My speech to the Texas Board of Medical Examiners today, Aus

[azskeptic]

TEXAS STATE BOARD OF MEDICAL EXAMINERS
BOARD MEETING
AUGUST 13, 2004 1 PM
333 GUADALUPE, AUSTIN, TEXAS
Tower 2, Suite 225)

"Diploma Mills, Legitimate Offshore Medical Schools, and the Vast Difference"
by Dean Hughson

It is an honor to be given the opportunity to address the Texas Board
of Medical Examiners. While many consumers may not fully comprehend
what you do, I am one who understands that you are one of the state
Boards that truly performs a life saving activity in watching out for
the medical safety of consumers by performing the licensing and
discipline actions. If consumers truly knew what went into your work,
I am sure they would say "Thanks" but sadly much of what you do isn't
known or understood by the general public.

A logical question to ask is why is a 53 year old man who works as a
consultant in the egg industry speaking in front of a medical board?
In a perfect society, it probably wouldn't be needed but the need for
my remarks, I believe, is increasing almost daily with the growth of
new medical schools daily and constant changes in the approximately
1000 existing medical schools worldwide. The new schools range from
excellent Ivy League colleges investing in offshore schools in the
middle east, such as Cornell, to schools that exist only on the
internet and the offshore banks that students deposit their tuition
payments to. As a consumer I am concerned that our country has few
safeguards in place to check out the offshore medical schools, and
with the lack of funding given to state Boards it is a big task that
Boards like you face.

How I came about getting involved as one who asks questions about
these issues is purely accidental. My educational background is in
sociology and counseling psychology and I worked in hospitals as a
young man as a counselor. Accidentally I learned about the egg
industry and switched careers in my 20's. About 2 years ago my son
asked me what I knew about medical school as he was considering
attending one. I knew a bit since I grew up in a medical family as
my mother worked as a nurse at a hospital attached to the Kansas City
Osteopathic School in the 60's and 70's. We always had medical
students around us and we watched them study and work hard at gaining
their degrees. I have to admit to a bias; in my small town our local
doctor, Dr. Goldberg, was seen as the standard that everyone wanted
their child to achieve. In fact it was common practice to take your
child to him and ask him what your child should study. He practiced
medicine in our small Missouri town for 40 years and delivered nearly
everyone in town. He sacrificed much to become a doctor and spent his
life doing good things for my hometown of 886 people.

So as a good father would do I went to the internet and began looking
at the state of medical schools. If you do a search on the internet
and type in "medical school" what will strike you as strange these
days is that you will be bombarded with ads from a wide range of
medical schools, mostly in offshore locations. In fact if you go to
your computer and go to www.yahoo.com and type in medical school
usually you'll get 5 popup ads for schools from the Caribbean. This
was interesting to me so I started looking closer at the schools and
what they consisted of.

In addition I had been actively involved with studying the problem of
health fraud and quackery. Some people who live in Arizona where I do
play golf; I prefer to chase quacks or fight healthcare fraud but this
new project on medical schools got interesting quickly. One
chiropractor I had researched extensively claimed on her website to be
able to diagnose allergies by having a patient hold a sealed glass
vial of an allergen. She had recently written a book and now she was
using the title DC, MD. Knowing that she was doing a full time
chiropractic practice and on a national speaking tour I started
researching where her medical degree suddenly appeared from. I learned
that she had 'attended' the University of Health Sciences-Antigua
www.uhsa.com which offers advanced standing to chiropractors,
podiatrists, dentists, nurses, pharmacists, veterinarians, and allows
them to attend 'virtually' via the internet. One has to realize that
this is not like any US medical school because legitimate schools only
allow people to transfer in credit from other approved medical
schools. But quickly you realize when looking at some of these new
offshore medical schools they don't follow the same rules or standards
that our US schools do. How could students from a school like this
think that they could learn medicine by using the internet and not be
required to quit their day jobs? This was the first 'grad' I
encountered but it led to even more questions.

