Spurious Medical Schools and Their Concerning Business ... · Copyright © 2019 by ECFMG. All...

Copyright © 2019 by the Educational Commission for Foreign Medical Graduates. All rights reserved.Copyright © 2019 by the Educational Commission for Foreign Medical Graduates. All rights reserved.

Lisa L. Cover, MHA, CHE

Senior Vice President for Business Development and Operations

Association of Medical Councils of Africa23rd Annual Conference

July 19, 2019

Spurious Medical Schools and Their Concerning Business Practices

Plus2023 Accreditation

Copyright © 2019 by ECFMG. All rights reserved.

“Diploma Mills” have a long history

2

Diploma Mill - Published 2018By David A. JohnsonSenior Vice President, U.S. Federation of State Medical Boards

1860’s – 1880’sJohn Buchanan, Dean of the “Eclectic Medical College” in Philadelphia, USA

Sold between 3,000 and 10,000 fake diplomas “for a fee without attendance at lectures …” Source: John Buchanan’s Philadelphia Diploma Mill and the Rise of State Medical Boards, Bulletin of the History of Medicine, Vol 89, No1, Spring 2015.


On November 4, 1977,

the Association of American

Medical Colleges (AAMC) issued a

warning….

Although not new, it is a persistent issue.

3

F0 SCHRATI

Copyright © 2019 by ECFMG. All rights reserved.4

ECFMG Special Investigations 2016-2018

Source: ECFMG Special Investigations, April 2019

Irregular Behavior Cases9 9

Different Countries7from

Intended to Practice in Multiple Countries

01

And crossing borders.


ECFMG’s First Large Scale Investigation

New York Times,March 7, 1986

• Created and altered transcripts

• Falsified medical student evaluation forms

• Fraudulent degrees

• Individuals paid between $3,000-$20,000s

At least 44 individuals had their ECFMG Certificate revoked!

5


Modern Day Schemes Have Evolved

What you see …


Modern Day Schemes Have Evolved

May be a façade.• Whitewashing Transcripts

• Possibly Serving as a Front for Illegal Activity

• Selling Degrees

• Operating without Authorization

• False Advertising

• Other Questionable Activity

!


C

Whitewashing Transcripts

Total Medical School Students

2

All Reviewed

8 1

Students

Backdated/falsified attendance dates at new medical school

Did not disclose attendance at other schools, including those where they were dismissed

Institutions

Altered transcripts andgave credit forfailed courses elsewhere

Signed-off on falsified attendance dates

Offered a 60 minute exam for credit in lieu of course completion

•47 individuals found to have submitted false information

•Have note on their record & some have additional sanctions

• Students subject to enhanced review procedures

• Special note in WDMS

• School officials no longer able to sign off on documents

8

Case

#1


Possible Front for Visa Fraud?

“Anonymous Tip” that there is no physical campus

9

Case

#2



• Lists “accreditations” not available

• Legitimacy of president and clinical dean are questionable

10



• Reports of visa fraud

• Dean is also president of a test prep course

11



• Site visit finds abandoned hotel

• Reports of visa fraud

12



• “No campus but at one time there was an office with a sign on the door”

• “The Movement of people is big business”

Conversations with Local US Consular Official

13



• “Have no connection with the school”

14



• “Never been to county where school is located”

15

Ministry never responds to

ECFMG’s requests for information



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Total Medical School Students

2 9

All Reviewed


Selling Degrees

• School states that it is “Affiliated” with a highly regarded university

– The university denies any affiliation with the school

• Transcripts include incorrectly calculated GPAs

• School states that it is “In Franchise” with 2 American colleges

– Both affiliates are on-line, not accredited with the same address

– Several on-line references point to school being a diploma mill

• Host country has no knowledge of school

– Medical Regulatory Authority has not heard of school

– Not listed on the Ministry’s website of higher education institutions

#1

17

5 applicants had permanent note on their record for providing false information!

Notified international medical regulatory authorities of concerning school!

Investigation Completed 2018

Case #3

#1

#2

#3

#4


Mary Jones


Operating without Meeting Govt Requirements

1 accredited

2 haveaspirations

3don’t try

Government changes policy: Accreditation

Required`

18Countries

49 Schools

ECFMG learns

of policy

change

Launch Re-VerificationProject

76%Re-verified As

Acceptable

18%Not Acceptable

2%Under Review

ECFMG changed its note in WDMS indicating that graduates no longer

acceptable for Certification

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Region #1 Sweep, 7 schools, 355 applicants

Case #4


A guarantee to pass US licensing examsFake studentsA Test Prep CompanyFalsified credentials

Stealing Exam ContentCase #5

Micro video equipment

A recipe for disaster


Misrepresenting School LocationCase #6

Location of Government Charter

Actual location of all school activity


False Advertising

22

X

X

X

12

Case #7


Why are we concerned?

