U of Q and Ochsner clinic

[hwi]

Are you guys looking for a genuine discourse on this subject or just to prove to yourselves how clever you are and to express totally unsubstantiated opinions, which I admit, you clearly acknowledge as such.

The highest recognition available today for a foreign med school (outside of Canada) is through the NCFMEA and is in fact what the Australian Medical Council has from the U.S. This is not bogus, it is recognized and acknowledged as such by the U.S. Dept. of Ed., the AMA and the AAMC.

Dr. Millisevert, your suggestion is that the government organizations should modify their regulations because it would be a better model in your opinion. I agree with you. It would be better if there were a world body with high accreditation standards that would have reciprocal recognition for all members. However, you know that is not how things work. But I will mention it to the accreditors from both countries next time they ask for my opinion.

You conclude I think this program is a horrible idea. I don't know whoever came up with this, but I feel it will put UQ in a horrible light internationally and reduce their image to that of Caribbean schools. This is not the way to go! I hope it doesn't get approved.

People who offer such opinions to the world generally are experts in the subject. On what basis and with what experience in medical education, or developing any other educational programs, or perhaps starting any international endeavor, other than falling back on the unchallengeable, what "You think" do you have to assert such an opinion? I think based upon my observation of your posts, you are a hasty naysayer, more interested in expressing your opinion than understanding the issues you opine about.

And, no I don't work for the school, nor the hospital. Sorry, that is a lame way of dismissing this post.

Redshifteffect, you indicated that I "shot myself in the foot" (wouldn't be the first time) by saying there would be "university supervision." These days there are medical projects (academic and otherwise) that have colleagues working together all over the world. We don't know if the supervision in this program is good or bad yet, but we do know it certainly is possible today to have worldwide cooperation and interaction on projects. By the way there are more than a dozen U.S. schools which have started or are starting campuses worldwide, including med schools. Most are in the Middle East right now. These include Cornell, NYU, Harvard and other well regarded U.S. schools.

You then seem to indicate that it doesn't matter where, or who provides the basic science education. I don't agree. The academic medical community has widely endorsed PBL as a better approach for the last decade. Further, you leap from there as if that is some indication of an inferior clinical education. And you make assumptions (maybe right or wrong - but how would you know) that there is no daily contact. That is a jump to a conclusion. I'm sorry, I don't get the automatic connections and the leaps to conclusions?

Then you conclude -With 400 students in a graduating class I'd really have to question the quality of the clinical education you'd be receiving. No one has ever linked size of graduating class and quality of education. As far as good clinicals, I spoke with someone at Ochsner. Ochsner will not have 400 students, but groups that it can train successfully. Ochsner has been training Tulane and LSU students for many years with great success and student satisfaction. I think questioning is essential. But drawing conclusions by inference and without information is foolhardy and won't be good medicine.

I do think that being concerned about quality is the essential idea and the responsibility of student docs and practicing docs. I believe that outcomes are the best measurement of quality. I have asked about the prior outcomes for first time pass rate on Step 1 and Match rate for U.S. students from UQ and they are both very high by U.S. medical schools' standards. This new program hasn't proven anything - but there is no historical basis other than idealistically redesigning the infrastructure of U.S. and Australian medical education regulations to find it insufficient yet.

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[redshifteffect]

A
Redshifteffect, you indicated that I "shot myself in the foot" (wouldn't be the first time) by saying there would be "university supervision." These days there are medical projects (academic and otherwise) that have colleagues working together all over the world. We don't know if the supervision in this program is good or bad yet, but we do know it certainly is possible today to have worldwide cooperation and interaction on projects. By the way there are more than a dozen U.S. schools which have started or are starting campuses worldwide, including med schools. Most are in the Middle East right now. These include Cornell, NYU, Harvard and other well regarded U.S. schools.

Actually if you read my quote again:

Actually you shot yourself in the foot with that statement. The primary aim of offshore Caribbean schools is to graduate students with "US model" education. How is this any different? These students would hardly be more prepared to work in the Australian health care system then overseas trained doctors from India or Africa (who at least share a common British style clinical education).

I was simply saying that this program is simply more like a Caribbean school then you are leading people to believe. Also how can a University that is funded by the Australian government say the students of this program would be equally suited to practice in Australia as other Australian graduates would be (which is the implication if they are accredited by the AMC). A PBL course is basically only access to text books and student groups, but involves very little if any clinical experience, until students get into the clinical phase of their training (which in this case would be from the US). I think it wouldn't be fair for graduates of this program to be accredited, when graduates from graduates from British style clinical programs still have to write the AMC.

A

You then seem to indicate that it doesn't matter where, or who provides the basic science education. I don't agree. The academic medical community has widely endorsed PBL as a better approach for the last decade. Further, you leap from there as if that is some indication of an inferior clinical education. And you make assumptions (maybe right or wrong - but how would you know) that there is no daily contact. That is a jump to a conclusion. I'm sorry, I don't get the automatic connections and the leaps to conclusions?

PBL is only as good as the clinicians that teach it. That is the major pit fall of PBL programs world-wide. As someone who's had first hand experience with both standard curriculums and PBL style courses I find PBL graduates spend a lot of time talking in groups, but know very little of the underlying physiology, biochemistry, histology etc. of the various disease processes that they are talking about. In fact they are trained to "recognise patterns" but not critically evaluate a situation. At least that's been my experience with PBL trained graduates.

Inferior clinical education? I said that you could do a PBL course anywhere and I stand by that 100%. All you need access to is scientists (to teach the course, since clinicians are more expensive) the internet, and some books. The clinical portion of the course, well for that you need access to patients.

As for international collaboration - sure that does happen on multi-centre trials. But that is a different thing, data passing back and forth is a lot different then the day to day organisation that needs to be done to insure adequate clinical exposure. Things such as organising clinical tutorials, verifying the level of experience that clinicians responsible for teaching have etc. all require intimate and day-to-day contact between both institutions. Remember that these graduates will be qualified to work in Australia, and therefore should be taught at levels comparable with Australian standards. This is much more difficult to ensure when the campus itself is off shore (you will not I didn't say impossible).

