New AMA Policy on LCME/COCA Clerkships

https://wire.ama-assn.org/education/actions-taken-protect-clerkship-spots-address-bias

Good news for US MD and DO students; bad news for Caribbean and other international medical school students.

Additionally the AMA called upon ERAS to remove all non-academic identifiers pertaining to age, race, religion and national origin from residency application to minimize bias in candidate selection. This include a moratorium on the implementation of the standardized video interview (VSI) as part of the resident application process.

P,S. I wonder if the nixing of video interviews will affect med school applications as well for programs like Dell/UR-Austin and Carle/UIUC that use video secondaries?

“Require institutions that accept students for clinical placements ensure that all students are trained in programs that meet requirements that are equivalent to those of programs accredited by the LCME and COCA.”

I am confused, aren’t there already Foreign Institutions that meet requirements of LCME and COCA? Is there a change?

“…AMA called upon ERAS to remove all non-academic identifiers pertaining to age, race, religion and national origin…”
Does that include a photo with application.

I don’t see how it couldn’t. Programs might start requesting photos when they offer interviews but obviously this initiative is aimed at the pre-interview evaluation stage.

While the question about birthplace could get removed, the US citizenship question probably never will. Given government funding is used to support residents, I think it’s fair to have US citizen or not on ERAS.

There are, but there are many that don’t. I don’t know how many of the ones that don’t send their kids to the US for clerkships though.

Pretty funny that this is happening during literally the first year these were implemented.

RE:

Some Caribbean (and other international) med schools place their students in non-approved clerkship sites in the US. Even the Big Three sometimes place their students in non-approved clerkships.

Also as it stands, Green Book/Blue Book clerkships that so many overseas medical schools boast about are no guarantee of quality training. Green Book just means the clerkship site is associated with a ACGME/COCA approved hospital. It does not guarantee, however, that the international student will be allowed inside the hospital to rotate on inpatient wards. Some Green Book clerkships are outpatient only. (EX. A peds rotation only at a outpatient clinic associated with ACGME/COCA hospital or at a private practice of \ a physician who is on staff at approved hospital.) Blue Book clerkships are associated with hospitals that offer a ACGME or COCA residency in the same field as the clerkship. Again there is no guarantee that these clerkships permit a international med student to rotate on the in-hospital wards. Many are outpatient only or at non-approved secondary sites associated with a ACGME/COCA approved hospital. (Ex, a small rural non-teaching hospital owned by a larger hospital system. Presbyterian–Small Town is not an approved ACGME/COCA site, but Presbyterian–Major City is and Small Town belongs to the statewide Presbyterian health system that Major City owns & operates.)

The quality of clerkship training is highly variable, both among international med schools and among US-based rotation sites utilized by international med schools. I see this new push to more strongly regulate–and equalize-- the training environment for 3rd & 4th year med students, especially for students who attend a foreign medical school.

^another example of how the training might be different even at the same hospital: I know someone from a foreign med school who never set foot in an OR during his surgery clerkship. Not only are american medical students in the OR, they are usually scrubbed in and often assisting (anywhere from just holding a retractor/doing suction to ligating and removing a fallopian tube or steering the camera throughout a laparoscopic procedure).