Findings Brief: November, 1997 Leonard D. Baer, MS Thomas C. Ricketts, Ph.D., MPH Thomas R. Konrad, Ph.D. NC Rural Health Research and Policy Analysis Program Cecil G. Sheps Center for Health Services Research, UNC-Chapel Hill The benefit of international medical graduates (IMGs) in compensating for local physician shortages may be offset by the financial burden of a national physician oversupply. Since 1988, the rate of growth in the number of international medical graduates in residency training and practice in the United States has exceeded the growth of domestic medical graduates. The number of IMG residents has increased more than twofold between the 1988-89 academic year and the 1995-96 academic year. Such a dramatic increase was made financially possible, at least in part, because the Medicare program has been financing a substantial portion of US graduate medical education. As the number of IMGs in residency programs and the US physician workforce has increased, many policymakers have become concerned that there are too many international medical graduates competing for residency positions, employment opportunities, and public funds with US medical graduates. Yet any reduction in the number of international medical graduates may affect access to health care in rural areas, particularly if IMGs are practicing in rural, underserved areas.

International Origin Family Medicine Graduates

http://www.mc.uky.edu/RuralHealth/SORH/RHUpdate/Visa.htm

Certification of Foreign Schools circa 1998

Here's what I've learned about the certification of foreign schools for participation in U.S. federal student loan programs. It's a two step process. First, the country in which the school is located needs to be determined to have accreditation standards comparable to those used for MD schools in this country (e.g., the LCME standards). This determination is made by the National Committee on Foreign Medical Education and Accreditation.Executive Director is Ms. Bonnie LeBold (Phone: 202-260-3636; FAX:202-260-5049 or 205-3788). The Committee meets twice a year. Next meeting is Oct. 8-9, 1998, in Washington D.C. Part of the meeting is open to thepublic. Second, schools in countries determined to have comparable accreditation standards can apply to participate in U.S. federal loan programs. Renewal of certification must be sought every four years. The office that handles the certification is the Foreign Schools Team within the Case Management Division of the Dept. of Education. Their meetings are not open. The head of the team is Ms. Janet Buntebart, and her phone number is 202-708-8239 or-8820.To ascertain whether a foreign medical school is currently participating inthe federal loan program, call the following toll-free number:1-800-433-3243. I had to call twice - the first person I reached said she didn't have the information, but the second person knew where to look.I was curious about Caribbean medical schools. Here's what I learned:

1) St. George's in Grenada is certified.

2) Ross University in Dominica is certified (as is their Vet. School in St.Kitts, West Indies).

3) American University of the Caribbean is applying - hopefully they'llknow by the end of this year.

4) SABA Univ. of the Netherlands-Antilles has not applied, and may not be eligible to apply. Since SABA is a relatively new school they need to meet requirements that the other three Caribbean schools do not, i.e., at leas t 60% of the SABA students would have to be from countries other than theU.S. The above three Caribbean schools can get around such requirements by having a clinical training program that was approved by a U.S. state as of January 1, 1992 (and currently approved by that state). SABA does participate in a private loan program through the Bank of Boston called the TERI Loan Group.

There is a medical school in the Domincan Republic that is certified, but I know nothing about it (name is something like Univ. Ibero Americad).Bonnie LeBold sent me a list of countries whose accreditation standards have been reviewed. I note that Antigua and Saint Lucia were determined NOT to have standards comparable to the U.S. I was surprised, however, to see that countries like Austria, Belgium, France, Italy, Japan, Norway, Spain, Sweden, and Switzerland (and many more) were also determined NOT tohave comparable standards. I know there are good medical schools in those countries. Whether they work well for Americans, I don't know. All I know is that Americans can't get student loans supported by the U.S. Dept. of Education to attend medical school in those countries.

Charles (Chuck) F. Austerberry, Ph.D.