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Monday, January 7th 2013

Foreign Medical Students In Texas

It is a medical education themed day as I return to blogging after a month off.

We’re potentially awaiting this month a ruling from the Texas Higher Education Coordinating Board on January 24th whether medical students at the for profit American University of the Caribbean can do clinical clerkships during their third and fourth years in Texas hospitals. This ruling following the Attorney’s General office giving an opinion that THECB does have the authority to grant or deny AUC’s request.

To be clear, this wouldn’t require hospitals to take these students but if the THECB rules in AUC’s favor it would allow the university to negotiate with hospitals in the state to allow their medical students to come through. Considering the money AUC is likely flash to secure spots for their students it is almost a forgone conclusion there will be a number of opportunities for their students in Texas.

I’ve written previously about growing opposition to foreign medical students rotating in the United States in states that already allow such. And there is much opposition amongst Texas medical schools and organized medicine and legislators.

Texas medical schools, charged with increasing enrollment to meet the state’s physician shortage, are already “starting to stumble over each other” finding their students the right clerkships, said Dr. Cynthia Jumper, who heads the Texas Medical Association’s medical education council and chairs the internal medicine department at Texas Tech University Health Sciences Center. While there may be a few extra positions available now, Jumper said, there won’t be for long. 
“What extra room there is now has already been spoken for,” she said.

Senate Higher Education Chairwoman Judith Zaffirini, D-Laredo, also voiced opposition. In a letter to Fred Heldenfels, the chairman of the coordinating board, she said approving AUC’s request would set a precedent opening the door to a slew of foreign schools, and she questioned the board’s authority to approve private professional programs. “May God bless you and inspire you to agree with my perspective,” she wrote.

It isn’t merely a matter of physical capacity, in the sense of how many medical students Texas hospitals can support. There is a limiting factor in that Texas medical students cannot, for all practical purposes, rotate on the same teams within hospital that AUC foreign medical students are on. Examples exist of citations from the Liaison Committee on Medical Education, the body that accredits all allopathic U.S. medical schools, for mixing of LCME and non-LCME medical students on clinical rotations. A summary of the accredidations standards of the LCME can be found here (PDF).

Personally, I hope to keep foreign medical students out of Texas hospitals. That may be a little bit of a surprising stance from me. I think, however, that the primary concern here should be in protecting the education of Texas’ own medical students, which the state already has significant investment in. I think foreign medical students taking up clinical clerkships in Texas hospitals may put that at risk.