According to a GAO report released on June 28, 2010, the US government is questioning the quality of medical education received by students trained at foreign universities. The GAO data shows that subsidizing students with federal student loans who go to foreign and Caribbean medical schools may not be worth it.
Why do Premeds Choose Caribbean Medical Schools?
Because the competition as a premed student in the United States is so intense, many consider institutions outside of the country, especially at three key Caribbean medical schools where federal student loan funds are readily available. GPA and MCAT requirements are lower. In some cases, there may be no MCAT requirement at all. The GAO report found that ease of admissions is the primary reason why so many premed students are looking at foreign universities.
USMLE Pass Rates for Foreign Medical School Students
According to the GAO report, 27% of international medical school graduates (IMG) failed to pass the USMLE Step 1 Basic Sciences exam during the first attempt while only 6% of students from US medical schools failed. A significant number of IMGs who fail Step 1 never pass.
USMLE Step 1 and Step 2 scores are a significant factor in getting a match into a US residency. Government researchers found that those who need repeated attempts to pass have great difficulty in getting matched because they are perceived as weaker candidates. IMGs who fail to match into any US residency will either try to make their application better in the next interview season, take the USMLE Step 3 if allowed, or be forced to work outside of the medical field despite incurring huge student loan debt. Unfortunately, the latter is the most likely result for those who fail to match.
The GAO found that the IMGs who are successful in matching to a US residency program tend to practice in primary care on the US east coast. It is rare that IMGs get into highly competitive areas such as plastic surgery. US medical students spend a similar amount of money on education as IMGs, but they have much higher USMLE pass rates and many match into highly desired specialties.
Federal Student Loans for Foreign Medical Schools
Currently, IMGs can borrow a maximum of $20,550 in subsidized and unsubsidized federal student loans each year to study at foreign universities that meet Department of Education requirements. The maximum in student loans that can be borrowed for foreign education is $138,500. By contrast, students studying in the US can borrow as much as $224,000 in guaranteed federal student loans.
$633 million worth of federal student loans went to students studying at foreign medical schools in 2008. The GAO found that 90% of federal student loan funds going to foreign institutions went to three private for-profit medical schools in the Caribbean including St. George's University (SGU) in Grenada, Ross University in Dominica, and American University of the Caribbean (AUC) in St. Maarten.
The short term effect of these findings may be fewer choices for those seeking foreign medical schools. Congress passed a law requiring a 75% pass rate for participation in the federal government's Direct Loan program beginning in 2010. Before 2010, the statutory requirement was 60%. Note that SGU, AUC, and Ross have been statutorily exempt from the 60% pass rate requirement since 1992, and will continue to be exempt. The GAO found that very few foreign institutions can meet the new 75% pass rate standard.
References:
GAO. "Foreign Medical Schools: Education Should Improve Monitoring of Schools That Participate in the Federal Student Loan Program." June 28, 2010.
Yarbrough, Marcus. The Student Doctor Network Caribbean Medical School Primer: Everything you need to know before you go. Coralville, IA: MedRounds Publications, Inc., 2007.