A
Then you conclude -With 400 students in a graduating class I'd really have to question the quality of the clinical education you'd be receiving. No one has ever linked size of graduating class and quality of education. As far as good clinicals, I spoke with someone at Ochsner. Ochsner will not have 400 students, but groups that it can train successfully. Ochsner has been training Tulane and LSU students for many years with great success and student satisfaction. I think questioning is essential. But drawing conclusions by inference and without information is foolhardy and won't be good medicine.

Then these "people" probably don't have a lot of common sense. Assuming that the faculties and access to patients has not changed in the last few years, then how would adding additional students to a program not cause a degrading of the clinical teaching of the students? It follows that if 100 students have access to 50 patients and 25 clinicians, and then 200 of those students then have access to the same 50 patients and 25 clinicians, there is not going to be as good clinical teaching. There is really little that can be done to compensate for a lack of staff or patients, other than developing links with other hospitals to send your students too. However it takes time to vet out a locale, and to insure that the staff are not only motivated in teaching students; but are capable of it.

Further more, I never said Ochsner will have 400 students, you merely inferred that. I was talking about UQ in general. Unless they have developed more clinical facilities for their students, then there will certainly be a degrading of their clinical teaching.

A

I do think that being concerned about quality is the essential idea and the responsibility of student docs and practicing docs. I believe that outcomes are the best measurement of quality. I have asked about the prior outcomes for first time pass rate on Step 1 and Match rate for U.S. students from UQ and they are both very high by U.S. medical schools' standards. This new program hasn't proven anything - but there is no historical basis other than idealistically redesigning the infrastructure of U.S. and Australian medical education regulations to find it insufficient yet.

[/quote]

Measuring the outcome of UQ students in no way determines what the outcome of Ochsner graduates will be. As I said pre-clinical knowledge can be achieved by good reference text books, but actual clinical knowledge is really best achieved on the wards. We have no idea what the clinical experience of these graduates will be like.



Gambling a huge amount of money on a relatively unknown program, when other well established programs already exist is a bit of fallacy, don't you think? Why take the risk?

 

[Dr.Millisevert]

The highest recognition available today for a foreign med school (outside of Canada) is through the NCFMEA and is in fact what the Australian Medical Council has from the U.S. This is not bogus, it is recognized and acknowledged as such by the U.S. Dept. of Ed., the AMA and the AAMC. .

Again... I ask you: How does this set Australian medical schools apart from a US applicant perspective from any other overseas medical school? As I pointed out.. medical schools in India, Mexico, and many other 3rd world countries equally hold "NCFMEA accreditation".

Dr. Millisevert, your suggestion is that the government organizations should modify their regulations because it would be a better model in your opinion. I agree with you.

I will mention it to the accreditors from both countries next time they ask for my opinion. .

Thank you for that! If the US and Canada can develop a mutual agreement, there is no rule or reason that states that Australia and New Zealand couldn't also be apart of this agreement. (other than they don't wish to develop an agreement... which may be the case). Many of us would like a real answer to this however instead of... "the LCME just doesn't do that", which is not an acceptable answer.

By the way there are more than a dozen U.S. schools which have started or are starting campuses worldwide, including med schools. Most are in the Middle East right now. These include Cornell, NYU, Harvard and other well regarded U.S. schools.

Your point? I don't understand how this applies to the proposed UQ-Ochsner collaboration. Australia isn't "the middle east". We are a 1st world English speaking nation with (as you agreed) equal accreditation standards to Canada and the US. We have our own world class medical schools. We don't need the US to start med school programs in our country. However, we would be happy to work with Canada and the US to develop more mutual recognition of each other's programs and post graduate training programs.

Some of us simply feel that the UQ-Ochsner program is very one sided and only really benefiting Americans. There seem to be quite a few double standards that need to be addressed here.

Ochsner has been training Tulane and LSU students for many years with great success and student satisfaction.

Great! Again, how about developing a mutual exchange program where by 10 Tulane medical students and 10 LSU medical students complete their clincals in a hospital in Queensland?

 

[Dr.Millisevert]

hwi: I have a question. (and please try to be open minded... and honest with your answer)

What if I told you that next year we were starting a new medical program that was going to be heavily marketed to Australian college students (you know.. those that couldn't get into an AMC accredited medical school). We are going to create 20 spots (for Australian citizens only) to enter med school at LSU (a US state supported program). Then we were going to allow them to spend their clinical years back in Australia at Brisbane private hospital. This medical program would be LCME accredited, but not AMC accredited (because.. well, AMC "just doesn't do that sort of thing"). After that... those graduates would have the option to either 1) enter the match and try to return to the US for residency, or 2) they could try sitting the AMC exams (Australian FMG certification) and apply for an Australian internship and specialty training program there.

Do you think this sounds like a good deal? ...because that is effectively what you're proposing.


Hwi.. I would like to apologies. I didn't mean to come off as personally attacking you in any way. I just want to make sure that all of these issues and concerns are addressed. I hope you can understand. Thanks you for your consideration.

 

[Zuckman]

I definitely feel that Aus/NZ med schools should be LCME accredited. There is no reason why this shouldn't be the case. The physicians in North America are really trying to support their own interests and they fully know that the medical schools in Aus/NZ have superb training. I would love a real answer to this as well.

In regards to UQ-Oschner...I feel this program can be a great thing for Australia and the US. There are very similar programs out there right now that have gained great reputations. Sackler medicine in Israel only trains American students (they have an Israeli cohort as well) and all the students end up doing residencies in the US (mostly in New York). This program hardly helps Israeli health care. The program at first had a lot of controversy and was seen as another 'offshore' program. In a few years, it made strides and Sackler grads are now highly regarded by program directors. A similar thing has happened for Technion medical graduates in the American MD program.

