The california medical board and "republic of taiwan."

[CaliforniaEquality]

I have talked about this before, but I think that this topic deserves its own space.


The US government does not recognize taiwan as a separate country, and the US government admits that there is only one China.


According the California approved medical schools’ list, it listed taiwan not just as "taiwan", but it listed it as "republic of taiwan." This is not a simple mistake, it is a huge scandal! Why didn't it name it as "democratic republic of taiwan," or "people's republic of taiwan," it used the actual name of those pro Taiwan people like to use. Obviously, it is quite likely that someone from Taiwan paid some money to someone in charge of writing the approved the school list, so that someone who is charge changed the name to “republic of Taiwan.”


So it is very clear that this so called unbiased list is very biased. Pat who is a member of the board reads this site often. I have posted that message at least one month ago, they still haven't changed that list.

So here is the bomb for Pat and the rest of the members of the California medical board. Now it is no longer california citizens vs the board, it is Chinese government vs. the board!
Let's wait and see how long it will take the board to change this time. Hopefully, the chinese consulate does not have to contact the governor or even the president.

“Dear …..,

Thank you for the information you have provided. I have emailed Ms. Candis Cohen, the Board's public information officer and request that they should revise their website as soon as possible.

Best wishes,

Chinese Consulate

[swimguy23]

starting international fights is usually the best way to get what you want.....:rolleyes:

ok so they made a mistake there, fine but your target should be the cali board, not china

[Skipper]

once again go to a cali approved school!

skipper

[azskeptic]

starting international fights is usually the best way to get what you want.....:rolleyes:

ok so they made a mistake there, fine but your target should be the cali board, not china no mistake...they recognize graduates of who recognized schools...check WHO to see how the Taiwan schools are listed.

[PathOne]

OK, so you goofed because you could only get into a non-approved school, and now you want to get permission to work in California, or you'll start WW3 between China and the US.
Djeeezzz, I can understand why no reputable med school would want you as a student. Good luck with the rest of your life....

[azskeptic]

http://www.iamra.com/Indiv_search_results.asp?country=Taiwan%20(Rep.%20 of%20China)

[CaliforniaEquality]

Well, their official name is still "republic of China." not "republic of taiwan."

For you people who don't know, there is a huge difference. officially the government still admits that it is a part of China. if they start to use "republic of taiwan," that means that the government is declaring independence which China has warned not to do so.

so here we are, the california med. board is already using the name of "republic of taiwan." it is not a "mistake" at all, someone from the board is intentionally using that name. someone probably got some money from that government.

if those people don't want to correct, the only way left is to let the Chinese know. Now let's just wait and see how long it will take the california medical board to change this time! And they know this is not a joke, the Chinese take this name thing very seriously.

And for those who tell people to go to a california approved school, it is as if tell a black man to change his skin color.

[studentMD]

And for those who tell people to go to a california approved school, it is as if tell a black man to change his skin color.

im sorry but that analogy SO does not work..
ppl CHOOSE which school they go to....

[CaliforniaEquality]

no, like i have said it many times, if we can choose, we all want to go to stanford, ucla, etc etc.

and if we had choice, we would all go to a med. school in the states.

i am sure that if a black man has a choice of his skin color, he would chose something else.

someone wrote to me: " your post at http://www.valuemd.com/state-medical...tml#post394497 (http://www.valuemd.com/state-medical-licensing-information/99890-california-medical-board-republic-taiwan.html#post394497) has been reported for a racist comment. ...."

so i am not even white, how did i become a racist?

[studentMD]

no, like i have said it many times, if we can choose, we all want to go to stanford, ucla, etc etc.

and if we had choice, we would all go to a med. school in the states.

.

might not get into your number 1 choice..
but still havea choice among all the foreign schools
and if u cant get into a cali approved school..
then still have the choice to improve your app so that u can
doesnt take much to get into one of the approved schools other than a lil work.


i am sure that if a black man has a choice of his skin color, he would chose something else


i wouldnt be so sure about that..

[azskeptic]

Well, their official name is still "republic of China." not "republic of taiwan."

For you people who don't know, there is a huge difference. officially the government still admits that it is a part of China. if they start to use "republic of taiwan," that means that the government is declaring independence which China has warned not to do so.

so here we are, the california med. board is already using the name of "republic of taiwan." it is not a "mistake" at all, someone from the board is intentionally using that name. someone probably got some money from that government.

if those people don't want to correct, the only way left is to let the Chinese know. Now let's just wait and see how long it will take the california medical board to change this time! And they know this is not a joke, the Chinese take this name thing very seriously.

And for those who tell people to go to a california approved school, it is as if tell a black man to change his skin color. do a survey worldwide about recognition of Taiwan medical school graduates. They don't do it under China. Of course the US govt also sells planes to Taiwan but not to China.

[CaliforniaEquality]

you are missing my point here. US government dares not to call taiwan as "republic of taiwan." US government still agrees that there is only one China, and taiwan is a part of china.

now california medical board is an official government agent, so it is definitely violating the US policy by
1. calling taiwan province as "republic of taiwan."
2. approved 2 med. schools in cuba which the US governments bans any official contact with Cuba.

do a survey worldwide about recognition of Taiwan medical school graduates. They don't do it under China. Of course the US govt also sells planes to Taiwan but not to China.

