For sale?

House votes for efforts to keep offshore MD schools from buying U.S. GME slots

U.S.-based graduate medical education programs should maintain their ability to select residents based on merit, House says.


Given that many offshore, particularly Caribbean, medical schools are known to purchase clinical rotation slots for their students at U.S. teaching hospitals—for hundreds of dollars per student per week, according to an article in The Chronicle of Higher Education—the New York State Osteopathic Medical Society (NYSOMS) is concerned that these schools are beginning to buy residency positions for their graduates as well, according to the society’s executive director, Barbara Greenwald.

To head off this development, NYSOMS submitted a resolution to the AOA House of Delegates that calls on the AOA to collaborate with the American Association of Colleges of Osteopathic Medicine, the American Medical Association, the Association of American Medical Colleges and other stakeholders to ensure that U.S.-based graduate medical education programs maintain their ability to select residents based on merit.

The AOA House unanimously approved the resolution today.

“The offshore medical schools have had a critical impact and, in my opinion, a negative impact on educational access,” stressed New York delegate Robert B. Goldberg, DO, during a House committee meeting yesterday. He noted that certain for-profit Caribbean medical schools have class sizes of 700 to nearly 1,000 students. While only a third of their students graduate, the schools aim to secure GME positions for those who do, he said.

“They have started to buy residency positions,” said Dr. Goldberg, who is the dean of the Touro College of Osteopathic Medicine (TouroCOM) in New York City. “We want to make sure that program directors continue to be able to select their residents on merit.”

The problem of offshore medical schools buying clinical clerkships for their students has been most severe in New York state, but it is also occurring in California and elsewhere, according to California delegate David A. Connett, DO. “Offshore schools often ask for all of their tuition money up front,” Dr. Connett told The DO. This is how they can afford to pay enormous amounts of money for student rotation positions, displacing thousands of osteopathic and allopathic medical students who are enrolled in U.S. schools from desirable slots, he said.


  1. Rachel Ilagan

    Thank you for writing about this. I am a student in Touro California and our 3rd year rotation slots in Bakersfield, California were recently bought by Ross University which displaced 12 students from our school. It’s good to know the house is moving forward to resolve this issue.

  2. 4th Year OMS

    Though I completely agree with this matter, it has come to my attention that my Osteopathic school, as well as most others, do not reimburse hospitals for our clinical clerkships. If they do, it is very minimal amounts. Perhaps the large amount of tuition money we pay [by far more than most allopathic schools] should go towards our clinical education to help prevent “displacing” us as Dr. Connett wrote.

  3. M Hiserote, DO

    I hear the concern of tuition dollars and their use in the 3rd and 4th rotations, historically it has and probably still is valid, yet I would suggest you check your facts and you might be surprised that many schools now reimburse rotation sites for your participatiion. There is also the magnitude of reimbursement, the Kern county deal was for ten years and a sum of $32M, and who knows what other benefits are included in the contract. That kind of $ is generated through the large class size acceptance and much lower number graduated… With the 4 year tuition paid up front and in some cases $20k a year more than what you are paying. I am sure they would accept your transfer.

    M. Hiserote, DO

  4. ATM

    How can we assure that the proposed osteopathic medical schools will not become the new Carib here in the States? It has recently come to my attention that at least one of these new institutions have ties to offshore schools. With the impending demise of Carib education in the next 10-15 years, those with foresight seem to be making moves to ensure financial success through our education system. (The new Rhode Island school comes to mind). Will COCA make sure that our profession does not become the new Carib? Will they ensure high quality of standards (at least equal to our MD counterparts) or will they put the almighty dollar (in the name of physician shortages) first on their priority list?

    Quality should be of the upmost concern… quantity, not so much.

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