If UQ-Oschner is able to admit strong students, it'll gain a strong reputation.

I understand both views of the argument though. It's important to way the pros and cons and not just jump to conclusions.

 

[redshifteffect]

Although I can't comment on the Sackler program, what I would want to know about it is:

1. Can the graduates of this program practise medicine in Israel?

2. Is Israeli Healthcare similar to American healthcare?

3. Is the program funded in any part by the Israeli government?

If these students were licensed (graduates of Oschner) in Australia, it would be pretty difficult for the AMC to say that IMGs are only made to take the AMC exams to ensure that they are able to work safely in the Australian healthcare system. In most cases IMGs have superior theoretical knowledge to local graduates because they are taught the basic sciences, and even clinical theory in a very didactic manner, and thus tend to understand the underlying disease process. Where they suffer however is their understanding of how things work clinically in Australia.

These students would essentially be faced with a similar problem. The American and Australian healthcare systems are at opposite ends of a spectrum, and superficially though they share things in common operate very differently.

By allowing these doctors to be considered equivalent to graduates from the regular UQ program, the AMC might risk facing a lot of future lawsuits by IMGs.

 

[Zuckman]

For years, the American students could not practice in Israel. Only recently, because of pressure from the American students, have they been able to practise in Israel. Only a couple of students from the class of ~65 actually stay. Many of them fall in love with the country. The pay for Israeli doctors isn't very high. So, even if a student wanted to stay, it's very difficult because of the huge loans that the American MD graduates have. Israeli health care is very different from US health care. Just generally, Israel has universal health care where everyone has access. Not sure how the program is funded. It may differ for the different Israeli programs.

My point is, whenever anything new comes to the surface, there are always people who will argue against it. I think there are a lot of positives that can come with such new programs.

 

[redshifteffect]

There are always pros and cons with everything. If the situation only effected the graduates of this program I'd say that there really wouldn't be much to debate about.

However this situation will not only effect the graduates of this program, but Australian graduates in general, as well as the health care system in Australia. It will also effect IMGs who will then have a right to say they are being treated unfairly.

So something as simple as trialing a new program, may have far reaching consequences. The point is we don't know. That's really what this discussion is about.

 

[Dr.Millisevert]

If these students were licensed (graduates of Oschner) in Australia, it would be pretty difficult for the AMC to say that IMGs are only made to take the AMC exams to ensure that they are able to work safely in the Australian healthcare system.

By allowing these doctors to be considered equivalent to graduates from the regular UQ program, the AMC might risk facing a lot of future lawsuits by IMGs.

I understand what you're trying to say and you have some very good points and questions!

However, it all really comes down to protecting your region. Australian health care is I feel actually somewhere in between the English, Canadian, and US systems. Australia in many ways is VERY similar to Canada and everyone agrees we have identical standards for our medical education programs.

All that aside, I don't think this "program" they want to develop is very fair and it sounds like we are getting taken for a ride more than it sounds like a true mutual partnership.

If the American's want to use our facilities and honestly develop more mutual training programs that’s great… but we just need to make sure the agreement is fair to both sides.

 

[Dr.Millisevert]

There are very similar programs out there right now that have gained great reputations. Sackler medicine in Israel only trains American students (they have an Israeli cohort as well) and all the students end up doing residencies in the US (mostly in New York).

We already have med programs with great reputations! UQ is a great school. Developing such a one sided program for American applicants at UQ will actually LOWER the current high reputation of its program. Again, this sort of deal only benefits Americans. I don't think this is the sort of thing we would like to develop or encourage here in Australia. You can't single out just one program in a particular country and say we want to take from your facilities and give nothing back. Maybe in the Middle east or some 3rd world countries. However, I don't see how this applies to Australia or New Zealand. We don't need it and we won't stand for it.

It would be great to work "together" though if that is possible.

If we are to move forward in a true "partnership" then it has to be equal on both sides of the agreement. If you only want to accredit only 1 medical school program, that is fine.. but make sure it is dually accredited by both countries. Otherwise, the ideal thing to do is to simply allow the AMC have an equal/similar role to the CACMS (Canadian) in a mutual accreditation agreement with the LCME. It's the only fair way to play.

 

[jaketheory]

have to throw in my 2 cents.

UQ, nor any other similiar program, will ever be accredited by the LCME. It is not in the LCME's interest, nor, and more importantly, the AMA's. The AMA is the almighty powerful defender of not only the medical profession in the US, but also American doctors. I will not go on further regarding that. I'm sure many of you will blast it with arguments but i will only suggest you look into the history of the AMA.

the LCME extends accreditition to Canada solely because it is part of N. America and shares a border with the US. If Aus were a part of N. America, you could discuss the possibility of a mutual agreement regarding accreditation.

A primary accreditation criteria of the LCME is that schools are not-for-profit. While UQ is a govt supported public institution, I don't think they would meet this criteria considering it seems apparent the medical school is indeed profiting from international tuition fees. The cost to train a medical student in Aus is somewhere around 24,000 AUD. Indeed, the whole reason they have increased their international cohort and started this new oschler program is to take advantage of the fact that it can increase revenue for the university.

 

[JohnnyRockets]

I seriously doubt Aussie medical schools will become LCME accredited. Australian doctors also want to protect themselves from IMGs.

 

[Dr.Millisevert]

UQ, nor any other similiar program, will ever be accredited by the LCME. It is not in the LCME's interest, nor, and more importantly, the AMA's.

the LCME extends accreditition to Canada solely because it is part of N. America and shares a border with the US. If Aus were a part of N. America, you could discuss the possibility of a mutual agreement regarding accreditation.

You say that it is not in the LCME's interest... well... is equally not in the AMC's interest nor the AMA (Australian) to accredit all American schools. It could go both ways. The AMC is not a servant to the LCME, we are not beneath them. The AMC is very similar to CACMS and LCME and I feel it should be treated as such.

