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Foreign Medical Study - Page 3


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to license physicians; (4) successfully passing the complete licensure examination in any
state or licensing jurisdiction where a full and unrestricted license is issued upon satisfac-
tory completion of internship or residency without further examination; and (5) an
approach that is especially popular among one segment of foreign medical students, and is
for obvious reasons known as the Fifth Pathway, which is discussed in the next section.
Among the drawbacks of attending a foreign medical school is the difficulty in
securing a residency appointment at a U.S. hospital upon graduation. A substantial num-
ber of Americans, after investing much effort, time, and money, are unable to secure a
residency in this country due to a variety of reasons. First, they may have received a
poor medical education at the school they elected to attend, which seriously weakens
their candidacy for postgraduate training. Second, they are competing against other for-
eign graduates for the very limited number of places not filled by graduates of U.S.
schools. Finally, the total number of residency openings is diminishing in response to
the perceived over-supply of physicians that is anticipated. Consequently, the awareness
of this potential problem in the educational program of foreign medical students should
stimulate careful consideration of this career pathway.
FIFTH PATHWAY OPPORTUNITIES
Students who have completed all of the formal requirements of the foreign medical
school except internship and/or social service may substitute a year of supervised clini-
cal training for the required foreign internship (that is, clinical clerkship or junior intern-
ship) under the direction of an AMA-approved medical school. Upon successful com-
pletion, students may enter the first year of an approved residency program without
having to complete the social service requirement of the foreign country. Before begin-
ning the supervised clinical training, students must have their academic records
reviewed and approved by the school supervising the clinical training and must pass a
screening examination acceptable to the Council on Medical Education. The ECFMG
examination and/or Step 1 of the USMLE are used for this purpose.
Currently only mainland U.S. medical schools offer Fifth Pathway clerkships. This
option applies primarily to students in Mexican medical schools and is open only to
physicians who have completed their undergraduate premedical studies in an acceptable
manner at an accredited American college or university. The Fifth Pathway program
allows U.S. students who have completed the requirements for a medical degree in Mex-
ico to be eligible for a continuous academic year of supervised clinical training under the
direction of a medical school approved by the Liaison Committee on Medical Education.
The students who complete this supervised clinical training are then able to enter an
AMA-approved graduate training program without completing the Mexican-required
internship or social science obligation. This program facilitates graduates of Mexican
medical schools to pass into graduate medical programs in this country. The following
schools are associated with this Fifth Pathway program. They give preference to state
residents. Inquiries should be addressed to the directors of these programs.
University of Arizona
College of Medicine
Tucson, AZ 85724
(Arizona residents only)
University of California, Irvine
California College of Medicine
Irvine, CA 92717
(Preference for California Residents)
Loma Linda University
School of Medicine
Loma Linda, CA 92354
(Out of state residents discouraged)
University of Phoenix
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