[pruritis_ani]

you are missing my point here. US government dares not to call taiwan as "republic of taiwan." US government still agrees that there is only one China, and taiwan is a part of china.

now california medical board is an official government agent, so it is definitely violating the US policy by
1. calling taiwan province as "republic of taiwan."
2. approved 2 med. schools in cuba which the US governments bans any official contact with Cuba.

1. You are really grasping at straws with this one. Who freaking cares? China? Whoopdeedooo
2. How is this official contact with Cuba? This is merely stating that the school located in Cuba is acceptable to the board, and that any Cuban physician that successfully imigrates to the US and CA is eligible to apply for post graduate training and/or licensure.

You put up the absolute weakest arguments I have seen. Pretty clearly you got into the best school you could, which was still far below CA standards. Too bad. Have fun working in Kentucky or Mississippi, or wherever else your "degree" allows you to work.

[ASIANDOC]

I believe both CALIFORNIAEQUALITY and the oppositions are correct,the californiaequality calling the board unfair but that is not his opinion alone,many including top US org also feels the same way and calling on all states to judge individuals based on 14 yrs records and not 2 yrs basic sciences course,I am not advocate to any carribean school especially the few creedy ones that igonring all states requests to upgrade their standards but I am with the grads that passed all tests and completed training,and get certified by the speciality boards,such grads proven like anyone else comming from Cuba or Liberia that they are good.what about the hundreds of grads in the pre-approval era in the 83"s grads and been in practice for over 25 yrs what would we tell those,you should have gone to approved school when no such thing exist at that time!
on the other hand the opposition is correct that California rules are laws and its hard to change especially for few hand full of schools and if I was from California I would invest in CA approved school.
After the disapproval of excellent school like SMU I honestly do not blame any new school in not applying to CA because SMU records very impressive and far exceeds hundreds of the already approved schools,how would I know?because I seen many of such schools USMLE results and hospitals sites that way below standards.
the best way to evaluate applicants is to request premed GPA >3,ECFMG certificate,clinicals in greenbook hospitals,successful completions of residency,board certifications,and 3 years practice in good standing...then the public can be assured to be "super safe"...
physicians comming to USA from all over the world[25% of US physicians are IMG] and I have no doubt if the FSMB does site visits, half of such schools will fail inspections so lets not stick our head in the sand and tell our citizens all the 1800 schools except the carribean ones are schools with high standards because many are not,I am with most US authorities that the accreditation has to be thru experiences org like LCME equivalent,FSMB etc because states does not have the resources to do it,most states can't even finance the process!!!
personal thoughts and opinion
have great weekend.

[Aviv Imanuel]

... going to change anything in California? How do you think you will influence any change in their approval list? What VALID argument and on which constitutional grounds would you challenge it? Do you have any precedent case to sustain your argument?

Just food for our thoughts.





I believe both CALIFORNIAEQUALITY and the oppositions are correct,the californiaequality calling the board unfair but that is not his opinion alone,many including top US org also feels the same way and calling on all states to judge individuals based on 14 yrs records and not 2 yrs basic sciences course,I am not advocate to any carribean school especially the few creedy ones that igonring all states requests to upgrade their standards but I am with the grads that passed all tests and completed training,and get certified by the speciality boards,such grads proven like anyone else comming from Cuba or Liberia that they are good.what about the hundreds of grads in the pre-approval era in the 83"s grads and been in practice for over 25 yrs what would we tell those,you should have gone to approved school when no such thing exist at that time!
on the other hand the opposition is correct that California rules are laws and its hard to change especially for few hand full of schools and if I was from California I would invest in CA approved school.
After the disapproval of excellent school like SMU I honestly do not blame any new school in not applying to CA because SMU records very impressive and far exceeds hundreds of the already approved schools,how would I know?because I seen many of such schools USMLE results and hospitals sites that way below standards.
the best way to evaluate applicants is to request premed GPA >3,ECFMG certificate,clinicals in greenbook hospitals,successful completions of residency,board certifications,and 3 years practice in good standing...then the public can be assured to be "super safe"...
physicians comming to USA from all over the world[25% of US physicians are IMG] and I have no doubt if the FSMB does site visits, half of such schools will fail inspections so lets not stick our head in the sand and tell our citizens all the 1800 schools except the carribean ones are schools with high standards because many are not,I am with most US authorities that the accreditation has to be thru experiences org like LCME equivalent,FSMB etc because states does not have the resources to do it,most states can't even finance the process!!!
personal thoughts and opinion
have great weekend.

[ASIANDOC]

... going to change anything in California? How do you think you will influence any change in their approval list? What VALID argument and on which constitutional grounds would you challenge it? Do you have any precedent case to sustain your argument?

