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Letters to the Editor

More About Offshore Medical Schools Buying Clerkships in U.S. Hospitals

Olds, G. Richard MD

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doi: 10.1097/ACM.0000000000001453
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To the Editor:

In their broadside against international medical schools, Halperin and Goldberg1 erroneously tar the reputation of the medical school I lead, St. George’s University. Further, their proposals to restrict international medical students from domestic clinical training would exacerbate the U.S. physician shortage.

St. George’s students are held to the same standards as U.S. medical students. They must pass the United States Medical Licensing Examination, just like U.S. students. In fact, on their first attempts, our students pass Step 1 of this exam at rates equal to or higher than those of their U.S. counterparts.2

Furthermore, the United States will face a shortfall of up to 94,700 physicians—including 35,600 primary care physicians—by 2025.3 It needs international medical graduates (IMGs) to fill that gap. Already, a quarter of all U.S. doctors are IMGs.

IMGs are particularly important for reducing the primary care shortage. Today, two-thirds of U.S.-educated doctors become specialists.4 In contrast, three in four St. George’s graduates go into primary care.5

Many IMGs are U.S. citizens, too. Eighty-two percent of St. George’s medical students are American.6 Banning IMGs would prevent many American students from practicing in their own country.

The United States needs these doctors. If there were long lines at the gas pump, we would never ban foreign oil. Doing so would only benefit domestic oil companies—to the detriment of everyone else in the country. With lines growing at doctors’ offices, why would we consider banning international medical students?

G. Richard Olds, MD
President, St. George’s University, Grenada, West Indies;


1. Halperin EC, Goldberg RB. Offshore medical schools are buying clinical clerkships in U.S. hospitals: The problem and potential solutions. Acad Med. 2016;91:639644.
2. St. George’s University. St. George’s University USMLE Step 1 first-time test takers achieve 97% pass rate in 2014. May 5, 2015. Accessed August 15, 2016.
3. Association of American Medical Colleges. New research confirms looming physician shortage. April 5, 2016. Accessed August 15, 2016.
4. Thomas L. Hospitals, doctors moving out of poor city neighborhoods to more affluent areas. Milwaukee Journal Sentinel. June 14, 2014. Accessed August 15, 2016.
5. St. George’s University. Think you know us? We think you could know us better. Accessed August 15, 2016.
6. St. George’s University. About SGU: Student citizenship. Updated October 2015. Accessed August 15, 2016.
Copyright © 2016 by the Association of American Medical Colleges