Australia does not "share a border" with the US, however we do "share" a lot of similarities (more so than any other country in the world). Just like Canada we are a first world english speaking country with similar culture and standards. Not to mention salary. Financially doctors in Australia do quite well... most of them do better than their Canadian counterparts and many rival US salaries. Australian GPs for example usually make a lot MORE than their US family practitioner counterparts. On top of that, most would admit we have a higher standard of living than many (if not most) areas of the US as well.

Again, America does seem to sure want a piece of what we have now don't they? They are "in need of doctors", and they have also agreed that we are "of equal standards". So... If they want to do buisness and take from our education system. They will have to recognise us for it. Only Fair.

Australian doctors also want to protect themselves from IMGs.

Exactly. I don't care if Australian schools don't get recognition from LCME. However, I'm not going to let the US come into Australia and cherry pick our medical programs and get what they want out of them without giving back. Many American doctors would love to come and work in Australia as well, and the AMC equally has no interest or obligation to recognise their degrees either. However, if they want to move forward then hopefully we can work "together" equally.

 

[redshifteffect]

jake,

Where did you get your figure of 24k from? The figures I've seen quoted by the AMC during some of our meetings are that it's between 30k - 35k.

 

[jaketheory]

jake,

Where did you get your figure of 24k from? The figures I've seen quoted by the AMC during some of our meetings are that it's between 30k - 35k.

i know one of the Uni of Notre Dame medical schools' website states they charge 24k for local fee paying students because unlike other schools they dont want the fee paying students subsidizing the other students' fees. i've read it elsewhere which talked about how the local student contributions were determined.

i think 30-35k is in fact what most other schools charge local fee paying students. it is less than what internationals pay, but still above the actual cost of training.

 

[jaketheory]

Australia does not "share a border" with the US, but like Canada we are a first world english speaking country with similar culture and standards.

so are the british countries and ireland. but its not going to happen.

ou say its not in the AMA's interest. Well... America does seem to want a piece of what we have now don't they? They are "in need of doctors", they have also agreed that we are "of equal standards". If they want to do buisness and take from our education system. They will have to recognise us for it. Only Fair.

i do not deny that the US is desperate for doctors. but if the AMA had their way, the US would not have any DO's, chiropractors, or PA's or NP's (honestly, i wouldnt mind not having chiro's as i think they are scams anyway, but thats another thread). seriously, look into the AMA's history. they lobby to prevent any other profession that may take their doc's buisiness from entering the US healthcare system. fortunately there are other sides to every story.

there is that formal body mentioned above which states the aus schools are of equal standard based on certain criteria, mainly that the AMC accreditation process is similar to the LMCE accreditiation process. however, the process is certainly not the same. to get lmce accreditation, lmce officials would have to audit the school, a rather exhaustive undertaking. considering the lmce does not exist to accredit non N. american schools, they would not go to such lengths just to make it a little easier for foreign grads to come to the us. and noone would argue that aus training is identical to us training, and thus i wouldnt expect it to even pass an lcme audit.

that was more than 2 cents, so i'm not giving any more.

 

[Dr.Millisevert]

so are the british countries and ireland. but its not going to happen.

To that I would point out 1) (culturally) that the Australia is an immigrant country which has developed much more along the lines of Canada and the United States than the UK. Australia has (militarily) stuck by the United States in every single engagement since WWI (even when Canada and the UK have pulled out). We even have Vietnam and WWII memorials which are shared with the US located here in Australia. … and 2) (professionally) Australian medical training has been for the past 10 years moving more and more away from the traditional UK model and more towards the North American structure. Similarly the UK (which joined the EU in 2001) has equally been changing more and more towards a unified European model of training following the Bologna process directorate.

So… no, I disagree with this. If any outside country is going to develop a mutual accreditation agreement with Canada and the US it would be Australia and New Zealand only.

if the AMA had their way, the US would not have any DO's, chiropractors, or PA's or NP's (honestly, i wouldnt mind not having chiro's as i think they are scams anyway, but thats another thread). seriously, look into the AMA's history. they lobby to prevent any other profession that may take their doc's buisiness from entering the US healthcare system.

Australian medical graduates are not "alternative" or "mid-level" practitioners. We are not an "other profession". We are just like Canadian medical graduates. I don't see how allowing Australian doctors to work more freely in the US would hurt "American medicine". If anything it will help. A much larger % of Australian medical graduates (compared to US medical grads) enter GP (family medicine) training programs. Allowing more Australian and New Zealand doctors to work in the US will actually probably help reduce the US's dependence on NPs (or other midlevel/altnernative providers) in primary care. Heck the American Board of Family Medicine already considers those who complete Australian GP training programs to be US "board eligible".

i do not deny that the US is desperate for doctors.

…there is that formal body mentioned above which states the aus schools are of equal standard based on certain criteria, mainly that the AMC accreditation process is similar to the LMCE accreditiation process.

however, the process is certainly not the same. to get lmce accreditation, lmce officials would have to audit the school, a rather exhaustive undertaking. considering the lmce does not exist to accredit non N. american schools.

Yes, we agree that AMC and LCME standards are equal.

We agree that US is desperate for more doctors.

FYI:
LCME does not accredit Canadian schools either! The CACMS does, LCME simply officially recognises that CACMS has equivalent accreditation standards to the LCME (something they unofficially recognise about AMC standards).

LCME recognition of AMC schools would not require a team from LCME to come and visit for months every single AMC program as you suggest. (they don't do this even for Canadian schools) It would only require the same thing they require of CACMS.. to have regular meetings where they share information about their internal reviews of their own programs. They "may" have 1 LCME member present on a handful of reviews only. Yes, it would require lots of paperwork and changing the bylaws between CACMS and LCME to include AMC as a 3rd party. However, it is something that is completely possible should they wish to do it.

 

[jaketheory]

canada is not only on the same continent but right next door. Australia could not be farther away from the US.

just like canadian grads? i think it was you that pointed me to an article indicating canadian docs were encountering lots of trouble get through to the US.

would you not agree that canadian undergrad medical education is much more similar to US undergrad med education than aus' is?

i'm not contributing anymore. you seem religous about this.

