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NEW YORK (MainStreet) — Two members of the House of Representatives introduced a companion bill to Senate legislation this month that would cut millions of dollars in federal aid to Caribbean medical schools that have been criticized for the debt burden their U.S. students bear and the sub-standard training that they receive.

Reps. Michael Burgess (R-Texas) and Carol Shea-Porter (D-New Hampshire) said their bill, the House version of Dick Durbin's (D-Illinois) Senate bill, would close a loophole that allows for-profit colleges to operate medical schools off-shore with federal funds.

"These schools are not accredited by the Department of Education-approved bodies and are not required to meet the standards of other foreign medical schools," Durbin wrote in a letter to Education Secretary Arne Duncan last month. "But they are still eligible for federal Title IV funds." Title IV funds consist of loans and grants authorized by the Higher Education Act. A total of five Caribbean medical schools would be subject to Durbin's proposed law. Four are owned by for-profit corporations.

Durbin cited a report by Bloomberg Markets last September that over $450 million in federal funds went to two DeVry medical schools last year: Ross University School of Medicine and American University of the Caribbean School of Medicine. "It is my understanding that they were able to do this because of a 1992 loophole that allowed a small number of foreign medical schools to qualify for federal funds under lower standards than other medical schools," Durbin said.

Durbin's Foreign Medical School Accountability Fairness Act would close the loophole in the current law by requiring that all medical schools outside of the U.S. and Canada have at least a 60% enrollment of non-U.S. citizens and that the pass rate on the U.S. Medical Licensing Exam be at least 75% in order to get federal funding. Students at these off-shore med schools are believed to be virtually all Americans.

Ernie Gibble, senior director of global communications at DeVry Education Group, said these legislative efforts would deprive legitimate applicants of a medical career. "The Senator's bill, which limits the number of U.S. citizens at international medical schools to 40% of enrollees, would leave thousands of highly qualified U.S. college graduates without an option for medical school," he said.

Ross med school graduates, Gibble added, "have an 84% residency placement rate and American University of the Caribbean graduates have 82% – much higher than the 53% residency placement rates of foreign-trained doctors cited by the Senator." Both DeVry med schools are located on Dominica, a Caribbean island nation. The DeVry Education group is based in Downers Grove, Illinois.

Bloomberg said DeVry students are prone to quit during the first two semesters, leaving with loans but no degree. The average attrition rate at U.S. med schools was 3% for the class of 2008, according to the Association of American Medical Colleges. Bloomberg says DeVry's rate ranges from 20 to 27%, citing DeVry's own figures.

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Of those who remained, Bloomberg said that 66% of American University of the Caribbean School of Medicine students and 52% at Ross University School of Medicine finished their programs on schedule in 2012. Those programs generally consist of two years of sciences followed by two more of clinical training.

Bloomberg found that in 2013, American graduates of these foreign med schools had a residency match rate of 53% compared to 94% of graduates of U.S. medical schools. Off-shore schools also pay U.S. teaching hospitals for clinical training slots for their graduates, which are needed to complete medical school. In June 2013, Texas passed a law prohibiting foreign medical schools from sending students to the state to complete their training.

Debt incurred by students at these off-shore for-profit medical schools is significantly higher than their stateside counterparts. Bloomberg found that in 2012 the median debt at American University of the Caribbean was $253,000 compared to U.S. medical schools where it was is $170,000 for the same year. According to the Association of American Medical Colleges, that gap is even larger since US debt includes money borrowed for undergraduate degrees. The DeVry figure includes med school debt only.

Rep. Burgess, co-sponsor of the House bill, has a professional perspective — he was a practicing physician in Texas for three decades.

"This bill is a needed fix to a loophole that not only wastes taxpayer money but takes advantages of students," he said. "Some of the schools in question charge a significantly higher rate than American schools, while providing what some allege is a sub-standard education. This leaves students in debt and unable to find a medical residency."

DeVry's Gibble portrayed the off-shore med schools as a source of trained personnel who would be increasingly in demand. The Durbin bill, he said, "would limit our nation's ability to meet its healthcare workforce needs, cut short the professional career goals of qualified students, and negatively impact the health and well-being of thousands of Americans just as they enter the health care system via the Affordable Care Act."

U.S. medical schools have already noticed the shortfall. The Association of American Medical Colleges planned in 2006 for a 30% med school enrollment rise by 2017. They say they can meet that target.

-Written by John Sandman for MainStreet