The number one question that arose immediately is what kind of doctor
is turned out from these schools which range from schools with 2
cadavers and 3 professors with a few students over a Pizza Parlor to
massive newly constructed well staffed schools with major funding
behind them; the answer isn't easy to discern because as I found out
no national organization in the US evaluates these schools; only 2
states that I can find (California and New York) even attempt at
visiting the schools to find out if they are equivalent. We lack a lot
of information as to the education available there, the screening and
admission process, and the level of education and supervision they
offer their students. There has been limited amounts of research done
on the students who graduate from these schools and thus state boards
are dealing with a large 'unknown' in the increasing number of
students who apply for licensing each year having graduated from a
Caribbean or other offshore 'new school'. These schools are popping
up also in Central America and Oceania.

I found 4 members of the Board of a major oral surgeon's association
listing an MD from one of these internet medical schools. I found an
article where a graduate of one of these schools admitted in a court
case he had actually been at the school only 8 weeks during his
medical education. In another article a full time judge was shown to
be supposedly attending a school fulltime while sitting on the bench
full time. One state Board found a student who they had licensed had
been working a job fulltime while supposedly attending medical school.
Another state caught one of the students impersonating a physician in
a clinic he owned. Many of the people who get these MD degrees don't
intend to license them; they just want the prestige and advertising
power of the degree. But how would consumers know if the person they
are seeing is a licensed MD or not, if they are using the same title
as a Harvard graduate and actually went to a correspondence internet
medical school and are working as a chiropractor or dentist with MD
behind their real licensed title.

I also got some amazing emails and telephone calls after I started
writing about these issues; I received a physical threat from a
student of one of these schools over the internet and after checking
him out I found out he was working 80 hours a week as a chiropractor
and was stressed with trying to attend medical school via the
internet; I felt sorry for the young man to be honest.

Having been trained in university to try and learn as much about a
problem as you can before trying to change it here are some of the
things I did:

1. Read every state licensing law in the US, Canada, and other
countries that I could find on the internet.
2. Began meeting via telephone and internet Board directors, staff,
and support organizations like Administrators in Medicine
3. Did a web search and read the web pages of offshore medical schools.
4. Joined the online forums that potential students and current
students of these schools frequent and began dialoging with students
to understand them.
5. Began talking with medical school professors to understand how
education is done currently in the US.
6. Put up a website discussing my findings at
www.internetmedicalschool.homestead.com
7. I talked to some of the offshore medical schools. In fact one of
them tried to recruit me to go to medical school which I found odd.
8. I began a mailing list and began mailing all of the state Boards
articles I find on offshore medical schools and began pushing that we
need to enact more safeguards for consumers. I should also point out
that the students are victims also; if they don't check enough they
will get taken advantage of by some of the bad schools who actually
just want their tuition money.

One quickly realizes that these schools are not all the same. It
would not be fair, in my estimation, to penalize all of the schools
that are making valid attempts at being equivalent to normal state or
private US schools by lumping them in the same range as a few bad
actors. There is a vast difference between a school that is nearly
100% internet based over a school with modern facilities/medical
library/and professional faculty. However, the issue of equivalent to
your state schools, as many state laws read, makes this a difficult
thing to judge. One has to also see that even some of the better
schools have some major problems to overcome. Concerns I have:

1. Standards of admitting students are not the same as US medical
schools. Some of these students probably shouldn't be medical doctors
and were screened out of US schools for a reason; most of the
Caribbean schools admit that they take students with lesser scores on
MCATs (some schools don't even require MCATS) and lower GPAs. I have
seen convicted felons on some of the forums asking if they will have
problems getting licensed; some of the schools would admit them based
on their ability to pay tuition.
2. Some schools lack trained faculty to teach the students. I have
seen discussions on some of the forums where students in the school
who had degrees in science were hired to teach science while they were
attending the same medical school supposedly fulltime. I have found
some faculty in some schools to list degrees which are from known
diploma mills; they aren't qualified to teach. There is one offshore
school I've discovered that granted MD degrees and naturopathic
degrees to its staff when it started. Many of these schools don't have
professors who could legally license in the US and yet are teaching
students who supposedly must learn to the standard of US laws.
3. Some schools lack facilities; you have to wonder about a school
that has 2 cadavers that are in bad shape that have been used by too
many students repeatedly as I have read on some of the forums. Others
admit to having less than 1000 books in their library and no medical
librarian.
4. Some of the schools in the UK are actually schools with govt.
charters from Uganda or Senegal that are teaching their students
thousands of miles from where they are supposedly receiving their
Govt. supervision of their medical schools.
5. Students are being allowed to setup their own clinical training and
pick 'mentors' and are being allowed in some states to do rotations,
actually having patient contact; this has to concern regulators like
yourself when you realize that due to their schools lacking funds,
etc. they don't have adequate supervision of their students and
consumers can suffer at their hands.
6. Some schools have been in operation for many years and yet have few
licensed graduates.
7. Legitimate medical schools are sponsored and funded by governments
and/or universities or they have big endowments from private sources.
Fly by night, poorly funded, startup companies are a major concern to
me as a consumer as owners of a medical school.
8. The problem of these schools is being felt by other countries; some
countries have enacted bans against graduates already. One country
flew its medical staff person over to the US to find out what is being
done on the issue after they had someone apply with an online degree.

