Hundreds of doctors practicing across the country are graduates of medical schools that are banned in states including California and Texas because of questionable educational standards, a Hartford Courant investigation has found.
Inconsistent licensing rules from state to state allow nearly 900 doctors to pursue lucrative careers after graduating from offshore medical schools that would be hard-pressed to win accreditation in the United States.
Three schools — Spartan Health Sciences University on the Caribbean island of St. Lucia and the Universidad Tecnologica de Santiago, or UTESA, and the Universidad Eugenio Maria de Hostos, both in the Dominican Republic — are banned in at least six states. The University of Health Sciences in Antigua, another Caribbean island, is banned in four.
Only a handful of the 1,642 medical schools located outside the United States and listed by the World Health Organization have been banned by any U.S. medical board.
"We have to protect the patients," said Pat Park, the foreign schools liaison at the Medical Board of California. "That’s why we have to look into every aspect of how these people are trained and where they are trained. They can pose a serious danger to the public."
Spartan Health Sciences consists of four classrooms, one lab and three old cadavers in a building next to a brewery. In interviews, the students admitted that they sorely lack the academic qualifications to get into U.S. schools, and that the faculty includes teachers who do little more than stand in front of the class and read from textbooks.
Even officials on St. Lucia have for years refused to license Spartan graduates because of a "deep skepticism" about the school’s educational standards.
With an estimated 6,000 U.S. citizens attending foreign medical schools, some state officials say it’s time to eliminate the haphazard patchwork of regulations.
"We would really like to see a national organization do this," said Jill Wiggins, a spokeswoman for the Texas board of medical standards. "The standard should be national, not left up to the individual states."
After reviewing California’s methodology for banning schools, officials in Texas decided earlier this year to adopt California’s list. That sort of tough action, however, remains the exception. Only a few other states either ban graduates of certain schools or restrict their practice: Alabama, Indiana, Idaho, Kansas, New Mexico and Vermont.
The severity of the bans, which have been instituted over the past two decades, vary from state to state. In some, such as California, the ban is absolute. Other states permit exceptions and allow individual applicants to petition for a review of their experience and training.
Licensing directors in several states said that keeping up with the changing spectrum of offshore medical schools would be impractical and that dispatching inspection teams to the Caribbean would be costly.
"Without an international accrediting organization, the data would change from year one to year two," said Margaret Anzalone, deputy director of the Maryland Board of Physicians.
Dr. James Thompson, who heads an umbrella group that represents state medical boards, acknowledged that there is "no good system for accrediting all international medical schools."
But he insisted that the measures used by state boards to assess the knowledge and skills of individual applicants were thorough, weeding out people who can’t perform at the level expected of doctors in the United States.
"I think it does a remarkably good job of protecting the public," said Thompson, president of the Dallas-based State Federation of Medical Boards.
Officials from UTESA rejected the assessment of California authorities who have banned the school’s graduates. They say the school has hundreds of graduates who have passed U.S. licensing requirements and passed all the necessary examinations.
"The quality of graduates can be determined … by the high number of those who, having achieved their licenses, practice in the United States," Pedro Gil Iturbides, a UTESA official, said in a statement.
Officials from Spartan and the University of Health Sciences declined to comment for this story. The Universidad Eugenio Maria de Hostos closed in 1998.
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