 

[Dr.Millisevert]

canada is not only on the same continent but right next door. Australia could not be farther away from the US.

The UK and Australia (back when they used to be dual accredited) were both on the other sides of the world. They managed to do it. You're point.

just like canadian grads? i think it was you that pointed me to an article indicating canadian docs were encountering lots of trouble get through to the US.

Yes, just like Canadian grads! At least in Canada they fully recognize Australian post-graduate specialty training programs. Canadian and Australian medical graduates are equivalent. You disagree?

Not a lot of trouble.. but yeah, there was an article published in the late 90s about how (in a few states) Canadians were having some difficulties getting licensed. I think that is pretty silly. Do you?

would you not agree that canadian undergrad medical education is much more similar to US undergrad med education than aus' is?

i'm not contributing anymore. you seem religous about this.

Over half of all Australian medical programs are now 4 year graduate entry programs with similar curriculum and structure. Even if you want to bring up 6 year programs... Even in the US they have accelerated 6-7 year med programs. What you learn, educational standards, and outcomes for graduates are exactly the same! So yes.. I think its a moot point.

You may think I'm "religious" about this topic. That's fine with me. I just don't think its a fair deal.

Do you think the Louisiana tax payers or US citizen LSU med students would feel any differently if the situation was reversed?

Are you a US international student in Australian program?
Why do you feel that Australian medical schools aren't good enough to get recognized as "equivalent" to Canadian or American medical schools?

 

[jaketheory]

i wasnt talking of the 6-7 year programs in Aus. and im thinking the only 6 year program in the US is at UMKC. and the US 6-7 year programs are not that similar to the Aus programs. the 6th year in Aus is a year of research, which is why there are several 5 year programs in Aus (and the UK, etc. as well).

US accelerated programs still require completion of bachelor degree to get the MD, even the UMKC program. And no, the B. Med. Sc. that the 6 yr programs award iin addition to the MBBS s not the same.

the UMKC program is completed in 6 yrs because it is year round, no summer breaks, and awards a BA, which is far more flexible as far as requirements go in comparison to a BS, and thus some required coursework for the MD fullfills the BA requirements. in this way it is similar to 5 year combined bachelor/master degree programs.

the US would never have a 5 year med degree.

i was actually asking if you really think the 4 year graduate-entry programs are the same as US ones. When i starting visiting SDN to research going to Aus for med, i immediately found people complaining the curriculum is defecient for those seeking to take the USMLE. That was over 4 years ago that i start that and it hasnt really changed since. Considering the USMLE is required to practice in the US, i dont see how an Aus school can be seen as equal to a US school for someone who intends to end up in the US.

i am not a us international student in an aus program. im currently waiting for my PR visa so I can apply to Aus programs as a local.

the end.

 

[redshifteffect]

Actually back when I was looking around there were lots of 6 year programs. The two I got into were Brown and Case Western Reserve. I'm not sure if they still exist.

The deal was that you did two years of a bachelors program, maintain a B average, and then you are exempted from the MCAT and are guaranteed a spot in the medical program. So while it wasn't a true 6 year course, it was as close as you could get in the US.

Canadian programs are also very deficient in the basic sciences. I've had a few exchanges with students from McMaster in Ontario, and not only did they not know their basic sciences, but they couldn't take a history or perform a competent physical exam. The students were in 4th year, and the staff felt they weren't safe enough to see patients by themselves, so they put them in with our 4th years (instead of our 6th years). I'd say the Canadian students are a lot closer to the Australian 4th year students then they are to the American ones.

America may have gone to a 4 year program, but they haven't cut out a lot of the basic sciences, whereas Canada and Australia have.

 

[jaketheory]

Actually back when I was looking around there were lots of 6 year programs. The two I got in were Brown and Case Western Reserve. I'm not sure if they still exist.

neither brown nor case presently have a 6 yr program. they both have combined programs through which you can get conditional admission to the medical program upon commencing undergrad studies but both take 8 yrs.

The deal was that you did two years of a bachelors program, maintain a B average, and then you are exempted from the MCAT and are guaranteed a spot in the medical program. So while it wasn't a true 6 year course, it was as close as you could get in the US.

thus they were not 6 year courses at all. there are several 7 year combined programs in the US. the UMKC program is a true 6 year course, but they summer studies, which considerably more study than an Aus 6 yr program.

Canadian programs are also very deficient in the basic sciences. I've had a few exchanges with students from McMaster in Ontario, and not only did they not know their basic sciences, but they couldn't take a history or perform a competent physical exam. The students were in 4th year, and the staff felt they weren't safe enough to see patients by themselves, so they put them in with our 4th years (instead of our 6th years). I'd say the Canadian students are a lot closer to the Australian 4th year students then they are to the American ones.

huh? i thought mcmasters was a 3 yr program. how could they have been 4th years?

America may have gone to a 4 year program, but they haven't cut out a lot of the basic sciences, whereas Canada and Australia have.

exactly.

though if this is true, i guess it supports millisverts point: if canada, lacking basic science, can get LCME mutual accreditation, why cant aus? but again, i can pretty much spit on canada from where i am (not saying i want to)

 

[JoeNamaMD]

Actually back when I was looking around there were lots of 6 year programs. The two I got in were Brown and Case Western Reserve. I'm not sure if they still exist.

The deal was that you did two years of a bachelors program, maintain a B average, and then you are exempted from the MCAT and are guaranteed a spot in the medical program. So while it wasn't a true 6 year course, it was as close as you could get in the US.

Canadian programs are also very deficient in the basic sciences. I've had a few exchanges with students from McMaster in Ontario, and not only did they not know their basic sciences, but they couldn't take a history or perform a competent physical exam. The students were in 4th year, and the staff felt they weren't safe enough to see patients by themselves, so they put them in with our 4th years (instead of our 6th years). I'd say the Canadian students are a lot closer to the Australian 4th year students then they are to the American ones.

