Interesting Article/Reason for Concern/Management's Response/Should I worry??

[Kerrmd]

Quality concerns spur scrutiny of Caribbean medical schools
State medical boards worry about the caliber of graduates' training as they seek U.S. medical licenses.

mods note: edited for names. may be reposted without names.

[Kerrmd]

State medical boards worry about the caliber of graduates' training as they seek U.S. medical licenses.

By Name Deleted staff. Jan. 16, 2006.

Source: http://www.ama-assn.org/amednews/site/free/prl10116.htm

Names are deleted on SuperModerator's Instructions.

With a recent explosion in the number of for-profit Caribbean medical schools catering to U.S. students, state medical board officials want to make sure students attending these schools get the skills they need to practice medicine in the United States.
The increase has prompted the Federation of State Medical Boards to review the existing systems used to evaluate American and international medical license applicants. Also, some state medical boards have created lists of schools from which they will not license graduates.
Licensing board officials are concerned that some medical school graduates might pass the U.S. Medical Licensing Exam, complete the clinical physical exam test and get into a residency program, but do so without a medical education that truly qualifies them to practice unsupervised, which is what a license ensures.
"This is becoming a huge issue on a national level and in California," said JH, chief of licensing at the Medical Board of California. "You may find someone ... sharp enough to pass a test but not have the skills to practice medicine independently."
There's been no flood of disciplinary actions. Instead, it is the deluge of new schools that has raised concerns. Since 2000, California's board has documented 40 new medical schools outside the United States, with more than half of them in the Caribbean. At the other end of the pipeline, the Educational Commission for Foreign Medical Graduates reports that the number of U.S. citizens with foreign medical degrees seeking certificates to participate in the National Resident Matching Program jumped 39% in the past decade, from 527 in 1995 to 1,360 in 2004.
DA, the FSMB's senior vice president, said the changing statistics give medical board officials pause. One statistic that has caught their attention: In 2004, 53% of American citizens who graduated from international medical schools passed the USMLE Step 1 on their first try, a full 17 percentage points lower than the 70% of citizens of other countries who attended medical school outside the United States who passed the test on the first try that year.
In response to this and similar data, an FSMB committee's draft report recommends several things to evaluate the quality of medical schools outside of the United States, including creating a database to track international medical schools' records. The database could contain information such as the date a school opened, the percentage of Internet distance learning in the curriculum, the number of weeks of study required to earn a degree, graduates' job placement rates and USMLE scores.
"Boards are increasingly concerned about IMGs from these schools, their caliber and the rigor of their basic medical education," A said. "We have no good means of assessing that."
Increasing worries from FSMB member boards led to the special committee that produced the draft report. A final version is expected this spring. The proposed database is the most concrete report recommendation, but it's unclear if FSMB members will chose to pursue it, Austin said.
Call for a unified standard

International medical graduates make up a quarter of practicing physicians in the United States. The majority come from established schools, which state boards consider to be credible because they've existed for years and are geared to produce physicians to practice in their home countries.
The new Caribbean schools, however, have little history and are geared toward training U.S. citizens. While the schools often send students to the United States for clinical experience, the clerkship may or may not be as good as the ones U.S. students do through accredited programs.
In the United States and Canada, the Liaison Committee on Medical Education and the American Osteopathic Assn.'s Commission on Osteopathic College Accreditation maintain medical school standards. There is no comparable international accreditation group, the FSMB said.
California is the only state that visits foreign schools to determine whether they provide an education on par with U.S. schools. At least five other states keep lists of approved and non-approved schools but don't visit the campuses. The Kansas State Board of Healing Arts, for instance, has schools seeking acceptance to its approved list submit information on their curriculum and training to a review committee. Schools get automatic approval in Kansas if they've existed for 15 years or more. New York board officials visit campuses, but only for schools seeking U.S. clerkships, not for licensing.
RDF, MD, president of the Division of Licensing for the Medical Board of California, has conducted site visits. He'd like to see states adopt uniform standards so offshore schools have a clear idea of the measures they must meet.
"Let's embrace these schools and work with them," Dr. F said. "But let's put a group together to say, 'This is what our standards are.' "
He said the USMLE is just one element of the licensing process and that students' medical education also needs to be evaluated. "Are you going to certify process or applicants?" Dr. F asked.
California sees medical school admissions and curricula as a critical element to consider before issuing medical licenses. For example, the board wants to know how a school selects its students. Dr. F said that if there is no admissions committee, it's likely that little screening occurs. If the school has a committee, he said he would want to know its criteria.
BW, MD, chair of the American Medical Association's IMG Section, agreed that uniform U.S. medical licensing standards were the way to go.
"When individual states create their own standards, this creates a patchwork that discriminates against candidates who are highly qualified," Dr. W said.
Without uniform standards, Dr. W said, medical residents might train in a state and discover they can't get a license there because they attended a school on the state's disapproved list. He was contacted by a medical resident in Indiana who faced this situation and after finishing training had to move in order to practice.
The IMG Section's stance on this issue is not the same as the AMA's. The IMG Section, while under the AMA's umbrella, may hold views that are not AMA policy. An IMG-sponsored resolution to support uniform licensing standards was rejected by the AMA House of Delegates in recent years, Dr. W said.
The AMA does support the FSMB's efforts to look at designing a way to evaluate international medical schools and determine whether their programs are stringent enough for graduates ultimately to receive licensure from a state medical board.
Caribbean schools respond

