While there are no
data on the number in clinical clerkships in the United States, about 2,400 United States FMGs applied
each of the last two years for Educational Commission for Foreign Medical Graduates (ECFMG) certification; thus, there may be as many as 5,000 students from foreign schools in clerkships each year.
Such clerkship arrangements are negotiated entirely between the administrative authorities of an
individual hospital or clinical site in the U.S. and the offshore school and typically include payment to
the clinical site on a capitation basis. Anecdotally, a few such arrangements are beginning to compete
with LCME-accredited programs in the U.S for clinical training sites.