America may have gone to a 4 year program, but they haven't cut out a lot of the basic sciences, whereas Canada and Australia have.

Actually you would be surprised, most of the schools have considerably beefed up the basic sciences, especially USyd and UQ. Some schools like UNSW's grad entry program only allow medical science undergraduates to apply. A lot of US schools will shock you, I know a few people in some very reputable US programs who have a strongly self directed basic science curriculum. America was always a 4 year program for years, so was Canada according to my understanding.

As far as UK-Australia reciprocity that would make sense since Australia used to be a British colony and many Aussies have a second British passport. That is gone since Britain is now EU. Aussie doctors have to take the PLAB and other health professionals have various hoops to jump through. Dental grads cannot practice in the UK, funny, since some of the faculty at UQ and Usyd's Dental schools are from the UK. Working internationally has other issues, if you cannot speak the local language, it will not be of much help. People from Australia will mostly work in English speaking countries. I knew one GP who went to work in Switzerland but married a Swiss woman, so that is a different issue.

I am not gung ho about the UQ-Ochsner program. Monash has a campus in Malaysia but that is different. Duke also has a program in Singapore but that is in conjunction with the National University of Singapore.

 

[jaketheory]

Actually you would be surprised, most of the schools have considerably beefed up the basic sciences, especially USyd and UQ. Some schools like UNSW's grad entry program only allow medical science undergraduates to apply. A lot of US schools will shock you, I know a few people in some very reputable US programs who have a strongly self directed basic science curriculum. America was always a 4 year program for years, so was Canada according to my understanding.

historically, N. American training was 4 years - that includes canada.

As far as UK-Australia reciprocity that would make sense since Australia used to be a British colony and many Aussies have a second British passport.

exactly.

 

[redshifteffect]

neither brown nor case presently have a 6 yr program. they both have combined programs through which you can get conditional admission to the medical program upon commencing undergrad studies but both take 8 yrs.



thus they were not 6 year courses at all. there are several 7 year combined programs in the US. the UMKC program is a true 6 year course, but they summer studies, which considerably more study than an Aus 6 yr program.



huh? i thought mcmasters was a 3 yr program. how could they have been 4th years?



exactly.

though if this is true, i guess it supports millisverts point: if canada, lacking basic science, can get LCME mutual accreditation, why cant aus? but again, i can pretty much spit on canada from where i am (not saying i want to)

1. It was a 6 year program because if you maintained that B average you went into medical school right after your second year of the Bachelors. So 2 +4 = 6 years

2. McMasters is a 3 year program, but only because they work all year. So in my books they were 4th years (or final year students).

3. I don't know about now, but there were definitely 6 year accelerated medical programs in the US with a similar set up to that described above. These were not combined programs, but actually 6 year courses. That however was nearly 7-8 years ago (when I was looking around). I still have the acceptance letters for both, so I can take a look at what exactly they said, but I'm pretty sure it was 6 years total.

 

[redshifteffect]

I'm not saying that all American 4 year schools are good (the range between the good ones and the bad ones is shocking, as I've met a few Howard students who couldn't even work a reflex hammer). Neither are all 4 year Australian or Canadian programs necessarily deficient.

It's just that from speaking with graduates of these courses, as well as working with them, they clearly lack a fundemental understanding of the underlying Histopath, Physiology etc. They admit it as well. That doesn't mean that they are deficient clinically though, because a lot of the underlying sciences doesn't necessarily have any relevance clinically. Though it does mean that extra preparation will be needed for the USMLE.

 

[jaketheory]

1. It was a 6 year program because if you maintained that B average you went into medical school right after your second year of the Bachelors. So 2 +4 = 6 years

acknowledged.

so why did you turn down case and brown for UTas?

 

[redshifteffect]

Cost, and the job (residency) wasn't guaranteed in the US either, since I am not a Greencard holder/US citizen.

I also liked the lifestyle option in Australia and knew that it would be much easier for me to stay there if I wanted to, then to live out the rest of my days in the US.

 

[all4xtrm]

Just for your information, here is the email I received from OzTREKK today regarding the new UQ MBBS Program.


=======================================================



How are you?


I want to inform you about a new University of Queensland (UQ) School of Medicine program, which will commence in January, 2009 for new American students. This new initiative has only just been approved by the School of Medicine at the University of Queensland. I want to tell you about this new initiative, so that you are informed about the program and to ensure OzTREKK is keeping you updated about UQ’s School of Medicine projects.


UQ’s School of Medicine is partnering with Ochsner Health System in New Orleans, Louisiana, in the delivery of its graduate-entry Bachelor of Medicine/Bachelor of Surgery (MBBS) program. A new UQ MBBS degree has been launched, and admitted American students will study Year One and Year Two of the MBBS program at UQ in Brisbane, and then spend two years in Louisiana at the Ochsner Health System to complete clinical rotations.


Twenty new spots for American citizens or permanent residents have opened for the January, 2009 intake at UQ. The School of Medicine at UQ has informed us that only those students who have not already accepted an offer to the UQ MBBS program for 2009 are eligible to apply. According to International Pathways, a New York-based corporation, which provides “certain administrative, recruiting, and related services to the University of Queensland and Ochsner Clinic Foundation/Ochsner Community Hospitals”, only U.S. citizens or permanent residents are eligible to participate in this specialized program (visit: http://mededpath.org/internationalpathways/terms_privacy.php)


This MBBS program, with two years of pre-clinical education at UQ in Australia and two years of clinical instruction at Ochsner in Louisiana, is subject to approval by the Australian Medical Council (AMC). UQ has submitted to the AMC an application for program accreditation. Until the AMC completes its review of this new program, UQ will accept students eligible for the program into its four-year MBBS program in Australia. In the event that the AMC does not timely accredit the new program, students who enrol will be expected to complete their four-year medical education at UQ in Brisbane.


