Policies on U.S. Citizens Studying Medicine Abroad Need Review and Reappraisal

HRD-81-32: Published: Nov 21, 1980. Publicly Released: Nov 21, 1980.

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GAO reviewed U.S. citizens studying medicine abroad, concentrating on: (1) the education or training provided by six foreign medical schools in which several thousand U.S. citizens are enrolled; (2) the clinical training which U.S. citizen foreign medical school students receive in U.S. hospitals; (3) the avenues available for entering the American medical system; and (4) federal financial assistance provided to U.S. citizens while studying medicine abroad. Many U.S. citizens attend foreign schools with the goal of returning to the United States to practice medicine. Much concern has been expressed about the recent proliferation of medical schools established abroad to attract U.S. citizens, and questions have been raised about the adequacy and appropriateness of that educational experience for practicing medicine in the United States.

GAO believes that more appropriate mechanisms are needed to ensure that all students who attend foreign medical schools demonstrate that their medical knowledge and skills are comparable to their U.S.-trained counterparts before they are allowed to enter the mainstream of American medicine. The foreign medical schools which GAO visited differed considerably, but did not offer a medical education comparable to that available in the United States because of deficiencies in admission requirements, facilities and equipment, faculty, curriculum, and clinical training. A serious shortage was the lack of adequate clinical training facilities. Many U.S. citizen foreign medical school students obtained part or all of their clinical training in U.S. hospitals, but that training was not comparable to that provided to U.S. medical school students. State licensing boards are becoming increasingly concerned about U.S. citizens from foreign medical schools obtaining their clinical training in U.S. hospitals. Foreign medical schools do not receive direct federal financial assistance, but may receive guaranteed student loans or Veterans Administration (VA) educational benefits.

Matter for Congressional Consideration

  1. Status: Closed - Not Implemented

    Comments: A follow-up review was performed and HRD-85-112 was issued on September 27, 1985. The report offered alternative approaches to resolving the problems which this recommendation addressed. Therefore, this recommendation is no longer valid.

    Matter: Congress should direct the Secretary of Health and Human Services to work with state licensing authorities and representatives of the medical profession to develop and implement appropriate mechanisms that would ensure that all students who attend foreign medical schools demonstrate that their medical knowledge and skills are comparable to those of their U.S.-trained counterparts before they are allowed to enter the U.S. health care delivery system for either graduate medical education or medical practice.

Recommendations for Executive Action

  1. Status: Closed - Not Implemented

    Comments: A follow-up review was performed and HRD-85-112 was issued on September 27, 1985. The report offered alternative approaches to resolving the problems which this recommendation addressed. Therefore, this recommendation is no longer valid.

    Recommendation: The Secretary of Education should ensure that the government's interest in outstanding guaranteed student loans at foreign medical schools is adequately protected by properly verifying the status of all U.S. citizens with outstanding loans and initiating repayment where appropriate.

    Agency Affected: Department of Education

  2. Status: Closed - Not Implemented

    Comments: HRD-85-112 offered alternative approaches to resolving the problems which this recommendation addressed; therefore this recommendation is no longer valid. In addition, the regulations issued by the Secretary of Education were challenged in court and the Secretary was ordered to reconsider a key provision of the regulation.

    Recommendation: The Secretary of Education should issue regulations establishing procedures and criteria for implementing the legislative requirement that the Department of Education ensure that foreign medical schools are comparable to medical schools in the United States before authorizing guaranteed student loans for U.S. citizens attending these schools.

    Agency Affected: Department of Education

  3. Status: Closed - Not Implemented

    Comments: A follow-up review was performed and HRD-85-112 was issued on September 27, 1985. The report offered alternative approaches to resolving the problems which this recommendation addressed. Therefore, this recommendation is no longer valid.

    Recommendation: The Administrator of Veterans Affairs should accept foreign medical schools approved by the Secretary of Education as a basis for authorizing educational benefits to qualified veterans, their spouses, and their dependents.

    Agency Affected: Veterans Administration

  4. Status: Closed - Not Implemented

    Comments: HHS stated that it will cooperate with state licensing authorities and the medical profession. However, it considers the issue raised a matter to be resolved by the private sector and the respective state boards and plans no specific action. HRD-85-112 offered alternative approaches to resolving the problems, therefore this recommendation is no longer valid.

    Recommendation: The Secretary of Health and Human Services should, in cooperation with state licensing authorities and representatives of the medical profession, address the current practice whereby students attending foreign medical schools receive part or all of their undergraduate clinical training in U.S. hospitals.

    Agency Affected: Department of Health and Human Services

 

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