JT, PhD, vice president of St. Matthew's University School of Medicine on Grand Cayman Island, said that although rogue schools are popping up in the Caribbean, the numbers being discussed were unreasonably high. He estimated that there were 30 medical schools in the Caribbean, as opposed to other sources who pegged the total near 65.
Dr. T believes his institution and four others among the 30 schools provide an education equivalent to that of American schools. But he questioned state boards' ability to provide qualified inspectors to evaluate them. When the California board reviewed his school, he said, the site team consisted of a pediatrician, a social worker and an attorney. His school failed a review by the board in February 2005. It paid $65,000 for the evaluation.
He thought his school had every piece of the puzzle in place. Its students are allowed to do clerkships in Florida and New York, and its alumni are among board-certified physicians practicing in the United States outside of California.
"It was very disappointing," Dr. T. "We went through a two-year examination period that culminated in a site visit and exit interviews. We had no sense that there were problems."
Meanwhile, some international schools are taking matters into their own hands. The newly formed International Assn. of Medical Colleges' provisional members include five schools from the Caribbean, two from Poland and one from the Philippines. The group aims to adopt standards similar to those of the LCME by early 2006, gather a team of experts for site visits, begin evaluating schools and make the results public.
Medical licensing and education experts in the United States said the IAOMC's efforts were commendable, but they said an inherent conflict of interest could limit creditability.
Austin with the FSMB said a simple solution was unlikely. "In the final analysis, the grantor of a medical license is protecting the public," Austin said. "Are you licensing the wrong individual? That's what keeps you up at night."

Best Regards,
Mark

[Kerrmd]

http://www.ama-assn.org/amednews/site/free/prl10116.htm

[DocSquatch]

This article basicly reiterates what I already told you...

The state with the highest standards is CA. They conduct thourough invesitagations into schools that have graduates or clerks seeking to practice in CA. These visits while expensive for the school allow for an objective assesment of the school to determine whether or not the school meets the same standards of education as a school in the US.

http://www.medbd.ca.gov/Schools.htm provides a list of schools that passed a site inspection and were deemed equivalent to US schools in terms of quality of education.

http://www.medbd.ca.gov/Saba_Report.pdf is the report that the survey team evaluating SABA composed and provides what is in my opinion the most objective source of information for SABA.

http://www.medbd.ca.gov/Applicant_Schools_Unapproved.htm provides a small list of schools that the medical board of CA sent an inspection team to that were not deemed equivalent to US medical schools. And the fact is that yes most of them were in the Carribean.

CA really is considered the gold standard for licensing FMG's and if you e-mail some residency directors they will likely tell you the same thing.

Also call some of the hospitals where Saba students are doing clerkships (I did when I was applying) and they will likely give you an honest assesment as to how they feel Saba students perform.

I really do hope this helps you out, and now maybe you can stop wasting everyone's time on these boards.

I think the answers you may be looking for are within yourself, and with some intense psychotherapy maybe you can start asking yourself the right questions.

Best of luck with that,
Matt

[ASIANDOC]

This article basicly reiterates what I already told you...

