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Letters to the Editor

Extending Graduation From Medical School

Hueston, William J. MD; Grosse, Kerry J.; Paschal, Linda L.

Author Information
doi: 10.1097/ACM.0000000000002063
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To the Editor:

The Perspective by Bumsted and colleagues1 in the July 2017 issue of Academic Medicine, entitled “Considerations for Medical Students and Advisors After an Unsuccessful Match,” was very timely and quite thorough. We are concerned, however, by the authors’ suggestion of potentially delaying graduation for students who presumably have met all graduation requirements. The authors note that this action is not permitted at their own institution, but that other institutions may offer this option for students who wish to continue their clinical training with the benefit of applying as a medical student, rather than as a medical school graduate, through the electronic residency application service the following year.

Our concern with this practice stems from federal financial aid regulations. Students who complete all degree requirements are no longer eligible for federal financial aid as they no longer meet the federal definition of “regular student.”2 These students may consequently incur additional debt through private loans for tuition and/or living expenses. Furthermore, these students may be delayed in their obligation to start the repayment of loans.

In addition to federal financial aid regulations, U.S. Immigration and Customs Enforcement (ICE) regulations are relevant. We note that ICE regulations do not allow nonimmigrant students (i.e., non-American citizen students who are temporarily in the United States for a specific purpose such as education) to remain enrolled after completing their degree requirements.

According to our interpretation of federal financial aid and immigration regulations, we feel that failure to graduate students at the time they complete degree requirements places institutions and possibly students at risk of noncompliance. While institutional policies may vary, federal regulations are consistent, and we encourage our colleagues to ensure their programs are compliant. It would be regrettable if institutions believed that not graduating students upon completion of degree requirements is a permissible practice based solely on the article by Bumsted and colleagues.

William J. Hueston, MD
Senior associate dean for academic affairs, Medical College of Wisconsin, Milwaukee, Wisconsin; e-mail:

Kerry J. Grosse
University registrar, Medical College of Wisconsin, Milwaukee, Wisconsin.

Linda L. Paschal
Director of financial aid, Medical College of Wisconsin, Milwaukee, Wisconsin.


1. Bumsted T, Schneider BN, Deiorio NM. Considerations for medical students and advisors after an unsuccessful match. Acad Med. 2017;92:918–922.
2. U.S. Government Publishing Office. 34 CFR 600.2—Definitions. Published 1965. Accessed November 14, 2017.
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