I am not qualified to evaluate medical schools but a layman quickly
realizes that someone needs to evaluate schools before you allow their
graduates to practice in your state.
It is my recommendation to the State of Texas that in the absence of a
national system to accredit offshore medical schools (which in my
opinion is years away), you have no choice but to follow the State of
California and New York's lead in requiring these schools to pay the
expenses of a team from Texas, made up of retired medical school
professors, residency directors, etc. to evaluate the schools.

Schools that are properly run will welcome your evaluation and
quickly you can approve their schools. Schools that are lacking much
will be encouraged to improve themselves if they want their graduates
practicing in Texas. Students will quickly realize which schools meet
the standards of Texas and if they truly want to practice there, they
will attend a school that can meet your states requirements. I don't
have to tell you that there are frustrated students already on some of
the discussion lists threatening to sue the State of Texas because
they feel they should be able to license their degrees in your state
despite that Texas isn't the only state questioning their training.
Lobbyists have been hired to lobby your political leaders in Texas to
try and force the approval of their graduates: in my opinion these
schools money would better be spent paying for your staff and
consultants to come and evaluate their schools. I have told students
that if your medical school is one that you have to have an attorney
sue to get you licensed you are probably in the wrong medical school.

I realize the important role that foreign physicians play in our
society; 28% of our physicians were trained outside of the US. In no
way should my comments be looked at as being negative towards foreign
physicians in general because it is my experience, having traveled
widely, that most of them are extremely well trained and good doctors.
Schools that are supervised by govt. agencies in other countries turn
out doctors that are equivalent to ours. Some will argue that if you
are too restrictive in licensing it will keep doctors out of needed
areas but one needs to maintain their standards even in the face of
need. If Texas wants to attract more doctors to serve rural Texas I
would urge you to look to the Mexican medical school graduates who are
well trained and have language skills of many of the underserved
people of Texas; the State of California is working on a program
similar to this to find physicians to service underserved areas.

I believe that under the leadership of Dr. Patrick and your capable
staff the State of Texas will help lead other states in figuring out
the answer to the problem of how to qualify these schools and their
graduates. I applaud your work and appreciate this opportunity to
raise some of the questions I do and stand ready as a volunteer to
help your state deal with this complex issue.

Dean Hughson and his wife, Yoly, reside in Fountain Hills, Az where he
is an international consultant in the egg industry. He is active in
bringing free medical care
to the poor of Mexico and has been on the Board of Directors of
Dentists To The World. He is a graduate of the University of
Missouri-Kansas City, attended graduate school at the University of
Nebraska-Omaha and has been active in his community as a volunteer. He
can be reached at deanhughson@gmail.com or tel 602-696-3248

List of website he suggests that you review to learn more about these issues:

www.valuemd.com
www.internetmedicalschool.homestead.com

[anencephalic]

Nice Job, AZ!

Hopefully the fact that it was posted on Friday the 13th is just purely coincidental .

Aloha,

[azskeptic]

Originally Posted by anencephalic

Nice Job, AZ!

Hopefully the fact that it was posted on Friday the 13th is just purely coincidental .

Aloha,

ha ha.....good point...I'm going to watch my back today. az skeptic

[FLK]

was that Numbraepad you debunked?
there is a nice article about this person on www.quackwatch.com as I am sure you know

PS: Nice Job with the TX boys !

[teratos]

Great.

