Many Canadians dream of becoming a doctor. The reality is that only a fraction of the students who apply to Canadian medical schools are admitted. This reality is driving a growing number of Canadian students to offshore medical schools in Dominica, Jamaica, Guyana, Aruba and other Caribbean countries.
There are over 50 of these private medical schools across the Caribbean serving international students. They promise low fees, a tropical beach location, and the opportunity to practice medicine at home or in the United States after graduation.
But offshore medical education is also risky – for Canadian students and for the population of their host country. We know Canadians who graduate overseas schools face tougher competition for housing in their home country. Often times, they end up with higher debt.
For-profit schools in the Caribbean also fail to meet the traditional social obligations of medical schools. These commitments are defined by the World Health Organization and Health Canada and include a duty to train local doctors and address local health problems.
Our research group at Simon Fraser University is examining medical education in the Caribbean as part of a broader research program on the equity and ethical implications of global healthcare mobility. We focus on international movements of patients or healthcare providers that are not tracked, tracked and regulated. Our well-established research on medical tourism in the Caribbean first introduced us to the growing number of offshore medical schools in the region.
Graduation gifts: Higher debt and tougher competition
We have attended offshore medical schools in St. Lucia, Grenada, Cayman Islands and Barbados. We attended briefings hosted by recruiters from some of these schools in our hometown of Vancouver. We see posters promoting these schools across our university. And we are often targeted by ads on social media encouraging us to apply.
We recently published an analysis of the advertising messages that Caribbean medical schools use on their websites. We found that they encourage students to participate so that they can help out at home if there is a shortage of doctors. They also frequently advertise low tuition fees and the opportunity to practice medicine at home after graduation. Many Canadians studying medicine in these schools abroad hope to return to Canada to practice.
What is most interesting is what such advertising messages do not convey. They do not state that Canadian graduates are required to apply to study as international medical graduates. In 2013, only 499 of the 2,962 international medical graduates who applied were successfully placed for residency. Nor is it explained that Canadians studying medicine abroad often graduate with significantly higher debts.
Medical faculties: public institutions with social obligations
Caribbean offshore medical schools train international students for international practice. Students are taught to pass American medical licensing exams. Success in these American license exams is so important that school websites and billboards often report their success rates.
However, medical faculties are traditionally public institutions. As a rule, they not only receive public funding, but also train doctors to treat people on site. It is believed that due in part to their public nature, they have social obligations.
The World Health Organization says medical schools have a social obligation to align research, clinical and educational activities with local health priorities. This commitment has led Canada to issue a statement on how social values can be incorporated into medical education. It has also led to the development of a global consensus statement on medical education.
Medical schools should be integrated into local communities. Trainers should practice in local clinics and use community-based knowledge to teach. Administrators should include local public health priorities in the curriculum. Research should address global as well as local problems. Many students should be local and want to work locally. They should know how to identify urgent local health problems.
Offshore medical schools in the Caribbean typically fail to meet such social obligations. They train international students to practice elsewhere. Your organizational structures are heavily dependent on international lecturers and foreign investments. This makes it very unclear who they are responsible for.
What is lost when medical school students are educated without strong social mandates or accountability to local populations? Do these schools contribute to the inequalities in the local health system and the lack of trained medical staff?
These are important questions. Given the growing number of Canadians enrolling in Caribbean offshore medical schools looking to practice in Canada and the importance attached here to social responsibility in medical education, we believe these questions are worth asking yourself to deal with.
By Valorie A. Crooks, Full Professor, Simon Fraser University and Jeffrey Morgan,, Simon Fraser University
This article was originally published on The Conversation. Read the original article.
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