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Richard D.
Democrat IL

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  • Foreign Medical School Accountability Fairness Act

    by Senator Richard J. Durbin

    Posted on 2013-12-17

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    DURBIN. Mr. President, last week I introduced the Foreign Medical School Accountability Fairness Act. The bill seeks to fix a loophole exploited by for profit schools to tap into the federal Treasury at the expense of students.

    Under current law, a small number of medical schools in the Caribbean--about five, four of which are for profits--are exempt from meeting the same requirements to qualify for title IV funding that all other medical schools outside of the U.S. and Canada must meet. This loophole allows these schools to enroll large percentages of American students--which means access to more Federal dollars.

    The biggest of these schools are St. George's, Ross, and American University of the Caribbean whose enrollments of Americans are 70 percent, 91 percent, and 86 percent respectively. Other schools are prohibited from having U.S. citizens make up more than 40 percent of enrollment.

    These for profit schools have turned the idea of being a foreign school on its head--they are located outside of the United States, but have majority-American enrollments. They do not have to meet the same high standards U.S. medical schools must meet, but also do not have to meet the same requirements as schools located outside of the U.S. to access hundreds of millions of dollars of Federal funding.

    Pretty sweet deal, huh? In fact in 2012, the three schools I mentioned earlier--St. George's and the two DeVry-owned schools--took in more than $450 million from the Federal Government from American taxpayers. That amounted to more than two-thirds of all title IV funding that went to all foreign medical schools.

    To sum up--three schools, two-thirds of the Federal funding, exempt from the law.

    Not only are these schools exempt from the enrollment requirement, but they don't have to meet a minimum standard of success--having 75 percent of their students pass the U.S. board exams--a requirement for any of its students to actually practice medicine in the United States. The University of Sydney--with its dozen or so American students--has to meet this standard in order to receive title IV dollars. But DeVry's Ross University, with 1,000 or more American students, does not.

    It doesn't seem right to the Department of Education, which says there is no rationale for continuing the exemption. And it doesn't seem right to me, either. Especially when you consider what students are getting for this Federal investment--more debt, higher rates of attrition, and lower residency match rates than U.S. medical schools.

    Translation: More debt and less chance of becoming a doctor.

    In September, an article in Bloomberg by Janet Lorin entitled ``Devry Lures Medical School Rejects as Taxpayers Fund Debt'' shined a bright light on the poor student outcomes of these schools.

    It is no secret that for profit foreign medical schools prey on students who have been rejected by traditional U.S. medical schools. They promise to fulfill the unrequited dreams for students who want to be doctors, but for one reason or another, did not make the cut in the U.S. On average, scores on the MCAT, the test required to enter medical school, of students attending these offshore for profit schools are lower than those of students who are admitted to medical schools in the U.S. In 2012, students at U.S. medical schools scored an average of 31.2 out of 45 on the MCAT while students at the DeVry medical schools scored an average of 25.

    The attrition rate at U.S. medical schools averaged 3 percent for the class beginning in 2009, while rates at for profit foreign medical schools can be up to 26 percent or higher. More than a quarter of the students at some of these schools drop out.

    On average, students at for profit medical schools operating outside of the United States and Canada amass more student debt than those at medical schools in the United States. For example, in 2012, graduates of the American University of the Caribbean had a median of $253,000 in student debt versus $170,000 for graduates of U.S. medical schools.

    To add insult to injury, these foreign trained graduates are on average less competitive candidates for coveted U.S. residency positions. In 2013, residency match rates for foreign trained graduates averaged 53 percent compared to 94 percent for graduates of medical schools in the United States. They are even less likely to land a residency position the second time around.

    According to the Bloomberg article I referenced earlier, one graduate of St. George's University, Michael Uva, amassed almost $400,000 in medical school loans, but failed to land a residency spot twice. Michael now works at a blood donation clinic earning $30 an hour. Although he sacrificed years of his life training for it, without completing a residency he will never get to practice medicine and this $400,000 debt will likely follow him throughout his life.

    Congress has failed taxpayers and students by subsidizing these Caribbean schools with billions in Federal dollars for years without adequate accountability and oversight. This bill takes a first step at addressing that failure by ensuring these Caribbean schools must meet the same standards other schools outside of the United States and Canada must meet.

    At the same time, these schools are just another example of the systemic problem we have with for profit colleges trying to make a buck off of students in this country and usually bilking Uncle Sam to do it. In fiscal year 2010, we sent $32 billion to all for profit schools.

    There are three numbers you need to remember when thinking about for profit schools: The percentage of high school graduates that enroll in for profit schools--12 percent; The percentage of Department of Education title IV funds that go to for-profit schools--25 percent; The percentage of student loan defaults for profit schools are responsible for--47 percent.

    I have been fighting these schools for a long time. But today I have a message for those schools down in the sunny Caribbean who may have thought they could continue to exploit taxpayers and students without anybody noticing--we're watching.


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