Caribbean medical schools under scrutiny – Medical students burden the American taxpayer

POSTED: 09/18/13 12:49 PM

St. Maarten – The party for for-profit medical schools in the Caribbean may come to an end in the foreseeable future if grumbling American politicians get their way. Medical schools like the Devry-owned AUC Medical School in Cupecoy – and 33 others like them in different countries in the region – attract the debris of the US medical student population, an article on Bloomberg reveals. Some students have been refused entry to as many as twelve schools in the States before coming for their training to the Caribbean.

Bloomberg-reporter Janet Lorin names David Adams as an example. Adams became a paramedic as a teen, graduated from the University of Utah with a bachelor’s degree in health promotion and education and was then rejected by twelve US medical schools. Last year, Adams earned a Master of Science in medical health sciences from Touro University in Nevada. Then he was accepted at Devry’s AUC School of Medicine in Cupecoy.

Lorin describes the arrival of the 31-year-old Adams in St. Maarten and his perspective in the medical profession like this: “He moved with his wife, Jessica, and their two young children to a two-bedroom apartment that smelled of dog urine and had a broken stove on the Dutch part of St. Maarten on January 1. After financing his first two semesters with $67,000 in U.S. government-backed loans, Adams expects to leave medical school with as much as $400,000 in debt — and about a 20 percent chance of never practicing as a physician in the U.S.”

That study loan is paid for by American tax payers and politicians have started to notice a thing or two. One is that the dropout rate at de medical schools in the Caribbean is dramatic. Lorin quotes figures from the American Association of Medical Colleges that claim a 3 percent dropout rate for US-based colleges. The dropout rate at Devry is between 20 and 27 percent – up to nine times higher.

And while the medical school in Cupecoy touts the fact that its students are accepted for internships at hospital in the United States, Lorin reveals that the company is actually paying these hospitals to take its students in for the two years of clinical training they need to complete their degree.

US medical schools offer training hospitals faculty appointments and access to their medical school library and not – like Devry – cash per student per week.

Senator Dick Durbin, a Democrat from Illinois, says that congress needs to examine the law that makes foreign for-profit medical schools eligible for federal loans. The medical schools in the Caribbean are according to Lorin not accredited in the US.

Durbin sent a letter to Education Secretary Anne Duncan in which he asks for a study of the medical schools in the Caribbean “that have feral loan access, yet may be subject to standards below those set for medical students in the US.”

Devry’s two medical schools in the Caribbean – AUC and Ross University in Dominica– plus two others also receive tuition benefits from the American Department of Veteran Affairs, Lorin reported. The students Devry accepts in its medical schools in the Caribbean amass more student debts than their counterparts at home. In June of last year the average study debt for AUC-graduates was $253,000 versus $170,000 for graduates in the States.

The Bloomberg-report says that 66 percent of AUC-students finished their program that ended on June 30 of last year. At Ross University, the percentage was just over half: 52.

The universities are not accredited by the body that approves medical programs in the US. In 2012, the student loans totaled $310 million. Bloomberg reports that the American taxpayer is on the hook for the loans that won’t be repaid.

That the climate in the US is turning against the Caribbean medical schools became apparent when the state of Texas outlawed foreign schools from operating on its territory. Texas plans to establish two new medical schools with place for 200 students each. In time, these students will have to find a training hospital for their internship and that is where the competition from the pay-for-play model Devry uses hurts.

Here are a few numbers: Devry pays Nassau University Medical Center about $1.4 million a year until 2022 for 64 internship places. St. George’s University, another for-profit medical school in the Caribbean, has a 10-year $100 million contract with New York City Health 7 Hospitals Corp. for internships.

Last year, 78 percent of US medical schools said they were concerned about the number of clinical training sites available for their students; a quarter of these schools cited competition from offshore medical schools as the reason form their concerns,.

To obtain a license for practicing medicine in the US, students from overseas schools have to spend three years in a residency program; aspiring specialist like neurosurgeons could take as much as seven years in these programs.

There also appears to be a difference in the perception of the quality medical schools deliver. The American National Resident Matching Program said that 94 percent of fourth-year students schooled at home landed a first-year match this year versus 53 percent of students with an international training.

Comparatively, Devry scores not all that bad. Of the 914 Ross students that applied for residency this year, 76 percent (699 students) found a place. AUC placed 79 percent if its 268 students. For the students that failed to find a match, the future looks bleak. More than half of them fail to find a residency spot the second time around

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