Foreign-Trained Doctors

How good are the foreign-trained doctors now flocking to the U.S.? In far too many cases, not good enough, says Dr. Willard C. Rappleye, dean of Columbia University's Faculty of Medicine. Reason: their schooling is inadequate by U.S. standards.

Long exercised over this problem (TIME, Feb. 22. 1954), Dean Rappleye returned to the attack last week with new statistics:

P: More than 25% of the house staffs in U.S. hospitals are now composed of foreign-trained doctors;* in a few states, more than 50%. They total about 7,000.

P: This year 5,000 to 6,000 more will enter the country, as against 6,977 graduates from all U.S. medical schools.

The result, according to Dr. Rappleye: "In many sections of the country there are now two classes of citizens . . . those who are to be cared for by physicians who have had a satisfactory preparation for medical practice, and those whose medical care will be provided by physicians who are graduates of substandard schools." To Veteran Educator Rappleye (Harvard Medical. '18) the situation is "reminiscent of the diploma-mill era of 50 years ago," when fly-by-night schools turned out thousands of inadequately trained doctors.

The U.S. Government welcomes foreign doctors under liberalized immigration policies. Hospitals, which have thousands of internships and residencies going begging every year, welcome them to fill their staffs. In most cases these are hard-pressed or smaller hospitals, which cannot give the arriving doctors the extra training they need, and may exploit them as cheap medical labor.

Of the 7,000 foreign-trained interns and residents now in the U.S., 6,000 are exchange students, and theoretically must go home when their time is up. But many --just how many, nobody knows--find a way to stay or to get back in quickly; e.g., by marrying a U.S. citizen. One answer to the problem is in the works--an "Evaluation Service for Foreign Graduates," due to begin soon under the auspices of the A.M.A. and other U.S. medical bodies. The idea: to cull the foreign crop by examining medical graduates on their own campuses abroad before they even buy a ticket to the U.S.

* Not all aliens; many U.S. citizens have gone to schools overseas (mostly in Switzerland and The Netherlands) because they failed to get into U.S. schools or lacked premedical science requirements. Canada's schools are rated on a par with U.S. schools, have similar standards.

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