Quality concerns spur scrutiny of Caribbean medical schools

State medical boards worry about the caliber of graduates' training as they seek U.S. medical licenses.

By Myrle Croasdale, AMNews staff. Jan. 16, 2006.

With a recent explosion in the number of for-profit Caribbean medical schools catering to U.S. students, state medical board officials want to make sure students attending these schools get the skills they need to practice medicine in the United States.

The increase has prompted the Federation of State Medical Boards to review the existing systems used to evaluate American and international medical license applicants. Also, some state medical boards have created lists of schools from which they will not license graduates.

Licensing board officials are concerned that some medical school graduates might pass the U.S. Medical Licensing Exam, complete the clinical physical exam test and get into a residency program, but do so without a medical education that truly qualifies them to practice unsupervised, which is what a license ensures.

"This is becoming a huge issue on a national level and in California," said Joyce Hadnot, chief of licensing at the Medical Board of California. "You may find someone ... sharp enough to pass a test but not have the skills to practice medicine independently."

There's been no flood of disciplinary actions. Instead, it is the deluge of new schools that has raised concerns. Since 2000, California's board has documented 40 new medical schools outside the United States, with more than half of them in the Caribbean. At the other end of the pipeline, the Educational Commission for Foreign Medical Graduates reports that the number of U.S. citizens with foreign medical degrees seeking certificates to participate in the National Resident Matching Program jumped 39% in the past decade, from 527 in 1995 to 1,360 in 2004.