Medical Licensing By Endorsement:

Requirements Differ for Graduates of Foreign and U.S. Medical Schools

HRD-90-120: Published: May 17, 1990. Publicly Released: May 17, 1990.

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Pursuant to a legislative request, GAO reviewed state requirements for medical licensure by endorsements to determine whether any state endorsement requirements discriminated against graduates of foreign medical schools.

GAO found that: (1) U.S. schools were accredited by the Liaison Committee on Medical Education (LCME), but there was often no corresponding organization for foreign countries, which made it more difficult to assess the educational backgrounds and credentials of foreign school graduates; (2) the six state medical licensing boards used similar standards for foreign and U.S. medical graduates to determine whether endorsement applicants' medical education was acceptable; (3) five of the six states that GAO reviewed had documentation requirements related to clerkships that applied only to foreign school graduates; (4) documentation requirements posed more difficulty to foreign school graduates; (5) officials of the six state boards believed that such problems affected only a small percentage of endorsement applicants; (6) organizations representing foreign graduates believed that they should not be required to provide documentation other than that required of U.S. graduates; and (7) Federal State Medical Board and American Medical Association officials believed that states should establish standards and requirements to ensure competency, at their own discretion. GAO also found that: (1) examination requirements for graduates of U.S. medical schools were different in most states from those for graduates of foreign medical schools; (2) over 30 state medical licensing boards required more years of accredited U.S. or Canadian postgraduate training for foreign medical school graduates than for U.S. graduates seeking licensure; and (3) organizations representing foreign medical school graduates were opposed to postgraduate training requirements.

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