Just food for our thoughts.

no interest in changing anything,I personally been in practice for over 20 yrs and what you read here is not what you feel in reality,everyone I dealt with in my career from state boards to hospital privileges,to international consultant treated me with respect and appreciations.that's why you do not see too many practicing physicians here because they are fine,I started comming because I am slowing down in practice ready for retirement[I will be 47 soon],I tried everything academics,private practice,research and I loved my career ,you will love it too.
I believe the issue is too serious that changes will occur all over the States,for better or for worse?will wait and see....

good luck

[CaliforniaEquality]

You are right, most people don't care whether it is republic of taiwan or republic of china, but the Chinese government cares. And let's just wait and see how long it will take for those california medical board bureaucrats to change that list. To the Chinese government, this is a serious issue.

This is a perfect example of bureaucracy inside the california medical board. Now it is time to bring some outside force to make the change inside that board! As the Chinese say, "a journey of thousands of miles begins with a single step."

We can't change it in just one day, but at least, they are now being forced by the Chinese government to change the list.

2. for your second argument, it is truly absolute weakest one. as I have explained many many times. the board members are prohibited by the US government to travel to cuba to do inspections, so how can they approve those schools in cuba that they have never visited??! and at the same time, did not approve any med. schools in north korea. that simply does not make sense.

1. You are really grasping at straws with this one. Who freaking cares? China? Whoopdeedooo
2. How is this official contact with Cuba? This is merely stating that the school located in Cuba is acceptable to the board, and that any Cuban physician that successfully imigrates to the US and CA is eligible to apply for post graduate training and/or licensure.

You put up the absolute weakest arguments I have seen. ...

[pruritis_ani]

The board makes it clear that they DO NOT INSPECT every school. They only inspect schools that offer degrees that are primarily exported to the United States. Therefore, Cuban degrees are recognized due to the fact that the government of Cuba utilizes these graduates to care for it's own citizens. Same with North Korea. Same with all the native schools. Carib schools are subject to inspection because they have little outside quality control or governmental oversight. A pretty simple concept to grasp, that you have yet to understand.

It is pretty clear that you are so bitter about picking a crappy school that it destracts you from making logical or coherent arguments. While there is certainly some room for complaint about the CA list, none of your posts even come close to addressing real issues.

[CaliforniaEquality]

pruritis, you must either work for the board, or a member of the board.

......They only inspect schools that offer degrees that are primarily exported to the United States.

there are lots of indian doctors working in the US, did the board actally inspect all of those med. schools?

....... Therefore, Cuban degrees are recognized due to the fact that the government of Cuba utilizes these graduates to care for it's own citizens. Same with North Korea.

that totally does not make sense. north korean graduates also have to care of their own sick citizens. so why is the board treating two countries differently? that is obviously discrimination!

that should be "A pretty simple concept to grasp, that you have yet to understand."

It is pretty clear that you are working for the ca board that it destracts you from making logical or coherent arguments. While there is certainly plenty room for complaint about the CA list, none of your posts even come close to addressing real issues.

[swimguy23]

pruritis, you must either work for the board, or a member of the board.

......They only inspect schools that offer degrees that are primarily exported to the United States.

there are lots of indian doctors working in the US, did the board actally inspect all of those med. schools?

....... Therefore, Cuban degrees are recognized due to the fact that the government of Cuba utilizes these graduates to care for it's own citizens. Same with North Korea.

that totally does not make sense. north korean graduates also have to care of their own sick citizens. so why is the board treating two countries differently? that is obviously discrimination!

that should be "A pretty simple concept to grasp, that you have yet to understand."

It is pretty clear that you are working for the ca board that it destracts you from making logical or coherent arguments. While there is certainly plenty room for complaint about the CA list, none of your posts even come close to addressing real issues.

i think somoene workin for the cali board would have a more creative screenname than an itchy bum

[ASIANDOC]

in my opinion that an argument saying that a board inspect schools that catered and import physicians to CA is a weak argument because check with the highest # of IMG's in CA and where they are comming from?not from the carribean.The other argument that the non carribeans schools mostly for the local citizens government hospitals also not a good one especially for person like myself who practiced in thirld world countries and such grads committing malpractice everyday in countries malpracticed lawyers unheared of and such grads "very weak academically"and many citizens dying due medical errors,to say that the applicants to non carribean schools done well in premed,well half of applicants in Iraq and Syria carry high GPA called affiliation and referal letter from Baath party and most international students in Eastern Europe went to such countries because "they are rejects"in there own countries[just like the American going to the carribeans].
my point not to complaint or tell people what's right or wrong,just sharing info that some of your arugument does not make sense for a person who was on the other side[the third world countries non carribean side]of the argument.I believe all states should avoid creating special laws for special group and treat all applicants equally so no highly qualified physician get discriminated against[soory I had to borrow last idea from the AMA official].
personal experiences and opinion.

[jpryor]

AsianDoc,

I enjoy reading your opinions. It's nice to have your perspective here.

