Meeting of the Board of Regents | February 2009

Summary

Issue for Discussion:

Presentation of the State Education Department’s process for evaluating international medical schools that seek to place their students in clinical clerkships within New York State hospitals.  

Reason(s) for Consideration

For Information

             

Proposed Handling

This presentation is before the Professional Practice Committee for informational purposes and discussion at the Committee’s February 2009 meeting.                            

Procedural History

In 1981 the Board of Regents approved section 60.2(c)(3) of the Regulations of the Commissioner of Education, which governs the circumstances under which students enrolled in unregistered and unaccredited medical schools may engage in clinical clerkships totaling more than 12 weeks within New York State.  

Background Information

In the 1970s there was a proliferation of what are commonly referred to as “split-campus” medical schools. Today they are also commonly referred to as “offshore” medical schools and are mostly located in the Caribbean.  These “offshore” schools are characterized as “split-campus” because the theoretical or didactic part of the medical education is conducted at one location, while the clinical training is conducted in one or more locations outside of the country in which the medical school is located.  For example, the Ross University School of Medicine is located in and organized under the laws of Dominica, a sovereign nation located in the Caribbean.  The didactic phase of medical training is conducted in Dominica during the first two years of the school curriculum.  Thereafter, students embark on clinical training which may take place at any of the hospitals throughout the United States that maintain formal affiliation agreements with the Ross University School of Medicine.

DOH regulations generally authorize post-graduate trainees (residents) to provide patient care services in New York hospitals only if the program of medical education which they completed “included no more than 12 weeks of clinical clerkships in a country other than the country in which the medical school is located.”  However, more than 12 weeks of clinical clerkships may be included if “the clinical clerkships were offered by a medical school approved by the State Education Department for the purposes of clinical clerkships” (10 NYCRR 405.4).

The State Education Department’s process for the approval of medical schools for clinical clerkship purposes, which is set forth in section 60.2(c)(3) of the Regulations of the Commissioner of Education, includes the performance of a site visit and the review of formal agreements between the medical school and the hospitals in which the clerkships are provided.

              After careful review, the Department has approved 14 international medical schools for clinical clerkship purposes. The “on-site” evaluation of the schools is conducted by the Executive Secretary of the State Board for Medicine with the assistance of four or more independent consultants who satisfy the regulatory requirement of having experience in medical program evaluation (the site visit team). 

              Through review of extensive documentary submissions, interviews with administrators, faculty and students, and review of curriculum content, among other factors, the site visit team assesses:

• the depth and breadth of the curriculum and the integration of the basic sciences and clinical experiences;
• admissions standards and maintenance of student records;
• the adequacy of the physical facilities (e.g., lecture halls, laboratories, study rooms, etc.);
• the financial resources of the medical school;
• the library resources available to students; and
• faculty qualifications.

          Upon completion of the site visit, the hospitals with which the medical school maintains affiliation agreements are visited to assess the integration of the clinical training program with the medical school curriculum.  Among the factors considered are the background and training of clinical instructors, the administration of the clinical clerkship program, the supervision of students, facility resources, and other factors that determine whether the site is capable of providing an adequate clinical training experience.

              A final report is issued outlining the findings and conclusions of the site visit team, including the strengths and weaknesses of the program.  Recommendations are made to improve the quality of the program.  Where the medical education program is found to be inadequate, approval is denied.  Approved programs are scheduled for a follow-up visit, usually within three years, depending on the findings, conclusions and recommendations of the site visit team.