The state with the highest standards is CA. They conduct thourough invesitagations into schools that have graduates or clerks seeking to practice in CA. These visits while expensive for the school allow for an objective assesment of the school to determine whether or not the school meets the same standards of education as a school in the US.

http://www.medbd.ca.gov/Schools.htm provides a list of schools that passed a site inspection and were deemed equivalent to US schools in terms of quality of education.

http://www.medbd.ca.gov/Saba_Report.pdf is the report that the survey team evaluating SABA composed and provides what is in my opinion the most objective source of information for SABA.

http://www.medbd.ca.gov/Applicant_Schools_Unapproved.htm provides a small list of schools that the medical board of CA sent an inspection team to that were not deemed equivalent to US medical schools. And the fact is that yes most of them were in the Carribean.

CA really is considered the gold standard for licensing FMG's and if you e-mail some residency directors they will likely tell you the same thing.

Also call some of the hospitals where Saba students are doing clerkships (I did when I was applying) and they will likely give you an honest assesment as to how they feel Saba students perform.

I really do hope this helps you out, and now maybe you can stop wasting everyone's time on these boards.

I think the answers you may be looking for are within yourself, and with some intense psychotherapy maybe you can start asking yourself the right questions.

Best of luck with that,
Matt

This issue is very old.Having approval list does not automatically certifies a state with the highest standards.If you look at the views of the experts in this like the LCME,AAMC,FSMB...ETC most believe that states unfit to do medical education reviews,and even if a school is already approved,some states will still give grads hard time[Ex:if you read state of IN minutes you find that even after SABA approved in CA they still gave grads hard time],
and if California standards so high and been around for 25 years why no state simply copies the reviews and rules?because some did and simply did not work because they were discriminating against good applicants as stated in the above article,so they judging applicants based on qualifications.
Having California approvals is very good things and is a must these days but in no way provide immunity from difficulties in other states and California standards is not the standards approved and applied by all states.

[azskeptic]

This issue is very old.Having approval list does not automatically certifies a state with the highest standards.If you look at the views of the experts in this like the LCME,AAMC,FSMB...ETC most believe that states unfit to do medical education reviews,and even if a school is already approved,some states will still give grads hard time[Ex:if you read state of IN minutes you find that even after SABA approved in CA they still gave grads hard time],
and if California standards so high and been around for 25 years why no state simply copies the reviews and rules?because some did and simply did not work because they were discriminating against good applicants as stated in the above article,so they judging applicants based on qualifications.
Having California approvals is very good things and is a must these days but in no way provide immunity from difficulties in other states and California standards is not the standards approved and applied by all states. Co-incidentally, another state has just voted in executive session to follow California's laws for their state. When they do the press release on it I'll be sure others see it.

[Kerrmd]

why this thread has counters tuned off

[stephew]

no counters are turned off go to new posts and check the right hand side.

[ASIANDOC]

I recieved few PM asking how to review board minutes,boards minutes are public info to review and if you go to any board site you enter board minutes and review it.
I am enclosing a quote from one minute to point out to everyone with negative attacks on carribean schools here will hurt all carribean grads even if a school approved in CA ,all should be united to ease the hassle against carribean grads and to be treated in equality with other international grads based on qualifications,most that here in the US[except few states like NY]do not know the difference between carribean schools[all they know is carribean or Islands grad],licensure boards know the differece now.



", M.D.: Dr. resubmitted another application for licensure. He now has a license to practice medicine in Michigan and Saba has been placed on the approved list by California. That is for a matriculation date of 2002 and he graduated in 2001. Dr. asked why Dr. thought the board should reconsider his application. He passed the USMLE on the first attempt with good scores. He went in to one of the oldest and most renowned family practice residencies at ..in . He has tried to show that he is loyal to the State and does respect the Board’s decision. He would hope that the California decision in conjunction with his credentials would show that he is qualified to practice in Indiana. Dr. brought a fellow physician who trained with him and he recommended him to the Family Practice program and was his chief during residency training. He stated that Dr. has always shown the highest degree of professionalism and medical knowledge. He was a ...years prior to going to medical school at age ....

The Board commented about his application. His scores are good, but the code is written about the school, being an LCME approved program or the equivalent. The thing is that this is a school that does not offer any post-doctoral training. The Board Still haven’t seen that the school is equivalent.

...: He is not a big proponent of the Caribbean schools; however New York and California have accredited the school. He was given a residency permit, he completed his training in Indiana and has an unlimited license to practice medicine in Michigan. Giving him a waiver would be consistent with Dr.... and her situation. He is much more inclined to grant a waiver to a graduate of an Indiana residency training program with a license held elsewhere rather than just an initial license.A motion was made to grant a waiver for licensure, understanding that this by *no means infers that the Board approves of the school or will
license any other graduates from SABA will be approved for licensure."