[ASIANDOC]

AsianDoc,

I enjoy reading your opinions. It's nice to have your perspective here.
Thank you jpryor
many who reads my messages feels on its surface that I am pro non approved schools,actually deep into my messages I am not at all and strongly against many carribean schools that operating above shopping plaza's and rented hotels as well as some lazy administrations not interested in applying to easy approval states[easier]like NY,FL...
however when I read a big title like CT hospitals open to students that there education country refused to take them and in the same article the officials in that country tells us our hospitals are not fit for clerkships then I feel that is public deception,when I read that all except English speaking Eastern European schools approved in CA and not require site visit and many grads immigrating to CA and such weak schools [many]is a safe heaven to rejects from all over the world with poor academics I have to say as a citizen "what's going on,why are we not protected from such grads too,if my family member harmed by Burgarian Nigerian,or St Lucian grad it does not make any difference and I am entitled to be protected from all schools?"
in the 80's I was the first group of applicants to gain acceptance to AUC,Dominica,also I paid 300 dollars to agency overseas and got acceptance to 6 schools in Eastern Europe schools[very cheap],
and again many of such schools are the place for the med schools rejects from the Middle East,Asia,Africa[not western Europe because most not approved].
I like to come and share opinion based on actual experience not just guess and predictions.
opinion shared

[pruritis_ani]

California Equity: no offense, but you don't even deserve a reply. It is impossible to get a coherent statement out of you. For your sake, I hope that people who are better informed are helping you in your fight. With you logic, I have a feeling you won't be getting anywhere.

Asiandoc: I never said that I agreed with the CA policy, simply outlined what it was so that CaEquity could understand it. If that it the policy that he disapproves of (the policy that inspections are limited to schools that export degrees), then that is the policy he should address. Simply addressing the titles CA uses for these countries is pretty ridiculous. If and when CA simply change the names on the list, then his argument is shot.

As for the policy in place, I actually agree with it. CA is taking the position that a medical school in place to provide education for it's citizens health care would logically have a vested interest in assuring that the doctors that graduated there would be well trained. Otherwise the citizens of that country would suffer. Does that mean the school is going to be perfect? No. But, I do think that is a more rigorous control then simply passing a one time inspection by the state of CA.

I don't understand you argument about the Eastern Europe countries. The English language progams at these schools do have to be inspected. Many already were, and were approved.

I do understand your point about licensure and residency being the great equalizer. However, I do think that adequate education needs to be in place before allowing students into residency. Not sure how to best do this, but I think an approval or accreditation process does need to be in place for offshore medical schools. CA does a reasonable (not perfect) job of this. However, we should remember that the board is going to always err on the side of protecting the citizens of the state, which is the right thing to do. The priority of the board is protection of these citizens, and the state has no duty to "protect" the "rights" of doctors that attend non approved schools.

[ASIANDOC]

California Equity: no offense, but you don't even deserve a reply. It is impossible to get a coherent statement out of you. For your sake, I hope that people who are better informed are helping you in your fight. With you logic, I have a feeling you won't be getting anywhere.

Asiandoc: I never said that I agreed with the CA policy, simply outlined what it was so that CaEquity could understand it. If that it the policy that he disapproves of (the policy that inspections are limited to schools that export degrees), then that is the policy he should address. Simply addressing the titles CA uses for these countries is pretty ridiculous. If and when CA simply change the names on the list, then his argument is shot.

As for the policy in place, I actually agree with it. CA is taking the position that a medical school in place to provide education for it's citizens health care would logically have a vested interest in assuring that the doctors that graduated there would be well trained. Otherwise the citizens of that country would suffer. Does that mean the school is going to be perfect? No. But, I do think that is a more rigorous control then simply passing a one time inspection by the state of CA.

I don't understand you argument about the Eastern Europe countries. The English language progams at these schools do have to be inspected. Many already were, and were approved.

I do understand your point about licensure and residency being the great equalizer. However, I do think that adequate education needs to be in place before allowing students into residency. Not sure how to best do this, but I think an approval or accreditation process does need to be in place for offshore medical schools. CA does a reasonable (not perfect) job of this. However, we should remember that the board is going to always err on the side of protecting the citizens of the state, which is the right thing to do. The priority of the board is protection of these citizens, and the state has no duty to "protect" the "rights" of doctors that attend non approved schools.

Again,I am not here to argue who should or should not be approved or why,I simply as a person who look at 2 group of grads that is comming as doctors to the USA and comming from 2 regions that have easy admissions and catered to rejects from there homeland:
Eastern Europeans non-English schools
------------------------------------------
Romania,Bulgaria,USSR,....etc
above schools takes hundreds of rejects from premed grads of D and less,
poor quality education to the point that most licensing authorities in many countries do not recognized such degrees and if you visit any third world country you see advertisments all over the streets and newspapers ads looking for candidates[just like if not worse than what's called "offshore
schools".
Carribeans
---------------
catered mainly to the American who failed access to US schools,easier admissions than US schools,and the standards varies.

