Don't block foreign med students
Nassau University Medical Center in East Meadow is paid by foreign schools to train their medical students. Credit: Paul Mazza
American medical schools have got a sweet deal with the hospitals that train their students. The hospitals provide clinical training and the schools pay them nothing. But medical schools in the Caribbean are disrupting that arrangement by paying hospitals for the same training.
So now New York's medical schools are pushing state officials to slow or eliminate the flow of students from offshore schools, questioning the quality of the schools and the impact of their students on the training programs. The New York Board of Regents should make sure that offshore medical schools whose students come here meet the rigorous quality standards required of domestic medical schools. But they shouldn't stanch the flow of students from abroad by insisting that the offshore schools instead provide the clinical training they need in their home countries.
With a looming shortage of doctors in this country, the training deals can be a win-win for U.S. hospitals and underserved communities, where many offshore students train and, later, as doctors, elect to work in primary care specialties.
Medical students usually spend their first two years in classrooms, but years three and four in hospitals, completing clinical rotations needed for licensure. There are about as many offshore students training in New York's hospitals as there are from schools in the state. But foreign schools don't necessarily mean foreign nationals. Many are U.S. citizens.
Both the Nassau University Medical Center and the New York City Health and Hospitals Corp. have training deals with offshore schools. Sixty-four of the 161 students in clerkships at NUMC are from the American University of the Caribbean on St. Maarten. They're occupying slots the hospital couldn't fill with students from local medical schools. And NUMC will collect about $20 million over the 10-year deal - money that is paying for an amphitheater, classrooms, additional staff and upgraded technology.
Not all Caribbean medical schools are created equal, but the 14 already approved by New York for clinical training here are among the best in that region. But New York State's criteria for evaluating offshore schools hasn't been updated since 1985. Since then the number of students in some offshore schools has soared, with graduating classes at some of those schools topping 900 - compared with the 120 or so from most U.S. medical schools. As the number training in New York hospitals has increased, so has concern that their presence limits the number of medical procedures those from U.S. schools will see, compromising the quality of their education. Hospitals and state education officials must make sure that doesn't happen.
But the nation needs more doctors and there is no compelling evidence that those from Caribbean schools are inferior. They must pass the same state licensing exams as everyone else to practice in the United States. State officials should address any questions of quality, but they shouldn't hand U.S. medical schools a monopoly on training in the state's hospitals. hN
