Health Professions Training Abroad

International and U.S. Students Seeking Health Professions Training Abroad

There are many reasons why students wish to pursue health professions training outside of the U.S.  Some students would like to return to their home country for professional school.  Others seek a different cultural experience during this phase of their education.  Students who have been unsuccessful in securing admission to U.S. health professions schools might consider pursuing training outside of the U.S.  Below is some information about medical, dental, and veterinary education abroad.

Professional schools outside of the U.S. are frequently referred to as “foreign”, “off-shore”, or “international”.  For the purposes of this discussion, we will refer to these schools as international schools.  In addition to location, international health professions schools differ from each other in many respects.  Aspects to consider include physical environment, living conditions, economic and cultural factors in the community, safety, availability of heath care, climate, admissions requirements, tuition, eligibility for U.S. government loans, class size, language of instructors, qualifications of faculty, quality of teaching, quality of clinical facilities, amount of academic support, opportunities for clinical rotations, curriculum length and structure, and graduation rates.  In addition to learning about schools through websites, published materials, and admissions officers, it is very important for students to talk with current students and graduates.

International students may wish to return to their home country to pursue graduate medical education.  Because of the great variety of educational systems that exist, it is impossible to apply one uniform rule to the likelihood of a student being able to return to his/her own country for education in health care.  Students should contact their educational attaché at the consulate of their own country to learn more about options.

The largest concentration of international medical schools for U.S. citizens is in the Caribbean, but there are medical schools with programs for graduates of U.S. undergraduate colleges and universities in Australia, Ireland, Israel, Mexico, the Philippines, Poland, England, and in many other countries.  U.S. citizens at many international medical schools are eligible for U.S. Government Guaranteed Student Loans.  Some international schools have affiliations with U.S. medical schools.  For example, Duke University has a collaboration with the National University of Singapore (NUS) called Duke-NUS.  Their mission is to bring the American style of medical education to Singapore in order to prepare the next generation of physician scientists and leaders.  Completing the 4-year curriculum results in a MD degree awarded jointly by Duke University and NUS.  The Duke-NUS program offers a range of financial assistance, including scholarships and loans.  All medical students are required to sign a service commitment upon completion of the first year of internship (5 additional years of service in Singapore for international students).  Columbia University Medical Center has a collaboration with Ben-Gurion University of the Negev Medical School for International Health.

The International Medical Education Directory (IMED) is a free web-based resource for accurate and up-to-date information about international medical schools that are recognized by the appropriate government agency in the countries in which they are located. In most countries, it is the Ministry of Health that accredits and lists the school on IMED.  Information includes name, university affiliation, address, contact information, website address, degree offered, language of instruction, duration of curriculum, total enrollment, and eligibility of non-national students.  IMED can be used to search by geographic region, country, name of school, or name of city.

Students who elect to pursue health professions education at an international school may wish to return to the U.S. for additional training or to practice.  Please note that very few students are accepted in transfer from international to U.S. medical schools.  Because medical schools outside of the U.S. vary in educational standards, curricula, and evaluation methods, international medical school graduates must be certified by the Educational Commission for Foreign Medical Graduate (ECFMG) before they can apply to accredited medical residency programs or to obtain an unrestricted medical license to practice in the U.S.  In order to obtain ECFMG certification, a student must graduate from a school listed on IMED with at least 4 credit years, and pass the USMLE Step 1, USMLE Step 2 -Clinical Knowledge, and Step 2- Clinical Skills exams.  Students who wish to return to the U.S. to do residency training are strongly advised to plan clinical clerkships in the U.S. during medical school.  Of note is that graduates of international schools may have to contend with extra board specialty certification and state licensure issues.