both above 2 groups with similar standards comming to practice to the USA after completing all exams and residencies and boards.
my question:
as a consumer,how can I be protected from one group and not the other?
if I have a heart attack and rush to LA county hospital and the board prevents an X grad[like saint something] from taking care of me for my safety,but an eastern European grad who's academic standards assumed to be top notch but in reality its not,and killed me,who was suppose to protect me from such physician that get automatic school clearance based on being old government schools not catered for the Americans,I am dead who cares about that!!!
Having said above I must also say there are excellent med schools in Eastern Europe[but usually not the one taking foreigners,yes they are non English government]and also top notch carribean schools far better than any other international schools.
opinion from someone who actually applied to Eastern Europeans schools and looked at them as an option....carribeans in my opinion by far better.
my point also to inform people that the carribean schools are not the only group that import physicians,that is for profits,that takes rejects from homeland and international students targeting stratagies.
boards are doing good job but never focus on one area just like a patient comming with anal itching and drop of blood,if you focus only focus on hamorroids you will miss colon cancer and kill the patient>>>>>>>>>>just investigate everything.

hope we will have a better system in the future to assure our safety.

personal opinion

[pruritis_ani]

Asiandoc, I am not sure what you are trying to say....as far as the Eastern Europe schools, if they offer english language programs they need to be approved, just like the carib schools. If you are talking about the non-english programs, I think you are a bit off. The few doctors I know from Russia are very well trained.

I agree that there are schools in the carib that do a fine job educating doctors. These schools are already CA approved. I think you are saying that the non-approved carib schools are at least as good as some of the native language programs on the list. Well, I don't know about that. I think that the vast majority of schools out there that operate to provide care for thier own citizens have good controls in place. Do they all have the best equipment? No. Do they all have the best research? No. But, the job of educating doctors that are not dangerous is being done well, as the citizens of most of these countries demand it. The doctors that are coming to the US from these schools would certainly come from an adequate background, in my opinion, even though it may not be the best or most advanced.

Contrast that with the carib schools...anybody can rent a house, buy a charter in the carib and call it a med school. There is no oversight into the education, and the country hosting the school has no health risk from the school, as the "doctors" will all be returning to the United States. So, the government does not care about the quality of education. The owners may or may not care about education, but they certainly care about the cash the school can generate. So, you have the potential for abuse, with no oversight from the local goverment, no natural control in place, such as the concern for the well being of the citizens of the country in which the school is located. So, what should the states do? Accept passing of the USMLE as suffecient demonstration of medical knowledge, and let the grads into the state for residency? In my opinion, the answer is no. The states need to verify that the school is adequate.

As a citizen, I would take a internationaly trained doctor from Belarus or Africa over a fly by night carib grad any day. Why? Because I have much more confidence in the government of a third world country watching out for it's own citizens than I do in the for profit carib school watching out for US citizens.

Is this a perfect system? Not even close. But, it is far, far better than no system. And it is certainly NOT discriminatory. Come up with a better plan, and I am all ears. But, sitting on here stating that it is unfair when we all know the rules, that it is discriminatory, when all they are asking for is some demonstration of oversight or offering to provide evaluation of the schools quality, is not getting anybody anywhere. The fact is, the policy exists. All a school has to do to get around it is to get approved.

[ASIANDOC]

whaterver you say...
good luck

[CaliforniaEquality]

The discrimiation that the board has against all caribbean med. school graduates are very obvious.

Now it is time to bring the Chinese government to force the board to change. Even thought it is not related to us - imgs, we are still forcing the board to change.


Let's do it one step at a time.

[jpryor]

The doctors that are coming to the US from these schools would certainly come from an adequate background, in my opinion, even though it may not be the best or most advanced.

The USMLE scores do not support your argument. A third of the non-US/Canadian testees failed the first attempt and the pass rates posted by the schools indicate that greater than 80% (rough average) of their testees passed--so the balance has to be coming from individuals educated in these schools you allege to be doing adequate jobs. That is the crux of AsianDoc's argument.

You seem to have a bias against Caribbean schools. In case you really do have an interest, you might want to check where the majority of the 'diploma mills' have been located...I'll give you a hint, it's not the Caribbean.


So, what should the states do? Accept passing of the USMLE as suffecient demonstration of medical knowledge, and let the grads into the state for residency? In my opinion, the answer is no. The states need to verify that the school is adequate.

You aren't alone in this thinking, as one of the directors of the Medical Board of California is on record having made a similar statement. She alleged that it is possible for an individual to perform well on the Step exams and yet still be a poorly prepared. Personally, I think this kind of comment is poorly constructed and I sincerely doubt there is any objective evidence to support it.

If a test relies on assessing rote memorization skills then I could possibly get there with the argument that it is a poor instrument to evalutate a person's knowledge; however, the Step 1 exam requires identifying the best answer from similar answers for a given set of variables. One cannot fake this knowledge and the test design is the best instrument for assessing the scope of retained information. The FSMB agrees.

[ASIANDOC]

[quote=jpryor]The USMLE scores do not support your argument. A third of the non-US/Canadian testees failed the first attempt and the pass rates posted by the schools indicate that greater than 80% (rough average) of their testees passed--so the balance has to be coming from individuals educated in these schools you allege to be doing adequate jobs. That is the crux of AsianDoc's argument.

