Letter to state medical boards/license testing programs

[azskeptic]

TO: State Medical Boards/Medical license testing
staffs
FROM: consumer advocate
www.internetmedicalschool.homestead.com

date: 2-9-04

As one who has been looking at the issue of foreign
medical schools and their level of educations in terms
of how equivalent they are to US medical schools, I am
concerned that there are some medical schools offshore
that have found 'loopholes' to the US and Canadian
systems and are promising students that they can
maintain their full time day jobs as
chiropractors/podiatrists/dentists/nurses and attend
the basic science portion of their medical educations
virtually via internet correspondence.

I have written extensively about this to medical
boards, not only in the US but abroad also. Some
medical boards have studied the issue and have chosen
to ban grads from these 'internet virtual medical
schools' but some haven't dealt with the issue and
have actually issued some residents 'licenses' to do
residencies, even after reading newspaper articles
saying that the students have spent as little as 3
months at a medical school physically
(http://www.wcfcourier.com/articles/2...38000c8c62.txt).
I haven't found ANY of the graduates of these schools
licensed yet but the potential is there.

My website at
http://www.internetmedicalschool.homestead.com shows
the websites of these 'virtual' schools where your
$20,000 check is your admission requirement; not your
MCAT scores.

But the resulting problems of these schools is being
seen in consumer fraud already. For instance there are
dentists who are now listing themselves as DDS/MD's
with no intention (or chance) of getting licensed as
MD's but their potential patients,getting oral surgery
think they are getting additional protection by going
to someone with the dual degrees. There are 'medical
students' who have studied on the internet, now doing
clinicals in hospitals,unbeknowst to patients and
potentially putting patients at risk.

The question is complex: Who will evaluate these
medical schools and judge which offshore schools are
equivalent and which ones are not? Many states lack
the budget to send evaluators to the schools in the
Carribean, Mexico,etc. Can the organizations that
'approve' graduates to take licensing exams look into
the schools instead of accepting carte blanche any
school that is WHO approved? Can we require that
offshore schools,like US schools, actually have
inspections and supervision by the local country's
educational/health department staffs? Should schools
not located in the country of their WHO
recognition,such as some in England (St.
Christophers/Kigezi)for instance, grads be accepted
for testing and licensing in our countries? How can a
medical school that is 6000 miles from the agencies
who are supposed to supervise it be seen as equivalent
to traditional medical schools? It makes sense that
perhaps the Federation of State Medical Boards get
involved or the US govt. but so far no one has stepped
up to take responsibility. A few states have done
admirable jobs,such as
Indiana/California/Alabama/Pennsylvania,etc. in
disapproving some of the questionable schools but
there is no uniformity.

I urge your industry, the last protective device for
we consumers, to put together a study group to fix
this problem. I would like to read a lot less sad
ending stories such as recently written by a newspaper
at:


http://www.ctnow.com/news/health/hc-...lines-breaking



We consumers are depending on you to protect us.

Sincerely:

consumer advocate

[Japhethi]

If the schools in the Caribbean were slimmed down to half the number, maybe they would get taken more seriously.

Sons Of Jafeth

[TooOld?]

Then maybe you would have attended all of them.

[agnostic]

To: Consumer Advocate Azskeptic

From: State Medical Board

Date: 2-9-04

Whereas people who can do things well underrate their abilities, the truly incompetent remain in blissful ignorance of how inept they are.

Not only do they reach erroneous conclusions and make unfortunate choices but also their incompetence robs them of their ability to realise it.

The skills required for competence are the same skills necessary for recognising it.

Asked to evaluate how well they had done at a logic test, those who scored in the bottom eighth reckoned that their ability was in the top third. Those in the bottom tenth in grammar also considered that their ability put them in the top third.

Those who really were in the top third tended to underestimate themselves. This is because, in the absence of iinformation about how well others do, highly competent people tend to assume that others are just as competent.

When shown other people's work, however, the competent soon revised thir opinion, but the incompetent did not - some even inflated their self estimates.

Interpretation of these findings by an incompetent as inspired by the malevolence of those dark forces of medical education they are sworn to oppose, is a common but regrettable feature of the classically, incurably incompetent.

Sincerely

U R A Jokke

[azskeptic]

Originally Posted by agnostic

To: Consumer Advocate Azskeptic

From: State Medical Board

Date: 2-9-04

Whereas people who can do things well underrate their abilities, the truly incompetent remain in blissful ignorance of how inept they are.

Not only do they reach erroneous conclusions and make unfortunate choices but also their incompetence robs them of their ability to realise it.

The skills required for competence are the same skills necessary for recognising it.

Asked to evaluate how well they had done at a logic test, those who scored in the bottom eighth reckoned that their ability was in the top third. Those in the bottom tenth in grammar also considered that their ability put them in the top third.

Those who really were in the top third tended to underestimate themselves. This is because, in the absence of iinformation about how well others do, highly competent people tend to assume that others are just as competent.

When shown other people's work, however, the competent soon revised thir opinion, but the incompetent did not - some even inflated their self estimates.

Interpretation of these findings by an incompetent as inspired by the malevolence of those dark forces of medical education they are sworn to oppose, is a common but regrettable feature of the classically, incurably incompetent.

