International Med Schools Answer Call

American graduates of foreign programs help fill need for doctors in rural areas

By Melissa Korn

With U.S. medical schools struggling to churn out enough doctors to meet the demand in rural and other underserved areas, overseas programs that cater to their admission rejects are helping to pick up the slack.

The international schools have long carried a stigma of being pricey, mainly for-profit and a little too close to the beach for proper studying. And health-care professionals say many still do have lax admission standards and abysmal outcomes.

But amid uncertainty over whether the pipeline of foreign doctors will slow due to tighter immigration rules under the Trump administration, some offshore institutions have polished their images as their American graduates help to fill a critical need in places like Louisiana and Wyoming.

New Jersey native Chantel Taylor was turned down by more than 20 U.S. medical schools with a 3.0 grade point average from Brown University and an “average” score on the MCAT medical school admission test. To get her dream job as a primary-care doctor, she enrolled in a program created eight years ago for Americans—in Australia.

Dr. Taylor, 29 years old, attended a joint program between the University of Queensland and the Ochsner Health System in Louisiana. Now she is about to start her second year of residency at the Louisiana State University rural family-medicine program in Bogalusa, La.

“The work we do makes a huge impact,” she said. “There are not a lot of doctors here.”

The Association of American Medical Colleges forecasts a physician shortage of between 40,800 and 104,900 by 2030. U.S. medical schools have increased first-year enrollments by more than one-quarter over the past 15 years, with 21,030 such students this year.

Still, demand for a medical education far outstrips the supply of seats on U.S. campuses. And that is where overseas schools are stepping in.

In 2016, 3,298 U.S. citizens from international medical schools were certified to enter American residency and fellowship programs, up from 1,858 in 2006, according to the Educational Commission for Foreign Medical Graduates, which grants the certificates.

Chantel Taylor of New Jersey attended medical school in Australia and is about to start her second year of residency in Bogalusa, La.

Even though students at international schools often face higher tuition and less lucrative assignments as generalist doctors after graduation, their student-loan default rates are low, often under 2%, according to government statistics.

Studying medicine overseas can be a risky move, since only about 54% of American students in foreign schools are accepted into a U.S. residency program the first time around, compared with about 94% for U.S. students in domestic programs, according to the National Resident Matching Program, which matches medical school students with hospitals.

A few of the schools outperform when it comes to getting students into residency programs at U.S. teaching hospitals. UQ-Ochsner, a nonprofit institution, this year achieved a residency match rate of 95%. And graduates from for-profit Ross University Medical School in Dominica, American University of the Caribbean School of Medicine in St. Maarten and St. George’s University School of Medicine in Grenada, along with a handful of others, regularly post match rates over 85%.

“You have high-quality candidates that come from all walks of programs,” said Stephen Knohl, internal medicine residency program director at SUNY Upstate Medical Center in Syracuse, N.Y. “You have to take a chance.”

Nearly half of the 59 first year residents starting this summer are U.S. citizens from Caribbean schools.

Of aspiring doctors who applied for residency matches in 2016, 15% were U.S. citizens who attended foreign schools, nearly double the share of such candidates in 2000, according to the match program. These days, the overseas schools are becoming a magnet for students interested in general practice or working in rural areas. Dr. Leonardo Seoane, head of school at UQ-Ochsner, said clinical rotations in Haiti and the Ninth Ward in New Orleans are a draw.

Ross and American University of the Caribbean, both owned by Adtalem Global Education Inc., have been focusing their messaging in recent years on how their graduates fill coverage gaps in places like Nevada, Wyoming and Tennessee.

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