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Duty to the publicto ensure doctors have received basic medical

education


Medical Education Systems• Some schools are issued a one-time permit to

operate without follow-up

• 1/3 of countries do not have an accreditation program

• Accreditation, if available, is not always mandatory

• Significant variation of systems, duration, and standards

• Accrediting agencies differ in the specific protocols employed in implementing quality assurance reviews

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High Variability Compounds Problem

Lack of Oversight &/or self-regulation


18762188

2655

2002 2010 2018

Total # of Schools Acceptable for ECFMG Certification

Source: ECFMG/FAIMER

3,117 Operational Schools in the World Directory of Medical Schools2,655 (81%) are acceptable for ECFMG Certification.

+ 312

+ 467

42% increase from 2002 to

2018

And growing.


#1 Remove ECFMG “Sponsor Note”

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2010 - 2017


#2 Give “Notice”

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Send To:

• IAMRA

• ECFMG Partners

• Government Authorities

• U.S. Consular Officials

• U.S. Law Enforcement


#3 Enhanced Vetting

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For schools acceptable for Certification:

Re-verification with authorities

Remove schools with No Volume/

No Recent Volume (Recently removed

55 Schools)

Supplemental screening of schools

with “red flags”


#4 Resources for Students

29

Guidance on Medical School Selection

Web-site


#5 Resources for MRAs

30

Indicator that School is

Acceptable1967 - Present


#5 Resources for MRAs

31

Nothing Listed

Indicator that

School is NOTAcceptable


#6 Transparency

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For ECFMG acceptable schools:

Report ECFMG Certification Data by Medical School

For certain medical schools:

Report accreditation status in the World Directory of Medical Schools

For certain medical schools:

Include accreditation status on physician credential verification reports

Phase 1 – 2019 Phase 2 – ~2020 Phase 2 – ~2021


#7 Accreditation

33

Effective in 2023, individuals applying for ECFMG

Certification will be required to graduate from a

medical school that has been appropriately

accredited by an accrediting agency that is

formally recognized.


1. Stimulate international accreditation efforts

2. Promote universally accepted standards for

evaluating undergraduate medical education

3. Enhance quality of medical education

4. Protect the public

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2023 Accreditation Goals


Process

WFME is currently the only organization recognized by ECFMG


As of July 2019

WFME Recognition Statusof Accrediting Agencies

~15agencies

in discussion

20agencies

recognized

11agencies in review

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Does NOT apply to:

1) Verification services provided to clients

2) Regulatory Authorities outside the U.S. (Except Israel)

37


Better Education

Ultimately, it’s about the Patients

Better Patient Care


A rising tide

lifts all boats

Benefits Beyond Borders


Questions & Discussion

www.ecfmg.org |

[email protected]

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• Australia and New Zealand -Australian Medical Council (AMC)

• Brazil - System of Accreditation of Medical Schools (SAEME)

• Canada - Committee on Accreditation of Canadian Medical Schools

• Caribbean - Accreditation Commission on Colleges of Medicine (ACCM)

• Caribbean - Caribbean Accreditation Authority for Education in Medicine and other Health Professions (CAAM-HP)

• Egypt - National Authority for Quality Assurance and Accreditation of Education (NAQAAE)

• Georgia - National Center for Educational Quality Enhancement (NCEQE)

• Indonesia - Indonesian Accreditation Agency for Higher Education in Health (IAAHEH/LAM-PTKes)

• Iran – Secretariat of the Council for Undergraduate Medical Education

• Japan - Japan Accreditation Council for Medical Education (JACME)

• Kazakhstan - Independent Agency for Accreditation and Rating (IAAR)

• Korea - Korean Institute of Medical Education and Evaluation (KIMEE)

• Mexico - Mexican Board for Accreditation of Medical Education (COMAEM)

• Netherlands and Belgium -Netherlands-Flemish Accreditation Organization (NVAO)

• Sudan - Sudan Medical Council (SMC)

• Taiwan - Taiwan Medical Accreditation Council (TMAC)

• Thailand - Institute for Medical Education Accreditation (IMEAc)

• Turkey - Association for Evaluation and Accreditation of Medical Education Programs (TEPDAD)

• United Arab Emirates –Commission for Academic Accreditation (CAA)

• USA - Liaison Committee on Medical Education (LCME)

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Agencies Recognized by WFME


Agencies in Process of Review

• China – Working Committee for the Accreditation of Medical Education, Ministry of Education

• Colombia – National Council of Accreditation (CNA)

• Cyprus – Cyprus Agency of Quality Assurance and Accreditation in Higher Education (CYQAA)

• Ireland – Irish Medical Council

• Israel – Council for Higher Education

• Kazakhstan – Eurasian Centre for Accreditation and Quality Assurance in Higher Education and Health care (ECAQE)

• Morocco, Cameroon & Tunisia / Francophone countries – International Conference of Deans and Faculties of Medicine of French Language

• Pakistan – Pakistan Medical and Dental Council (PMDC)

• Panama, Venezuela & other select Latin American countries – International Accreditation Institute (IAI)

• Philippines - The Philippine Accrediting Association of Schools, Colleges and Universities (PAASCU)

• Saudi Arabia – National Center for Academic Accreditations (NCAA)

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