[Congressional Record (Bound Edition), Volume 159 (2013), Part 13]
[Senate]
[Pages 19270-19271]
[From the U.S. Government Publishing Office, www.gpo.gov]




           FOREIGN MEDICAL SCHOOL ACCOUNTABILITY FAIRNESS ACT

  Mr. DURBIN. Mr. President, last week I introduced the Foreign Medical 
School Accountability Fairness Act. The bill seeks to fix a loophole 
exploited by for profit schools to tap into the federal Treasury at the 
expense of students.
  Under current law, a small number of medical schools in the 
Caribbean--about five, four of which are for profits--are exempt from 
meeting the same requirements to qualify for title IV funding that all 
other medical schools outside of the U.S. and Canada must meet. This 
loophole allows these schools to enroll large percentages of American 
students--which means access to more Federal dollars.

[[Page 19271]]

  The biggest of these schools are St. George's, Ross, and American 
University of the Caribbean whose enrollments of Americans are 70 
percent, 91 percent, and 86 percent respectively. Other schools are 
prohibited from having U.S. citizens make up more than 40 percent of 
enrollment.
  These for profit schools have turned the idea of being a foreign 
school on its head--they are located outside of the United States, but 
have majority-American enrollments. They do not have to meet the same 
high standards U.S. medical schools must meet, but also do not have to 
meet the same requirements as schools located outside of the U.S. to 
access hundreds of millions of dollars of Federal funding.
  Pretty sweet deal, huh?
  In fact in 2012, the three schools I mentioned earlier--St. George's 
and the two DeVry-owned schools--took in more than $450 million from 
the Federal Government from American taxpayers. That amounted to more 
than two-thirds of all title IV funding that went to all foreign 
medical schools.
  To sum up--three schools, two-thirds of the Federal funding, exempt 
from the law.
  Not only are these schools exempt from the enrollment requirement, 
but they don't have to meet a minimum standard of success--having 75 
percent of their students pass the U.S. board exams--a requirement for 
any of its students to actually practice medicine in the United States. 
The University of Sydney--with its dozen or so American students--has 
to meet this standard in order to receive title IV dollars. But DeVry's 
Ross University, with 1,000 or more American students, does not.
  It doesn't seem right to the Department of Education, which says 
there is no rationale for continuing the exemption. And it doesn't seem 
right to me, either. Especially when you consider what students are 
getting for this Federal investment--more debt, higher rates of 
attrition, and lower residency match rates than U.S. medical schools.
  Translation: More debt and less chance of becoming a doctor.
  In September, an article in Bloomberg by Janet Lorin entitled ``Devry 
Lures Medical School Rejects as Taxpayers Fund Debt'' shined a bright 
light on the poor student outcomes of these schools.
  It is no secret that for profit foreign medical schools prey on 
students who have been rejected by traditional U.S. medical schools. 
They promise to fulfill the unrequited dreams for students who want to 
be doctors, but for one reason or another, did not make the cut in the 
U.S. On average, scores on the MCAT, the test required to enter medical 
school, of students attending these offshore for profit schools are 
lower than those of students who are admitted to medical schools in the 
U.S. In 2012, students at U.S. medical schools scored an average of 
31.2 out of 45 on the MCAT while students at the DeVry medical schools 
scored an average of 25.
  The attrition rate at U.S. medical schools averaged 3 percent for the 
class beginning in 2009, while rates at for profit foreign medical 
schools can be up to 26 percent or higher. More than a quarter of the 
students at some of these schools drop out.
  On average, students at for profit medical schools operating outside 
of the United States and Canada amass more student debt than those at 
medical schools in the United States. For example, in 2012, graduates 
of the American University of the Caribbean had a median of $253,000 in 
student debt versus $170,000 for graduates of U.S. medical schools.
  To add insult to injury, these foreign trained graduates are on 
average less competitive candidates for coveted U.S. residency 
positions. In 2013, residency match rates for foreign trained graduates 
averaged 53 percent compared to 94 percent for graduates of medical 
schools in the United States. They are even less likely to land a 
residency position the second time around.
  According to the Bloomberg article I referenced earlier, one graduate 
of St. George's University, Michael Uva, amassed almost $400,000 in 
medical school loans, but failed to land a residency spot twice. 
Michael now works at a blood donation clinic earning $30 an hour. 
Although he sacrificed years of his life training for it, without 
completing a residency he will never get to practice medicine and this 
$400,000 debt will likely follow him throughout his life.
  Congress has failed taxpayers and students by subsidizing these 
Caribbean schools with billions in Federal dollars for years without 
adequate accountability and oversight. This bill takes a first step at 
addressing that failure by ensuring these Caribbean schools must meet 
the same standards other schools outside of the United States and 
Canada must meet.
  At the same time, these schools are just another example of the 
systemic problem we have with for profit colleges trying to make a buck 
off of students in this country and usually bilking Uncle Sam to do it. 
In fiscal year 2010, we sent $32 billion to all for profit schools.
  There are three numbers you need to remember when thinking about for 
profit schools:
  The percentage of high school graduates that enroll in for profit 
schools--12 percent;
  The percentage of Department of Education title IV funds that go to 
for-profit schools--25 percent;
  The percentage of student loan defaults for profit schools are 
responsible for--47 percent.
  I have been fighting these schools for a long time. But today I have 
a message for those schools down in the sunny Caribbean who may have 
thought they could continue to exploit taxpayers and students without 
anybody noticing--we're watching.

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