Foreign Medical School Accountability Fairness Act

Floor Speech

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Mr. DURBIN. Mr. President, this week I was pleased to be joined by my Republican colleague from Louisiana, Senator Bill Cassidy, to introduce the Foreign Medical School Accountability Fairness Act.

I appreciate Senator Cassidy's leadership on this issue and his willingness to work across the aisle. We were joined across the Capitol by Representatives Michael Burgess and Elijah Cummings, who introduced a House companion bill today.

This bipartisan, common-sense bill fixes a loophole in Federal law used by for-profit medical schools in the Caribbean to gain access to Federal education dollars without meeting the same requirements as other foreign medical schools.

Under current law, a small number of medical schools--about six, 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 for-profits--St. George's, Ross, and American University of the Caribbean whose enrollments of Americans are 91 percent, 83 percent, and 86 percent respectively. Other schools are prohibited from having U.S. citizens or U.S. permanent residents 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 U.S., but have majority-American enrollments.

They don't have to meet the same high standards U.S. medical schools must meet, but also don't have to meet the same requirements as schools located outside of the U.S. to access hundreds of millions of dollars of federal funding. It's a pretty good deal for them.

In fact in 2012, the three schools I mentioned earlier--St. George's and Ross and American University of the Caribbean, both owned by DeVry, 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, 2/3 of the Federal funding, exempt from the law.

Not only are these three 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 2013, 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 out of 45 on the MCAT while students at DeVry's Ross medical school scored an average of 24.

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, graduates of the American University of the Caribbean have a median of $309,000 in Federal student debt versus $180,000 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 2015, 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 was forced to work at a blood donation clinic earning $30 an hour instead. 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.

This bill should send a message to those schools down in the sunny Caribbean who may have thought they could continue to exploit taxpayers and students without anybody noticing.

It has broad support among the U.S. medical school community--endorsed by medical school deans of more than 60 venerable U.S. medical schools and the American Association of Colleges of Osteopathic Medicine.

I look forward to working with Senator Cassidy as well as Chairman Alexander and Ranking Member Murray to address this issue as the HELP Committee begins consideration of the Higher Education Act.

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