You seem to have a bias against Caribbean schools. In case you really do have an interest, you might want to check where the majority of the 'diploma mills' have been located...I'll give you a hint, it's not the Caribbean.

It was hard for me to open a discussion with pruritis when I realized he/she had no background on the many Eastern medical schools standards so I closed the issue,if I discuss an issue with someone,he has to have some background.

I obtained broad background on the subject when I worked in the Gulf area,for people do not know much about the Gulf[Bahrain,UAE,Oman...],they are rich ,advanced countries but they have very few local doctors and depands on doctors from all over the world[Europe,USA,Asia,Africa....]to provide medical and nursing care,I was most senior[board certified with 15 yrs experience] and we had to have policies to decide which country have good standards and which does not for public safety,at that time many schools in Eastern Europe [all government local]were not eligible to obtain license because such schools catered to large # of international students with low admission standards and some had no standards[no attendance needed,corruptions...],few were accepted[Poland,Czeck...]but they were hired as assistants never consultants and attendings even if they have 10 yrs training.
many of the international students grads upon return home,they work as residents under hospital license[this is the general rules, with few exceptions ].
some schools in USSR are good but I am just sharing my experiences since I was involved in an issue very similar to the carribean issue and that's why I laugh when I read that all non carribean non Mexican schools have minimum standards,yes some do and many don't.
Also on a different subject,It amaze me to see here carribeans put down other carribean students,yes some carribeans are by far better than others but my experience living and working in the heart of USA for years I can assure you that if lets say[just an example]a big 4 student spreading the word that few carribeans schools are good big four one of them but most are joke,most people here in the USA going to remember that "most carribeans are joke" and another point that being approved in an axtra state does not remove the stigma and sterotype as being "offshore grad",even in articles attacking schools like Spartan they had a map of banned schools including the approved ones to show you no one immune,my point just unite and stick together because the eyes are on the area alltogether not on the smaller schools alone...............and do not destroy your reputation in your very own hands.
good luck

morning thoughts and personal opinion

[pruritis_ani]

The USMLE scores do not support your argument. A third of the non-US/Canadian testees failed the first attempt and the pass rates posted by the schools indicate that greater than 80% (rough average) of their testees passed--so the balance has to be coming from individuals educated in these schools you allege to be doing adequate jobs. That is the crux of AsianDoc's argument.

You seem to have a bias against Caribbean schools. In case you really do have an interest, you might want to check where the majority of the 'diploma mills' have been located...I'll give you a hint, it's not the Caribbean.




You aren't alone in this thinking, as one of the directors of the Medical Board of California is on record having made a similar statement. She alleged that it is possible for an individual to perform well on the Step exams and yet still be a poorly prepared. Personally, I think this kind of comment is poorly constructed and I sincerely doubt there is any objective evidence to support it.

If a test relies on assessing rote memorization skills then I could possibly get there with the argument that it is a poor instrument to evalutate a person's knowledge; however, the Step 1 exam requires identifying the best answer from similar answers for a given set of variables. One cannot fake this knowledge and the test design is the best instrument for assessing the scope of retained information. The FSMB agrees.
Pass rates quoted by the schools mean nothing. I am going from memory here, but I recall the pass rates of non-US citizen IMG's being higher than US citizen IMG's as published in First Aid for step 1. That leads me to believe that pass rates are NOT what is published by the school (or at least the data are manipulated). As most US citizens attend school in the Carib, seeing a first time pass rate in the 50's simply does not jibe with the pass rates in the 80's that virtually ALL Carib schools claim.

However, I do think that there are a few Carib schools that do a great job of preparing students for the USMLE and for practice. I do believe that these schools are well know and are also approved in Ca.

I have no bias against Carib schools. I have a bias against schools that are unwilling and/or unable to pass an outside accreditation process. If these schools are in Europe/Russia/Asia/Central America/Carib/Antartica (and I know there are several out there that are bad news), then they should also be held accountable and avoided. I think the Ca board does a reasonable job protecting against this sort of diploma mill outside the Carib as well by requiring inspections. Again, it is not a perfect job, but they do a good job.

I think the USMLE is a great test to HELP verify that you recieved a good education. I also believe that a test is just that....basically a means to HELP verify an adequate education. If that test was all that is neccessary to become a resident, than we could all just sit home and read books. I may be in the minority, but I believe that a quality education is just as important as a passing mark on step 1 and 2.

Also, if you have some quote or source that shows the FSMB disagree with the CA position (or that the FSMB support using USMLE alone) I would be interested in reading it.

[Jumanji]

What else "HELPS" verify a good education?... I tend to think that the majority of things learned during basic sciences are text book based / labs. If you can pass step 1 with average scores (200), you're knowledge is adequate right? .. How about doing rotations at "green book" hospitals? and doing just as well in step 2CK, CS ? ...

Would you say research is what can separate a good education? If that is the case, research opportunities are poor at most caribbean schools. Inclduing those that are CA approved.

[jpryor]

Also, if you have some quote or source that shows the FSMB disagree with the CA position (or that the FSMB support using USMLE alone) I would be interested in reading it.