Sincerely

U R A Jokke

Hmmm, Agnostic, curious posting there but as to claims, the shoe is on the foot of the questionable medical schools,not mine. The State Medical Boards are seeing through the smoke screen. The "Pirates of the Carribean" med schools are under cannon fire by truth,not just me.

This is a fascinating thing.....people impersonating MD's, professors posting as students.....people using fake IP addresses....oh, and one will learn how to be a good, honest physician from this? Amazing, o Agnostic.

az skeptic

[bts4202]

I think that much of this issue is being looked at in entirely the wrong way.

The first thing I want to address is Pat Park saying that part of the problem with caribb type schools is that they do not require the MCAT. Although most (not all) US schoosl require the MCAT for admissions, it is NOT a requirement for LCME accreditation. I have contacted the LCME and asked, you are free to do the same, and they say that they do not restrict the admissions criteria for medical schools. Any US medical school could discontinue the use of the MCAT as an admissions standard and they would NOT risk loosing their LCME accreditation. So if any offshore school that did not use the MCAT as an amissions standard was evaluated by LCME standards, barring all other facts, they would still be considered legit.

Second is this whole hooplah about pre-clinical education and how and where it is done. To me, this is somewhat ridiculous. If you ask the average practicing physician, they will say that the most important part of their medical education was the clinical part (clinicals and residency). Not to say that the basic sciences is useless, but that clinicals where vastly more important. SO, if a foriegn student has to take the USMLE, an exam that is getting so hard that even US med students scores are dropping lower than they have ever been, and they pass it... why should that not be an adequate representation of adequate pre-clinical knowledge no matter where or how it was done? And if that is not a good indicator, then why the hell are we using it in the US??

Besides that, lets talk about the real, most important part of this. Most of these schools have their students doing their clinical education (most important remember) IN THE US ALONGSIDE US STUDENTS. Basic sciences is 2 years and lets say it is done over the internet. Lets also say that a student who learned this way passed the USMLE. If done properly, that same student will do 2 more years of clinicals in the US in ACGME approved rotations. Then will enter a residency and do 3 - 5 more years of clinical education in the exact same program that US students do!! Then, that student will only be allowed to practice the type of medicine that they spent their residency time learning about, not to mention taking the speciality boards that all american grads have to take as well!! So that is 2 years of basics outside the US and 5 - 8 years of advanced training in the US. And that doesn't even take possible fellowships into account.

I think that the real solution is not to blackball student who did 2 years in a branch campus located in a country different than its charter or even students who did their 2 years on the internet. I think the real solution to stopping incompetent doctors is in the residency programs. Force them to hold stricter evaluations and more in depth testing. If someone isn't cutting it, expell them!! Some US grads are incompetent just like some foriegn grads. The evaluation should be on an individual basis rather than broad banning of schools for techinical details. Those kind of politcally motivated moves do not solve anything other than to give the general public a false sense of security. When other docs still make critical errors and kill people, there will be another scapegoat to blame. If there are no more little caribb schools to blame, they will likely move onto the bigger ones.

[stephew]

I would rather see a rigid set of standards for all applicants for liensure have to meet rather than this targeting of IMGs. The universal application of one exam (USMLE) years ago to all students and tghe extension of the CSA (inthe form of the Step two CS) to all is a great step in the right direction. But there are excellent IMGs who can't practice in some states because of political ideologies that essentially bar them merely for being IMGs (see Texas) and there are US grads who stink but once in the system are allowed to go on because, hey, that's how it works (and obviously, the reverse).

Once again, a little learning is a dangerous thing. Beware of what you advocate- you came to this board advocating for premeds looking for a decent education. You wouldnt want to see them locked out because of blind bias and misinformation.

[stephew]

oh and by the way, Pirates of the carribean? films on the island of St vincent's where I did 6 months of my med school like all sgu students. So frankly, more power to PofC med students.

[azskeptic]

Originally Posted by stephew

oh and by the way, Pirates of the carribean? films on the island of St vincent's where I did 6 months of my med school like all sgu students. So frankly, more power to PofC med students.

You realize I am not talking about SGU,Ross,Auc,Saba,St. James,etc. I think....but pirates are famous for stealing gold from those in white hats (students) and leaving them marooned on islands......I am talking about schools that are not in any shape or form equivalent to the good Carib, US, or other foreign schools.

I do not believe that survival of the fittest should be the way that medical students get licensed....I believe that medical schools should see the students during their education, supervise them closely, and weed out the bad actors before they get into the anonymity of residencies and practices.

Personally I enjoy watching Pirate movies but signing onto a pirate ship would be a dumb move for most upstanding citizens unless you want to fight.

az skeptic

[TooOld?]

Since this looks like an ongoing event, I have a question. I assume there is a legitimate reason why these particular schools are under attack here, so with that assumption that these schools are at the very best substandard, and at the worse completely fraudulant scams. Is it just the schools or are you against any form of online or distance education in medical in general. For instance, lets say that Ross, or St. Georges starts offering just a few online, or distance courses in subjects like: Medical & Legal Ethics, Medical Psychology, etc. would that put them in the same light or would it be ok since these courses really do not have to be taken in a lab. enviroment?

I am trying to understand the root of all of this, and why the same type of post, article, and letters to boards keep being brought up as new.

I understand if schools are trying to do an end around the process, but what if a legitimate school were to offer a few distance courses which may cut off a semester for an already practicing health professional?

None of this would help me, I am just trying to learn the motivation behind all of this.