Earlier this fall, the American University of Antigua (AUA) brought to the forefront a problem that graduates of some Caribbean-based medical schools are facing: limited opportunities for employment in some states, including Mississippi.

 

On April 27, New York attorney Leonard Sclafini sued the Arkansas State Medical Board on behalf of AUA and four of its students, claiming board policies unfairly and unconstitutionally exclude graduates of the school from practicing medicine in Arkansas.

 

In September, Sclafini appeared before the Mississippi State Board of Medical Licensure to argue against the state's newly adopted regulation limiting the grant of licenses to practice medicine. Dick Woodward, vice president for enrollment management for AUA, reported online: "After hearing from AUA's counsel and four other speakers, the Mississippi board voted unanimously to reject the proposed regulation. The Board indicated that it would go back to the drawing board to find a means of determining a standard for approval of foreign medical schools. AUA will monitor the Board's progress and will continue vigorously and affirmatively to prevent the adoption of any rule that would unfairly bar its graduates from practicing medicine in the State of Mississippi or any other state."

 

Not quite. Onlookers said Sclafini exaggerated his influence over the matter, and AUA representatives declined comment.

 

The Mississippi connection began in July, when the Board adopted a final rule to grant licenses to practice medicine to graduates of foreign medical schools (medical doctors and osteopathic physicians) approved by the California Medical Board or the Caribbean Accreditation Authority. No oral hearing was required before the rule's Sept. 17 effective date.

 

"The Board adopted California's lead in an attempt to raise the bar of medical practice in Mississippi," said Vann Craig, MD, executive director of the Mississippi State Board of Medical Licensure. "Then I received a call from UMC saying the new regulation would affect 40 of the 470 or so fellows and residents there. We investigated the matter, and it turned out that some of the residents attended schools whose names had changed, and they were OK. But there are still 12 or 13 residents at UMC who will not be allowed to practice medicine in Mississippi under this rule."

 

The Caribbean Accreditation Authority for Education in Medicine and other Health Professions (CAAM-HP) was established in 2003 to determine and prescribe standards and to accredit programs of medical, dental, veterinary and other health professions education.

 

"Until this fairly new organization came along to independently attempt to accredit more than 70 medical schools that have popped up in the Caribbean, there was really no other organization that undertook the work that it takes to do so," explained Craig, who said the California Medical Board has also undertaken time-consuming background checks on Caribbean schools. "It's been a big controversy because there's no organization that accredits medical schools worldwide. These Caribbean medical schools were originally designed for natives, but they've evolved into institutions for American citizens and others who were unable to get into medical schools in the states."

 

Craig said he recognizes that it's difficult for applicants to get into U.S. medical schools.

 

"There are only so many spots available," he said. "If you're not a 3.8 GPA student or better, you're probably not going to get in. Or perhaps older Americans who decided to change careers are going to these Caribbean medical schools. For whatever reason, many Americans are attending them."

 

When University of Mississippi Medical Center administrators alerted Craig of the potential for a dozen or more residents to be unable to get their Mississippi license to practice medicine because of the new rule, Craig and Board members decided to hold a public hearing in September.

 

"We held it because it was controversial, and Mr. Sclafini was one of several people attending the hearing," he said. "The Board is taking a very close look at everything involved."