"Don't mess with Texas" (he typed in his best George W. Bush accent)

[lavender]

Why pro mexian schools . according to some of the cali list i have read that a couple of schools were not accepted in cali and texas. as for free medical care to the mexicans texas already gives millions of dollars to the mexicans in medicaid they cross the border and have kids texas picks up the bill on the tax payers money. most texans cant get any assistance because they have a job or have a small bank account of few hunded dollars. i worked at the texas dept. of health for several years more medicaid is given to the mexicans than any other race. i had a man with renal failure and need help with the cost of meds and other medical fees and he was refused because he had a car that 5 years old he was told to sell it or no benfits. benfits were given to a 20 year old with 3 kids no job she was getting over 1000.00 a month for sitting on her butt doing nothing then she was told to go to night school for free and earn a GED she refused but the benfits continued.
as for the statements to the texas board i feel that some one with no education in medicine has any business addressing boards to fight a cause that poses no therats every applicant is checked by the board and given licensure. texas does not give them out for fun. there are many texas docs that have been doing wrong for along time i can name a couple myself that i know personally that went to texas med schools why not address that its more of a problem that the people trying to get a license. I can personally tell you of a psych doc who becomes friends with his clients and has them to move into of over to his home daily and then he convinces the daughters to move in with him and his wife then breaks ties with the parents to keep the teen daughter in home promise to pay for thier education and then dumps them when they are too old for him to enjoy. he has been turned into the board many time (3 familes i know of) and the board had failed to do anything. i also know of a doc that was dealing cocaine out of his office the board only took his license when he was arrested for the 4 th time and he is currently in jail for the next 15 years. or the doc that has been turned in many times for sexual abuse during exams and when under sedation again the board does nothing. why not address the problems that exist with licensed docs that is where the real focus should be not on people who arent even licensed yet.

[teratos]

The boards in MD are brutal. If you get a DWI you license may be suspended. People have their licenses suspended for having sex with patients all the time. Often for a period of a year. Here, if you were dealing cocaine out of your office, not only would you permanantly lose you license, but you would also be in federal prison after your 4th time.

G

[Skipper]

i have read your posts and i have not yet developed an understanding of your goal.....


do you really just want all offshore med school to be banned? i do agree internet based ones arent the greatest or the wisest choice.....I believe there are a few schools out there that are fairly good and have licensed thousands of docs and their education is equilvent to american med schools.....are you against them too?

skipper,

[azskeptic]

Originally Posted by AssyrianSkipper

i have read your posts and i have not yet developed an understanding of your goal.....


do you really just want all offshore med school to be banned? i do agree internet based ones arent the greatest or the wisest choice.....I believe there are a few schools out there that are fairly good and have licensed thousands of docs and their education is equilvent to american med schools.....are you against them too?

skipper,

No, my goal in the absence of a body to do it in the Carib. is to get the good schools that many of you go to approved and the bad schools banned.

The only way I can see it can be done is by individual states right now since the FSMB and other official groups are slow in getting an evaluation process. Students/graduates from good schools shouldn't be penalized.

For instance in Mexico, they have an accreditting organization that oversees schools as part of their govt. and oversight. It isn't perfect but they have a system in place and thus they are ahead of the Carib. schools.

az skeptic (Dean)

[wcb22]

i agree with skipper,

you are pointing out specifically great schools (like SABA, St. Matthews), who don't require MCAT. last i checked, some of these "great" indian, pakistani, mexican, etc, med schools don't require MCAT. it's not a pre-req for a good med school.

maybe it's just me, but i get the feeling of prejudice just against american students going abroad. maybe we weren't academically equivalent to some of these US students, but we make up for it in compassion. and we make up for it in very hard work in medical school. many of us had a rough freshman year in undergrad college, and did well the other 3 years. but not well enough for a US M.D. THERE IS NOT A LOT OF GIVE FOR ERROR IN GETTING INTO A US SCHOOL. that doesn't mean we are not qualified to be physicians.

i wouldn't see your claims as prejudiced if you pointed out more the educational deficiencies THROUGHOUT THE WORLD, INCLUDING THE US. Even the LCME has put some US schools in check. There are deficiencies in India. There are deficiencies in Europe. I appreciate a lot of your postings, but sometimes i think you get carried away.

When D.O. schools started up, I'm sure there were some azskeptic's.
But where are they now? They are quiet.