lizzie probably had a lot of experience practising in England before going to US therefore after her yr of intern could get an important job at County.

-- Juliet (Vizzn@AOL.com), April 25, 2000.

The Croation war was several years ago (early 90's) and I imagine Luka came to the US soon after his wife and kids were killed. So he has probably been here a few years and already become a citizen or at least got the necessary requirements in to become a doctor in the US before he came to CCH.

-- amanda (amanda.rehm@home.com), April 25, 2000.

I don't know how the system works but since Luka was introduced as a "moonlighter" I think there is an implication that he was qualified to practice in the U.S. Of course TPTB may never let us fully know his history. Of course that's part of the beauty of ER-the *unknowns* of each character are as much a part of why we like them as the *knowns*.

-- Bev (bev.burris@eer-h.com), April 25, 2000.

Since we're asking questions about Luka, in last week's rerun, "Humpty Dumpty" he comes in and Carol asks about his still being in Chicago, not having gone south yet (as he'd apparently said he did during the winter). He said he didn't leave until the first snowfall. Anyone else catch this and wonder about it? Later in the epi Kerry hired him full time keeping him in Chicago.

-- Diana (dilynne@juno.com), April 25, 2000.

With regard to the question about Luka going south for winter - I imagine he's probably a lonely guy just knocking around from place to place trying to find somewhere that someday may feel like home.

-- Linda (l.brown@mindspring.com), April 25, 2000.

I believe Luka is supposed to be an attending physician. Don't know if he did an internship somewhere in America, though we might assume he did.(But be careful, remember Amanda Lee.) This begs another question though. How old is Luka supposed to be? If he had a wife and 4 yr old kid killed, say, 3-10 yrs ago, has been in America long enough to do an internship and was hired as an attending physician in a major-ish hospital, would that put him comfortably into his 30's? It seems like somebody implied that he was the same age as the actor (27, IIRC).

-- Seb (fusion@poppy.ocn.ne.jp), April 26, 2000.

Do people marry younger in Croatia? If so, perhaps Luka was roughly 22 with maybe two kids - or a baby and a 2 yr old (we know he has a photo only of 1 of his kids, this means the other had probably not done something like taken a first step etc) when his family were killed, came to USA and spent a year of so going from place to place, maybe one doing intern then he could easily have been around 27 when he joined Country, perhaps younger.

I also don't think his family were killed so long ago - though I don't know the historical details - because he's still not over them - obviously you never get entirely over something like that, but if it was a long time ago his memories of his family would have faded and he would probably be ready to commit himself to someone else, though it is possible that the memory has always been clear in his mind over the years and that he is still grieving and brooding - however, I don't think this likely, considering his character.

-- Juliet (Vizzn@AOL.com), April 26, 2000.

There has been several queries about this and I hope this clears it up.

Luka was hired permanently because when Gabe Lawrence left, Kerry said there was a vacancy. This was in "Humpty Dumpty". At the beginning of the season, you'll recall that Kerry hired Gabe Lawrence as an ATTENDING. If Luka was hired to fill the vacancy that Gabe left, it stands to reason that he is also an ATTENDING.

I also think that the character is scripted to be a little older than the actor actually is. (This is also true of Carter) Luka could not possibly be 27 and already have a residency completed. (Unless he was Doogie Howser) Just do the math.

-- (trelles@ix.netcom.com), April 27, 2000.

There was a credentials question on another thread that made U.S. credentials very clear. Here it is in a nutshell.

If you got your medical training in another country and you want to practice in the U.S. you have to complete 1 years internship and pass an exam. Then you can practice. Remember in season 1 with Bob? This is what she was trying to do. The reason she was working at County was to pay bills until her English improved enough for her to take the exam. (They didn't say if she'd done her internship here. She was already certified in Poland, I believe.)

Lizzie was already a certified surgeon in the UK. She had completed her residency (I don't know how long it is over there). She came over here on a fellowship (sort of what Peter is doing now). When Lizzie lost her fellowship she had 3 choices: 1) Return to England (she didn't want to do this), 2) Find another fellowship and sponsor (iffy at best), 3) Get a license to practice in the U.S. and just get a regular doctors job. She chose 3. In order to do this, she had to complete a years internship here in the U.S. and sit an exam. She is now licensed to practice in the U.S. anywhere she chooses.

This protocol is the same for all foreign doctors. It stands to reason that Luka came over, completed his intern (hell) year and sat the exam before he came to County. Also, I read an article about this character that said he was an established (read certified!) doctor in Croatia when the war hit.

Another thing, you have to wait a certain period of time before you can apply for citizenship or permanent resident status. I'm not sure how long it is, but I'm certain Lizzie hasn't put in the time yet. We don't know about Luka. I'm willing to bet he's not a citizen yet, but probably a permanent resident. I'll ask my husband (he'll know) and get back to you all.

-- (trelles@ix.netcom.com), April 27, 2000.