Foreign Medical Study - Page 2
with the current admission policies and
procedures and whose advice should be
sought. This source may have applications and
descriptive literature or may pro-
vide the names and addresses of admissions
officers.
2. Institute of International Education, 809
United Nations Plaza, NY 10017,
maintains a library of foreign university
catalogs.
3. World Directory of Medical Schools published
by the World Health Organization,
Geneva. This publication, while providing some
helpful data, is not written espe-
cially for the potential American applicant and
lacks such useful information as how
to initiate an application, who is responsible
for admissions at a particular school,
and how many Americans are enrolled at the
school. Therefore, this volume may
not be worth purchasing but should nevertheless
be examined at a reference library.
Most German, Austrian, and Belgian schools have
relatively high admission stan-
dards and strict scholastic requirements. As
many as from 30 to 50% of the students fail
the basic science examination that is taken
prior to beginning clinical studies. However,
graduates from schools in these three countries
have some of the best records for pass-
ing the ECFMG examination. Italian, Mexican,
and Spanish schools have relatively low
admissions requirements and accept and graduate
relatively large numbers of students.
Graduates from schools in these countries have
had the most difficulty passing the
ECFMG examination. (This possibly may be due to
the poor quality of the students and
not necessarily the standards of education at
the schools.)
The course of studies in foreign medical
schools varies from four to six years. At
some schools, examinations are usually taken
voluntarily at the end of one- or two-year
periods and can be retaken a number of times.
This system of academic freedom adds to
the existing problem of studying medicine in a
foreign language.
TRANSFER TO U.S. SCHOOLS
In 1970 the Coordinated Transfer Application
System (COTRANS) was established on
an experimental basis to facilitate the
transfer of students studying abroad to U.S. med-
ical schools. In the past, this system involved
taking Part 1 of the National Board Exam-
inations at a U.S. or foreign test center, a
program terminated in 1979. During the
decade of COTRANS's existence, less than half
of those who took Part 1 of the NBME
passed and only about half of those who passed
managed to transfer to U.S. medical
schools. This points up the inherent
difficulties associated with overseas medical study.
In June 1980 a special examination was
developed by the NBME for U.S. citizens
enrolled in foreign medical schools who wish to
apply for transfer with advanced stand-
ing to a U.S. medical school. It was known as
the Medical Sciences Knowledge Profile
(MSKP). This examination was designed to
provide medical schools with a method of
evaluating such an applicant's knowledge in the
basic medical sciences and in introduc-
tory clinical diagnoses. No total score or pass
or fail was reported, but the difficulty of
transferring to a U.S. medical school is
reflected in the fact that less than 40% of stu-
dents have succeeded in doing so each year.
Moreover, the numbers transferring have
declined. The MSKP was replaced by the USMLE
Step 1 in June 1992. The grade on
this exam is now used to evaluate U.S.
applicants who wish to transfer.
INTERNSHIP AND RESIDENCY
There are five pathways for foreign graduates
to follow in securing AMA-approved intern-
ship and residency appointments: (1)
transferring with advanced standing to a U.S. med-
ical school and repeating one or more years
(the policies of U.S. medical schools regard-
ing transfer and advanced standing are given in
the profiles for the individual schools in
Chapter 6); (2) certification by ECFMG on the
basis of satisfying the ECFMG educational
requirements as well as passing the ECFMG
examination; (3) obtaining a full and unre-
stricted license to practice medicine, issued
by a state or other U.S. jurisdiction authorized
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