The UQ/Ochsner MBBS students will study alongside UQ MBBS students. UQ MBBS students, both Australian and international, have the opportunity to undertake international clinical rotations, including rotations in the U.S.A. at Ochsner.


The UQ/Ochsner initiative aligns with the university’s overall goals of internationalization as well as Head of School, Professor David Wilkinson’s vision to make UQ Australia’s first global medical school. The UQ/Ochsner partnership program is deemed by Professor Wilkinson as “a new model for preparing doctors to work anywhere in the world.”


If you have any questions about this new MBBS program or your studies as a medical student at UQ, please do not hesitate to contact me.


Hope you are well.


Cheers,
Matt


Matt Miernik
Director
OzTREKK - Your Canadian Connection to Study in Australia
A> 102 Sumac Lane
Perth, Ontario
K7H 3C7
P> 1 866 698 7355 ext. 202
Int'l> +1 613 267 4004 ext. 202
F> 1 866 698 7311
E> [email protected]
W> www.oztrekk.com

 

[Dr.Millisevert]

When i starting visiting SDN to research going to Aus for med, i immediately found people complaining the curriculum is defecient for those seeking to take the USMLE. That was over 4 years ago that i start that and it hasnt really changed since. Considering the USMLE is required to practice in the US, i dont see how an Aus school can be seen as equal to a US school for someone who intends to end up in the US.

Canadian students equally don't sit the USLME nor prepare for it. It is a US only exam. This again, does not mean that Aus grads are not "equivalent".

Actually you would be surprised, most of the schools have considerably beefed up the basic sciences, especially USyd and UQ. Some schools like UNSW's grad entry program only allow medical science undergraduates to apply. A lot of US schools will shock you, I know a few people in some very reputable US programs who have a strongly self directed basic science curriculum.

I'd say the Canadian students are a lot closer to the Australian 4th year students then they are to the American ones.

Thank you

Question:
Considering we've agreed that AMC and LCME (and CACMS) have equal standards.
Why then should the AMC even think about accrediting this program if the LCME is refusing to?

 

[redshifteffect]

Actually I still have a couple of GP friends in Canada that got into medical school and it was a 6 year program. I'm not sure when they matriculated, but I'm guessing it was in the 60's or 70's. They also said that when they were done they were automatically GPs (similar to what Australia had until only very recently; damn missed that boat). They also had a one year internship.

I think that Canada simply chose to copy America's style of medical education at some point, and distanced themselves from the British style of education.

Just did a little digging around on wikipedia:
http://en.wikipedia.org/wiki/Medical_school_in_Canada

All specialty residencies are accredited by the Royal College of Physicians and Surgeons of Canada; most are 5 years long. Internal medicine and pediatrics are 4-year programs in which the final year can be used to complete a fellowship in general internal medicine or general pediatrics, or used towards a longer fellowship (e.g., cardiology). A few surgical residencies, including cardiac surgery, neurosurgery, and some general surgery programs, last 6 years.

Actually training in Australia is not much longer then in Canada. If you include the one year internship most residencies in Australia are probably only about a year longer (and in some cases actually shorter), however the requirement to get into most specialties is the extra RMO year, which makes Australian programs on average 1-2 years longer. However Canadian residencies still are on average longer then US ones, meaning they are more similar in structure and length to Australian ones, then American ones.

 

[Dr Funk]

I recently found out that the two years of rotations at Ochsner cost around $50k a year. The four years average out to $40k a year. For perspective, Harvard is $44k/yr and U of Wash is $41k/yr (the most expensive US schools). Why would anyone want to spend $160k plus living expenses to get two years in Oz of lots of study time and little travel and two years in New Orleans? It looks like a great international program at two well known institutions, but that is way too much money. (cheaper than Ireland though)

 

[jaketheory]

I recently found out that the two years of rotations at Ochsner cost around $50k a year. The four years average out to $40k a year. For perspective, Harvard is $44k/yr and U of Wash is $41k/yr (the most expensive US schools). Why would anyone want to spend $160k plus living expenses to get two years in Oz of lots of study time and little travel and two years in New Orleans? It looks like a great international program at two well known institutions, but that is way too much money. (cheaper than Ireland though)

i was pretty sure that as of last year, Tufts was the most expensive at $45k/year and BU was not far behind. Was pretty sure Harvard was still in the upper $30k's.

most alternative routes are nearly just as expensive. I think St. George in the carribean is a pretty expensive school too. my pcp is a DO and told me to consider applying to his alma mater, Uni of New England. I checked it out and its over $40k/year and it is not out of the usual. medical school has gotten wicked expensive in the US.

 

[Dr Funk]

i was pretty sure that as of last year, Tufts was the most expensive at $45k/year and BU was not far behind. Was pretty sure Harvard was still in the upper $30k's.

most alternative routes are nearly just as expensive. I think St. George in the carribean is a pretty expensive school too. my pcp is a DO and told me to consider applying to his alma mater, Uni of New England. I checked it out and its over $40k/year and it is not out of the usual. medical school has gotten wicked expensive in the US.

You are right Jaketheory, Med school is expensive, and this program is not too far off from the price of the Caribbean schools. When I was looking at this program myself, I was comparing the $160k to the $80k for four years of my state school. I could not justify spending double the cost. I could live in Europe for a year and go to a state school for much less than the UQ-Ochsner program. Best of luck to those that will accept the price tag.

 

[jaketheory]

You are right Jaketheory, Med school is expensive, and this program is not too far off from the price of the Caribbean schools. When I was looking at this program myself, I was comparing the $160k to the $80k for four years of my state school. I could not justify spending double the cost. I could live in Europe for a year and go to a state school for much less than the UQ-Ochsner program. Best of luck to those that will accept the price tag.

if you can go to a state school do it.

the majority of people on here are interested in studying med in Aus because they are not sure they are competitive for their state's schools, or even schools of other states in their home country (mostly in N. America). In the US, there are at most a few public schools (ie. tax subsidized tuition) per state (some have none). If a US citizen doesnt get into one of those, they look to pay out-of-state/private school tuition which runs 35-45k USD these days, so paying international tuition overseas is not a stretch. The state I grew up in (SC) has 2 medical schools, both public, and a resident of that state will pay 100k USD in tuition over 4 years.

