Mister Carriger presented an application asking the board to determine whether Dr. Helfrich, whose medical education and anesthesiology residency were completed in Germany, has the equivalent of two years of ACGME‑accredited residency training in the United States.

Carriger noted the applicant passed all three steps of the U.S. Medical Licensing Examination and received Educational Commission for Foreign Medical Graduates certification. "She passed all 3 steps of USMLE, and she documented significant training completed in Germany as an anesthesiology resident," Carriger said.

Physician board members debated whether Germany's residency structure and clinical scope are sufficiently comparable to U.S. anesthesiology training. Several members, including Doctor London and Doctor Green, argued that differences in the medical training system and lack of primary‑source verification weighed against finding equivalence without additional proof. Other members, including Doctor Wolf and Doctor Sauer, described European training as rigorous and urged consideration of the Yale letters of support, while noting the need to verify primary‑source documentation.

Given the divided views, the board unanimously voted to table the application and requested DPH seek further information from Yale, including possible witnesses or a recommendation that Yale pursue an academic (medical school permit) route that would limit practice scope while the university sponsor the candidate.

Next steps: DPH will ask Yale for additional documentation or consider advising Yale to pursue an academic permit to allow supervised academic activity while satisfying board concerns.