Licensure

Licensure refers to the granting of a license, which gives a 'permission to practice.' Such licenses are usually issued in order to regulate some activity that is deemed to be dangerous or a threat to the person or the public or which involves a high level of specialized skill. The danger and skill elements inspire governments not to allow a free-for-all, but to regulate the activity, and licensing is a well-established and convenient method of regulation. Licensing includes such things as pilot and driving licenses, licenses to play professional sports, etc. In the case of certain occupations and professions, licensing is often granted through a professional body or a licensing board composed of advanced practitioners who oversee the applications for licenses. This often involves accredited training and examinations, but varies a great deal for different activities and in different countries.

In the USA and Canada, licensing (the term registration is sometimes used elsewhere) is usually required by law to work in a particular profession or to obtain a privilege such as to drive a car or truck or own a gun. Many privileges and professions require a license, generally from the state or provincial government, in order to ensure that the public will not be harmed by the incompetence of the practitioners. Teachers, medical practitioners, nurses, lawyers, psychologists, social workers, and certified public accountants are some examples of professions that require licensure. Licensure is similar to professional certification, and sometimes synonymous; however, certification is an employment qualification and not a legal requirement for practicing a profession.

In many cases, an individual must complete certain steps, such as training, acquiring an academic degree in a particular area of study, and/or passing an exam, before becoming eligible to receive their license. Individuals append an acronym to their name, such as CPA (Certified Public Accountant) or PE (Professional Engineer). In the United Kingdom, licensing as a form of professional regulation predominated in the centuries before 1900. It has largely given way to memberships of professional bodies. This usually involves registration with a professional body and the granting of grades of 'associateship,' 'membership' or 'fellowship' of such a body. Gaining membership of such bodies is usually restricted solely to those who pass additional examinations after university graduation. United Kingdom examples of professional bodies include: LRCP (licentiate of the Royal College of Physicians), MRCP (member of the Royal College of Physicians) and FRCP (fellow of the Royal College of Physicians).

Historically, in the professionalization process by which trades have transformed themselves into true professions, licensing fast became the method of choice in obtaining the occupational closure required by barring the unqualified from entry to the rites and privileges of a professional group. This was initially the preferred route of regulation whether for physicians, lawyers, the clergy, accountants, bankers, scientists or architects. However, licensing has given way to membership of professional bodies, as a means of excluding the unqualified.^[1]

License renewal

In places, licensure may still be a lifelong privilege, but increasingly nowadays, it requires periodic review by peers and renewal. It is very common for license renewal to depend, at least in part, on academia. In the United Kingdom such regular upgrading of skills is often termed continuous professional development, or CPD. In many professions this is fast becoming a standard, mandatory and annual requirement. For example, in the US, educators are subject to state re-certification requirements in order to continue teaching.^[2] The No Child Left Behind Act of 2001, enacted to improve performance in US schools, has led to an intensification of license requirements for both beginning and experienced educators.^[3] In the case of UK medical practitioners, the government has recently proposed that they should all be legally required to produce formal proof, every five years, that they are upgrading their standard of practise.^[4] This tightening of the UK medical licensing system has largely been a response to public and government unease about a series of recent and well-publicised cases of alleged medical incompetence, including the Harold Shipman case, the Alder Hey organs scandal^[5] and those involving David Southall,^[6] Rodney Ledward^[7] and Richard Neale.^[8] Such cases of medical malpractice in the 1990s are widely considered to have inspired the government to tighten professional control of medical practitioners and monitor the quality of their practice for their entire working life. One qualification for life is no longer deemed sufficient.^[9] Consequently, medical licenses can now be withdrawn when evidence of serious malpractice emerges. Currently, though such reviews of CPD are entirely voluntary, some form of professional development is already strongly encouraged within the medical profession.^[10]

Restricting entry

Licensure restricts entry into professional careers in medicine, chiropractic, nursing, law, business, pharmacy, psychology, engineering, surveying, and architecture. Advocates claim that licensure protects the consumer through the application of professional, educational and/or ethical standards of practice. Milton Friedman opposes this practice, believing that licensure effectively raises professional salary by placing limits on the supply of specific occupations. "It is hard to regard altruistic concern for their customers as the primary motive behind their determined efforts to get legal power to decide who may be a plumber."^[11]

Restrictions to employment without licensure can also prevent people with criminal records or severe mental health issues from working in occupations that require public trust.

Restricting entry by licensing is arguably a convenient and effective method of maintaining the high standards, high status and elite privileges of a profession as well as acting to eliminate competition from unqualified amateurs who provide a cheaper but (allegedly) sub-standard service. It means that only the most highly qualified persons are allowed entry into the profession and to enjoy its privileges, high salary and high status in society. Organizations such as the American Medical Association were explicitly set up to restrict the number of practitioners. However, libertarians like Milton Friedman have argued that this process is counterproductive as it seriously restricts the number of active professionals working in society and thus unnecessarily inhibits the working of a free enterprise economy.^[12]

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