 

[Dr.Millisevert]

the majority of people on here are interested in studying med in Aus because they are not sure they are competitive for their state's schools

Well.. I'm not sure this is always true. I think many North American's flat out choose Australia over the US because they feel its a better choice these days for a lot of reasons.

 

[jaketheory]

Well.. I'm not sure this is always true. I think many North American's flat out choose Australia over the US because they feel its a better choice these days for a lot of reasons.

i wrote majority, which implies it is not always true.

 

[JohnnyRockets]

USyd is 54k AUD not including living, books, and travel costs which will be another 25k , its probably not as bad since the Aussie Dollar is now .66US cents. However, I doubt the Aussie will stay at that level.

 

[Theillestill]

Let's keep praying it does so.

I might be paying A LOT less tuition next year.

 

[redshifteffect]

And I'm hoping It goes back up to its old levels

 

[shan564]

Yeah, I find myself checking the conversion rate at least 3-4 times every day... I waited until the rate was up to 1.64 AUD per USD before I paid my deposit at USyd.

 

[JaggerPlate]

So does it basically mean that if you attended UQ for two years and did two years at Ochsner you wouldn't be able to get a license/practice in California at all??

 

[Dr.Millisevert]

So does it basically mean that if you attended UQ for two years and did two years at Ochsner you wouldn't be able to get a license/practice in California at all??

More reason to just apply to the normal 4 year UQ program.

 

[JaggerPlate]

More reason to just apply to the normal 4 year UQ program.

It seems that way. BUT, would that be the case?? If you did two at UQ and two in the US would you not be able to practice in CA?? Or is there some way to make it work, etc??

I was going to ask on the FAQ on the UQ website, but it was weird.

 

[Dr.Millisevert]

It seems that way. BUT, would that be the case?? If you did two at UQ and two in the US would you not be able to practice in CA?? Or is there some way to make it work, etc??

I was going to ask on the FAQ on the UQ website, but it was weird.

The FAQ section hasn't been updated yet. There is a form on the website for you to ask your question. GO ahead and ask... This is the only way they will be able to realize what the issues are for potential applicants. I would encourage anyone interested in the program to ask as many in depth questions/concerns they have about the program on the FAQ website and send them in. Also, you should send emails outlining your concerns and questions to the addresses above.

 

[amakhosidlo]

GO ahead and ask... This is the only way they will be able to realize what the issues are for potential applicants. I would encourage anyone interested in the program to ask as many in depth questions/concerns they have about the program on the FAQ website and send them in. Also, you should send emails outlining your concerns and questions to the addresses above.

Yeah, I actually tried what you suggest.

Simple questions too.

1. Can US kids get loans?
2. What are the prospects like for applicants who wish to practice in Australia?

You know what I got?

Re #2: "The program is intended for students wishing to return to practice in the US, we don't hold a list of requirements for each country, so you should check with your specific country (in other words, affirming my concerns that this really is just another offshore program that has no interest in helping their grads stay domestic. How are they "not familiar" with the reqs for their own country? Pretty fishy if you ask me...)

Re #1: "We'll get back to you on that" (That's....confidence inspiring...)

I was really optimistic when I first learned about the program. Then I saw the ads plastered all over the place and got their vague run-around.
...Not so optimistic any more. I'd stay away...

 

[Dr Funk]

Yeah, I actually tried what you suggest.

Simple questions too.

1. Can US kids get loans?
2. What are the prospects like for applicants who wish to practice in Australia?

You know what I got?

Re #2: "The program is intended for students wishing to return to practice in the US, we don't hold a list of requirements for each country, so you should check with your specific country (in other words, affirming my concerns that this really is just another offshore program that has no interest in helping their grads stay domestic. How are they "not familiar" with the reqs for their own country? Pretty fishy if you ask me...)

Re #1: "We'll get back to you on that" (That's....confidence inspiring...)

I was really optimistic when I first learned about the program. Then I saw the ads plastered all over the place and got their vague run-around.
...Not so optimistic any more. I'd stay away...

To answer #1, I found that US students can get stafford loans for this program. However, you must look at what the cap is on how much per year you can borrow. You can also get the parent plus loan. While I am no longer interested in this program, the fact that US kids can get stafford loans is really nice.
Here is my reference: http://mededpath.org/internationalp...uq.edu.au/international/index.html?page=60982

 

[Dr.Millisevert]

I was really optimistic when I first learned about the program. Then I saw the ads plastered all over the place and got their vague run-around.
...Not so optimistic any more. I'd stay away...

Exactly.

Unless they can answer your questions and prove the information they are providing you is correct, why would you risk it?

the fact that US kids can get stafford loans is really nice.

Again, US kids can also get Stafford loans to attend medical school in Mexico, the Caribbean, and India. There is nothing "extra" or "special" that the UQ-Ochsner program is providing here.




Bottom line... You want to go to UQ med school, then just apply for the normal 4 year program and complete your clinicals in Queensland. You can do (up to) 6 months back in the US for electives at any hospital you want. (maybe at a hospital you will actually be applying to for residency)

 

[JaggerPlate]

Bottom line... You want to go to UQ med school, then just apply for the normal 4 year program and complete your clinicals in Queensland. You can do (up to) 6 months back in the US for electives at any hospital you want. (maybe at a hospital you will actually be applying to for residency)

Do you think there is a big bias against US students applying for the traditional 4 year program ??

 

[redshifteffect]

Do you think there is a big bias against US students applying for the traditional 4 year program ??

I don't see why there would be. If you can compete on grades/MCAT then you shouldn't have a problem getting in.