Student Loans: Millions Loaned Inappropriately to U.S. Nationals at Foreign Medical Schools
HEHS-94-28
Published: Jan 21, 1994. Publicly Released: Jan 21, 1994.
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Highlights
Pursuant to a congressional request, GAO reviewed the quality of education that U.S nationals receive at foreign medical schools, focusing on: (1) the adequacy of the Department of Education's efforts to approve foreign medical schools for participation in the federal student loan program; and (2) whether state medical boards have the information they need to assess the quality of education that foreign-trained physicians receive before granting them licenses.
Recommendations
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Department of Education | The Secretary of Education should improve the standards and processes used to determine the eligibility of foreign medical schools. Specifically, the Secretary, together with the congressionally mandated advisory panel of medical experts, should implement standards that are comparable to those that U.S. schools must meet. |
Closed – Implemented
The Secretary has established an advisory panel called the National Committee on Foreign Medical Education and Accreditation. The Department published a final rule on April 28, 1994, that defines procedures and establishes standards that foreign medical schools must meet in order to participate in the Federal Family Education Loan (FFEL) Program.
|
| Department of Education | The Secretary of Education should establish policies and procedures to help ensure that guaranteed student loans are made only to students attending medical programs that meet Education's standards. |
Closed – Implemented
In July 1997, based on recommendations of the Department of Education's National Committee on Foreign Medical Education Accreditation (NCFMEA), the Department of Education discontinued eligibility for federally guaranteed loans to students at 82 medical schools in 29 countries. At that time, Education also changed its student loan system used by guaranty agencies and lenders to ensure that the system identified whether the medical program of foreign schools was approved. Thus, all foreign schools with a medical program should have a marker in the student loan system to indicate to lenders and guarantors whether the medical program is approved, ensuring that loans are made only to students attending approved medical programs.
|
| Department of Education | The Department of Education should require that foreign medical schools demonstrate that: (1) they have formal affiliation agreements with the facilities they use to train their students; and (2) their training facilities are equivalent to those that teach U.S. medical students. |
Closed – Not Implemented
Education's elimination of eligibility for student loans to attend virtually all foreign medical schools makes this recommendation no longer applicable.
|
| Department of Education | The Department of Education should establish criteria for triggering site visits to schools' campuses and clinical training facilities to review the schools' operations and facilities and verify information. |
Closed – Implemented
The Department has developed and implemented criteria to trigger site visits to foreign medical schools. The Department has conducted several site visits and is currently taking action to remove the eligibility status for some of these schools.
|
| Department of Education | The Secretary of Education should establish formal policies and procedures regarding the foreign medical school approval process. |
Closed – Not Implemented
Education's elimination of eligibility for student loans to attend virtually all foreign medical schools makes this recommendation no longer applicable.
|
| Department of Education | The Secretary of Education should develop appropriate guidance for lenders and guaranty agencies. |
Closed – Implemented
Since the final regulations were published, notification and guidance was provided to lenders and guaranty agencies through a weekly status report that lists all changes in institutional status.
|
| Department of Education | The Secretary of Education should ensure that approving officials are knowledgeable and staff are properly supervised. |
Closed – Implemented
The Department has created a separate team responsible for approving foreign schools consisting of four people to replace the one person who had this responsibility at the time of this report.
|
| Department of Education | The Secretary of Education should require applicants for loans to identify when they plan to attend a foreign medical school. |
Closed – Implemented
Education disagreed with the part of the recommendation about identifying foreign medical schools on the student's application. Education indicates that it will identify foreign medical schools through the school application process.
|
| Department of Education | In cases of schools not cooperating with Education in providing information, Education should exercise its authority to prevent or terminate their continued eligibility in the guaranteed student loan program. |
Closed – Implemented
The Department's final regulation states that the failure of a foreign medical institution to provide, release, or authorize release of information required by regulation shall render the institution ineligible to apply for participation in the FFEL program.
|
| Department of Education | Once Education's standards and processes have been improved, the Secretary of Education should share information that Education obtains on foreign medical schools with state medical boards for their use in evaluating the education of licensure applicants. |
Closed – Not Implemented
Education's elimination of eligibility for student loans to attend virtually all foreign medical schools makes this recommendation no longer applicable.
|
| Department of Education | The Secretary of Education should work with the Federation of State Medical Boards to determine which information that Education gathers would be of most use to the state boards. |
Closed – Implemented
Education has begun to identify what information it believes FSMB needs, and will provide that information when its work is completed. But it has not done this, and does not plan to do so, in collaboration with FSMB.
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Americans studying abroadEducational standardsGovernment guaranteed loansInformation disclosureInstitution accreditationLicensesMedical educationMedical schoolsStudent loansForeign medical graduates