Here you go:
http://www.fsmb.org/pdf/GRPOL_Draft_SpcCmt_Eval_Undergrad_MedEd.pdf

[ASIANDOC]

Here you go:
http://www.fsmb.org/pdf/GRPOL_Draft_SpcCmt_Eval_Undergrad_MedEd.pdf

I am trying to find the June 2003 CT courant article that talked about UAG and Mexican,Phillipines,Carribean Map with banned school...etc
In that article the FSMB and other officials stated that states does not have the proper resources to accredit international medical schools,also as recent as Jan 16,06 article an AMA official stated that when states creates its own rules that might discriminate against highly qualified physicians[I did not use the term discriminate,the top physician group rep used it],also in the FSMB proposal the big message that I can read:
the licensure rules in the USA is the toughest ever in the hx of the FSMB.

going back to passing exam issues:
please note that passing examsUSMLE 1,2,3 does not qualify a person to practice,they need what we call here in the states residency training for 3-6 years then board certifications to certify us as experts.
In my current hospital,one friend was removed from hospital staff for failing to pass board exam after 5 yrs [most hospitals policy]and doing only clinic work,so as the FSMB stated we do have "super tough rules],any death we review the chart,any bad outcome we review the chart,any patient complaint we review the chart,in simple term if anyone no good enough we say good buy,even when you fill a license application and make honest mistake you need to appear to explain your answers,if your are off service and had DWI citation your license is also at risk....very tightly controlled as the FSMB stated.....and that's assure public safety.

[jpryor]

Here you go:
http://www.unmc.edu/Community/ruralmeded/model/medsch/med_schools_four.htm

[Aviv Imanuel]

...states does not have the proper resources to accredit international medical schools".

HOWEVER, they DO HAVE the right to regulate the medical professsion and that is the core issue on these arguments. I revert back to my question (and bear in mind I am an advocate for using USMLE results and residence training results as the evaluation method to determine competence) How do you think you can convince the California medical board that their list is discriminatory? Waht precedent case do you have? On what constitutional grounds?

Max



I am trying to find the June 2003 CT courant article that talked about UAG and Mexican,Phillipines,Carribean Map with banned school...etc
In that article the FSMB and other officials stated that states does not have the proper resources to accredit international medical schools,also as recent as Jan 16,06 article an AMA official stated that when states creates its own rules that might discriminate against highly qualified physicians[I did not use the term discriminate,the top physician group rep used it],also in the FSMB proposal the big message that I can read:
the licensure rules in the USA is the toughest ever in the hx of the FSMB.

going back to passing exam issues:
please note that passing examsUSMLE 1,2,3 does not qualify a person to practice,they need what we call here in the states residency training for 3-6 years then board certifications to certify us as experts.
In my current hospital,one friend was removed from hospital staff for failing to pass board exam after 5 yrs [most hospitals policy]and doing only clinic work,so as the FSMB stated we do have "super tough rules],any death we review the chart,any bad outcome we review the chart,any patient complaint we review the chart,in simple term if anyone no good enough we say good buy,even when you fill a license application and make honest mistake you need to appear to explain your answers,if your are off service and had DWI citation your license is also at risk....very tightly controlled as the FSMB stated.....and that's assure public safety.

[ASIANDOC]

I visit this forum to express opinion and share ideas,I am not interested in changing any laws especially after long successful career recieving great respect,support,and appreciation from the medical community in this great country of ours.

[jpryor]

How do you think you can convince the California medical board that their list is discriminatory? Waht precedent case do you have? On what constitutional grounds?

Max

The Constitutional arguments would be the strongest. I think the strongest argument is that California's criteria violate Article 4, Section 2 of the Constitution, as well as Article 1, Section 8.

I have long held the personal belief that the research and library criteria were ridiculous. If I was bringing a case against the MBC, I'd subpoena records from approved schools identifying the frequency and numbers of individuals participating in research projects and challenge the licensing of all those students who did not participate.

[pruritis_ani]

Here you go:
http://www.fsmb.org/pdf/GRPOL_Draft_SpcCmt_Eval_Undergrad_MedEd.pdf
Thanks for the link, jpryor. I reviewed it quickly, and have not yet found where the FSMB recommends using the USMLE as a stand alone measure. In fact, it does appear to be a "process" based list of recommendations, that look at many quality indicators for schools. It does appear to utilize the CA and NY lists as well, as indicators of school quality. I don't see how you deduced that the FSMB supports evaluating "outcomes" via USMLE scores as the principle evaluation. I may be misunderstanding you, but the message I am getting is that you think outcomes are what the FSMB wants to evaluate, and that they think the USMLE is enough. I just don't see that, but I could be missing something.

Also, I find it interesting that in this very document it references USMLE first time pass rates, and acknowledges that non-US citizen IMG's are outperforming US citizen IMG's on the USMLE step 1, and they are improving, where US citizens studying abroad pass rates are declining. It quotes a first time pass rate at 53%, which is pretty dismal. When looking at the where these US citizens are attending (ie the Carib), it becomes clear that there are some real issues with the published pass rates.

