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
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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.
Copyright © 2019 by ECFMG. All rights reserved.
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.
Copyright © 2019 by ECFMG. All rights reserved.
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!
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Copyright © 2019 by ECFMG. All rights reserved.6
Modern Day Schemes Have Evolved
What you see …
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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
!
Copyright © 2019 by ECFMG. All rights reserved.
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
Copyright © 2019 by ECFMG. All rights reserved.
Possible Front for Visa Fraud?
“Anonymous Tip” that there is no physical campus
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Case
#2
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Possible Front for Visa Fraud?
• Lists “accreditations” not available
• Legitimacy of president and clinical dean are questionable
10
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Possible Front for Visa Fraud?
• Reports of visa fraud
• Dean is also president of a test prep course
11
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Possible Front for Visa Fraud?
• Site visit finds abandoned hotel
• Reports of visa fraud
12
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Possible Front for Visa Fraud?
• “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
Copyright © 2019 by ECFMG. All rights reserved.
Possible Front for Visa Fraud?
• “Have no connection with the school”
14
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Possible Front for Visa Fraud?
• “Never been to county where school is located”
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Ministry never responds to
ECFMG’s requests for information
Copyright © 2019 by ECFMG. All rights reserved.
Possible Front for Visa Fraud?
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Total Medical School Students
2 9
All Reviewed
Copyright © 2019 by ECFMG. All rights reserved.
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
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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
Copyright © 2019 by ECFMG. All rights reserved.18
Mary Jones
Copyright © 2019 by ECFMG. All rights reserved.
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
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A guarantee to pass US licensing examsFake studentsA Test Prep CompanyFalsified credentials
Stealing Exam ContentCase #5
Micro video equipment
A recipe for disaster
Copyright © 2019 by ECFMG. All rights reserved.
Misrepresenting School LocationCase #6
Location of Government Charter
Actual location of all school activity
Copyright © 2019 by ECFMG. All rights reserved.
False Advertising
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X
X
X
12
Case #7
Copyright © 2019 by ECFMG. All rights reserved.
Why are we concerned?
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Duty to the publicto ensure doctors have received basic medical
education
Copyright © 2019 by ECFMG. All rights reserved.
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
Copyright © 2019 by ECFMG. All rights reserved.25
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.
Copyright © 2019 by ECFMG. All rights reserved.
#1 Remove ECFMG “Sponsor Note”
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2010 - 2017
Copyright © 2019 by ECFMG. All rights reserved.
#2 Give “Notice”
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Send To:
• IAMRA
• ECFMG Partners
• Government Authorities
• U.S. Consular Officials
• U.S. Law Enforcement
Copyright © 2019 by ECFMG. All rights reserved.
#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”
Copyright © 2019 by ECFMG. All rights reserved.
#4 Resources for Students
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Guidance on Medical School Selection
Web-site
Copyright © 2019 by ECFMG. All rights reserved.
#5 Resources for MRAs
30
Indicator that School is
Acceptable1967 - Present
Copyright © 2019 by ECFMG. All rights reserved.
#5 Resources for MRAs
31
Nothing Listed
Indicator that
School is NOTAcceptable
Copyright © 2019 by ECFMG. All rights reserved.
#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
Copyright © 2019 by ECFMG. All rights reserved.
#7 Accreditation
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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.
Copyright © 2019 by ECFMG. All rights reserved.
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
Copyright © 2019 by ECFMG. All rights reserved.35
Process
WFME is currently the only organization recognized by ECFMG
Copyright © 2019 by ECFMG. All rights reserved.
As of July 2019
WFME Recognition Statusof Accrediting Agencies
~15agencies
in discussion
20agencies
recognized
11agencies in review
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Copyright © 2019 by ECFMG. All rights reserved.
Does NOT apply to:
1) Verification services provided to clients
2) Regulatory Authorities outside the U.S. (Except Israel)
37
Copyright © 2019 by ECFMG. All rights reserved.38
Better Education
Ultimately, it’s about the Patients
Better Patient Care
Copyright © 2019 by ECFMG. All rights reserved.39
A rising tide
lifts all boats
Benefits Beyond Borders
Copyright © 2019 by ECFMG. All rights reserved.
Questions & Discussion
www.ecfmg.org |
40
Copyright © 2019 by ECFMG. All rights reserved.
• 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
Copyright © 2019 by ECFMG. All rights reserved.
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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