State Can Allow International Med Faculties to Prepare in Texas

Update, November 20, 5 p.m .:

The Texas Attorney General has ruled that no law will prevent the Texas Higher Education Coordinating Board from allowing overseas medical schools to send students to complete their education in Texas hospitals.

“Overall, nothing in the law indicates that foreign schools are excluded from the test,” the verdict said. “For the same reason, nothing means that the board has to contain them.”

Last spring, the coordinating committee chairman Raymund Paredes recommended that the committee approve the American University of the Caribbean’s proposal to allow its students – and especially those from Texas – the option of three and four years of medical school in Texas spend hospitals, salaried employees, or clinical electives.

Legislature obtained a statement from the AG on concerns from Texas medical schools that these students were taking up places that could otherwise be taken by domestic students.

The AG’s ruling states that there is nothing in the current law to prevent the Coordination Committee from approving such agreements. It should be noted, however, that there is no time limit for answering such inquiries and that the board could be delayed so that the legislature can take up the issue in the legislative period.

Update, 4 p.m .: On Wednesday, the Texas Higher Education Coordinating Board postponed its decision on the American University of the Caribbean’s application for a Certificate of Authority.

A majority of the Board of Directors voted to seek an opinion from the Attorney General on the scope of his authority to offer a certificate of attorney for a private professional program. State Senator Judith Zaffirini, D-Laredo, has questioned whether they currently have such authority.

A Power of Attorney would allow the AUC to dispatch some students to spend the three and four years of medical school in Texas hospitals, work as clerks, or take clinical electives.

The board members also asked the coordinating board members to conduct a study of the capacity of the state’s legal clerkship and the extent to which students from foreign institutions are accepted.

In view of these delays, the issue will not be on the table again until autumn.

Ernest Gibble, a spokesman for DeVry, Inc., said, “We appreciate the thoughts of the THECB on this matter and will work with them to find a solution that will serve the interests of all medical students in Texas.”

Original story: Depending on what the Texas Higher Education Coordinating Board decides today, Texan hospitals could soon open their doors to medical students from the Caribbean, and the prospect is enraging the state’s medical schools.

The American University of the Caribbean, a nonprofit medical school owned by DeVry Inc., has requested approval from the Coordinating Committee to allow its students – particularly those from Texas – the opportunity to study medicine for three and four years at school in Texas hospitals , Clerical or clinical electives.

AUC officials say they have followed the appropriate protocol to apply for a Certificate of Authority, have received a positive recommendation from outside medical advisors on the Coordinating Committee, and are one step away from getting the green light for paying hospitals in Texas for the education of their students. Yet they are facing fierce opposition from state medical schools, who fear that they will steal internship positions from state students.

In March, executives from state medical schools sent a letter to Raymund Paredes, Texas Higher Education Commissioner, recommending that the board approve the AUC. Principals argued that admitting students from overseas schools to Texan traineeships would “crowd out Texas medical students in already limited clinical training settings in hospitals in our state.”

Texas medical schools, charged with increasing enrollment to fill the state’s medical shortage, are “already stumbling on each other” finding their students have the right trainee lawyers, said Dr. Cynthia Jumper, who heads the Texas Medical Association’s Medical Education Council and chairs the Department of Internal Medicine at Texas Tech University Health Sciences Center. While there might be a couple of additional positions now, Jumper said it won’t be long. “We have already spoken about what additional room there is now,” she said.

The chairman of the Senate for Higher Education, Judith Zaffirini, D-Laredo, also spoke out against it. In a letter to Fred Heldenfels, chairman of the coordinating committee, she said the approval of the AUC’s application would set a precedent that opens the door to a number of overseas schools, and she questioned the committee’s power to offer private professional programs authorize. “May God bless you and inspire you to agree with my perspective,” she wrote.

In response, Heldenfels said he intended to “impose a moratorium on future applications for foreign medical schools” until the AUC’s proposed two-year approval could be renewed. He also noted that in September the Coordinating Committee staff intend to propose rules that would “significantly tighten” the requirements for foreign institutions in Texas.

This did not satisfy Zaffirini. “We either have this available to everyone or we don’t,” she said. “Why should we single out a university just because this is the first one it requested?”

Regarding the issue of the coordination committee’s power to approve professional programs such as those proposed by the AUC, the Senator is considering seeking an opinion from the Attorney General. But she said she would prefer the Coordinating Committee to simply delay its decision until lawmakers could look into the matter – she insisted it was an open discussion, not just “delaying the killing” – and that would ensure that the state puts Texas students first.

AUC officials say that’s what they want to do. “We’re trying to give Texas students and Texas residents an opportunity to come back and have their clinics at home and likely stay in the state at some point,” said Ernest Gibble, spokesman for DeVry. “The big argument is that it will take away slots from Texas medical students. These are medical students from Texas. You happen to be at the AUC. ”

Jumper argues that for international schools of varying standards, there simply isn’t the ability to get their students to do a clerkship in Texas. While the AUC pays US hospitals to accommodate their students, the budget of American medical schools excludes this. “In other states like New York, these Caribbean medical students have evicted New York state students,” she said.

AUC officials say their research shows that there is no shortage of clinical training places in Texas – but that they would still be willing to cap the number of Texan students to 20 annually. (Of the 1,100 students at AUC as of the fall of 2010, 90 Bruce Kaplan, the university’s academic director, swore in a letter to the coordinating body in March that they “would not use any practices that would result in medical school students in Texas no possibility of clinical learning “.

And they argue that students who completed their clinical traineeship in Texas are more likely to look for places to stay in Texas – and are more likely to want to practice in Texas after graduating from high school. Nearly 60 percent of AUC graduates practice in primary care specialty areas and half in medically underserved areas, two of the largest medical shortage areas in Texas. AUC graduates already practice medicine in 38 Texas counties.

Khushbu Sanjeev Patel was born and raised in Houston, got her bachelor’s degree from UT-Austin and enrolled at AUC – all with the aim of practicing again in Texas. That would be so much easier to accomplish, Patel said, if Texas – like New York, California, Florida, and several other states – allowed AUC students to complete their third and fourth years of clinical clerkship in a state hospital.

Instead, “I will most likely go to Miami or New York, and the chances of going back to Texas will decrease,” said Patel.

“My whole family is here. This is the community I want to serve. But it makes it so much more difficult when we can’t network with Texas doctors … and show them that AUC Caribbean medical students are on par with Texas medical students. “

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