Anyhow, I just want to be sure that nobody does mistake my opinions for bias against a certain school or region. I am simply a fan of standards being enforced, and having multiple levels of checks and balances. Additionally, I am a fan of a state maintaining the ability to regulate medical practice within that state, and to adopt a higher standard if they see fit. I am all for a minimum standard as well, for all states to follow. But, I think the current minimal standard (ie ECFMG certification) is a bit lenient. I would like the schools to be forced to have some accreditation that is seen as similar to LCME, or to have a US body provide an evaluation that says there is at least a minimal level of quality attached to the school. I don't mean having a library with a set amount of books, but I do think that demonstration of adequate infrastructure and student resources as well as showing that there are qualified faculty teaching at the medical schools is not too much to ask.

It is pretty clear that you are far better versed in the legalities of the matter than I will ever be, and that is a discussion I will leave to you and GenMax. It is interesting to read what you guys have to say.

[jpryor]

I read the USMLE reports for the statistics I used. As for the FSMB report, there are two sections called Recommendations and the FSMB breaks it down between the two sections.

I'm not disagreeing with your position in its entirety. I, too, agree with strict standards. But it is nonsensical to have individual states changing the rules and even more so when those rules become suspect.

I'm leery of advocating against abolishing individual states' rights to regulate the medical profession within their borders for the simple reason that the differences are one of the strongest barriers to a single-payor system. But I think there is a very strong argument to be made for why it is inappropriate for the states to have this ability--the current situation being a prime example.

[Aviv Imanuel]

Article IV defines the relations between the states. It requires each state to give "full Faith and Credit" to the laws of the other states; establishes that citizens are entitled to the same "Privileges and Immunities," or liberties and rights, as citizens in every other state;...but the question then will be....Does a citizen has an absolute right to be a doctor? or a lawyer? etc?









The Constitutional arguments would be the strongest. I think the strongest argument is that California's criteria violate Article 4, Section 2 of the Constitution, as well as Article 1, Section 8.

I have long held the personal belief that the research and library criteria were ridiculous. If I was bringing a case against the MBC, I'd subpoena records from approved schools identifying the frequency and numbers of individuals participating in research projects and challenge the licensing of all those students who did not participate.

[Aviv Imanuel]

however...The Fourteenth Amendment (1868)—which holds that no state shall "deprive any person of life, liberty, or property, without due process of law; nor deny to any person … the equal protection of the laws"—has been arguably the most important and far-reaching of all the amendments, particularly with regard to its Due Process and Equal Protection Clauses.

Where does becomming a physician or a lawyer or any profesional would fall under the equal protection of the laws?

The Constitutional arguments would be the strongest. I think the strongest argument is that California's criteria violate Article 4, Section 2 of the Constitution, as well as Article 1, Section 8.

I have long held the personal belief that the research and library criteria were ridiculous. If I was bringing a case against the MBC, I'd subpoena records from approved schools identifying the frequency and numbers of individuals participating in research projects and challenge the licensing of all those students who did not participate.

[jpryor]

My familiarity with the 14th Amendment is pretty much structured around its use on the abortion issue. There may be some relevance there, but I'm ignorant on any Case Law. The other two Articles are the Full Faith and Credit and Commerce. Case Law has been far ranging and I'll do some research on this, but I think the practice of medicine is actually one of the specifics. Dang...this is going back to some real old undergrad books!

[swimguy23]

By using the constitution for these purposes to remove power from the states is directly against why the constitution was designed and the direct opposite of what the ideas of the US were founded on.....government has too much control over states now as it is, you really dont want them to control all aspects of your medical license as well

[jpryor]

Well, in actuality, the Consitution states that any authority not specifically granted to the federal government reverts to the state...and therein lays all of the Constitutional arguments! It's rarely been the federal government attempting to seize too much authority that causes problems...it's usually individual states....the issue of eminent domain recently, as an example.

As to whether I'd like there to be federal or state control over medical licensure...federal controls are better managed, but state controls are more malleable...and local. I prefer state, with caveats.

[ASIANDOC]

http://online.ceb.com/calcases/C2/31C2d30.htm

http://www.oscn.net/applications/oscn/DeliverDocument.asp?citeID=49099


above are the only cases related to med licensure I could find on the internet.

[jpryor]

http://online.ceb.com/calcases/C2/31C2d30.htm

http://www.oscn.net/applications/oscn/DeliverDocument.asp?citeID=49099


above are the only cases related to med licensure I could find on the internet.

Let's hope that anybody who challenges the MBC didn't need 8 attempts to pass the USMLE!

[CaliforniaEquality]

Let's hope that anybody who challenges the MBC didn't need 8 attempts to pass the USMLE!

jpryor, that is what we are asking. we are asking the board to give US citizens an equal opportunity to practice and do rotations in california under the condition if they pass step 1, 2, 3 sucessfully.

and for conclusion, i just checked the list, the name has been changed. and it all happened because i notified the chinese consulate in california.

so it shows that we can and shall make them to change their own stupid rules!