II 

117TH CONGRESS 

2D SESSION S. 4792 

To amend the Higher Education Act of 1965 to establish fair and consistent 

eligibility requirements for graduate medical schools operating outside 

the United States and Canada. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 7, 2022 

Mr. DURBIN introduced the following bill; which was read twice and referred 

to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend the Higher Education Act of 1965 to establish 

fair and consistent eligibility requirements for graduate 

medical schools operating outside the United States and 

Canada. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Foreign Medical School 

5 Accountability Fairness Act of 2022’’. 

6 SEC. 2. PURPOSE. 

7 To establish consistent eligibility requirements for 

8 graduate medical schools operating outside of the United 


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1 States and Canada in order to increase accountability and 

2 protect American students and taxpayer dollars. 

3 SEC. 3. FINDINGS. 

4 Congress finds the following: 

5 (1) Three for-profit schools in the Caribbean 

have historically received nearly 3 6 ⁄4 of all Federal 

7 funding under title IV of the Higher Education Act 

8 of 1965 (20 U.S.C. 1070 et seq.) that goes to stu9 dents enrolled at foreign graduate medical schools, 

10 despite those three schools being exempt from meet11 ing the same eligibility requirements as the majority 

12 of graduate medical schools located outside of the 

13 United States and Canada. 

14 (2) The National Committee on Foreign Med15 ical Education and Accreditation and the Depart16 ment of Education recommend that all foreign grad17 uate medical schools should be required to meet the 

18 same eligibility requirements to participate in Fed19 eral funding under title IV of the Higher Education 

20 Act of 1965 (20 U.S.C. 1070 et seq.). 

21 (3) The attrition rate at United States medical 

22 schools averaged 3.3 percent between 1993 and 

23 2013, while rates at for-profit Caribbean medical 

24 schools have been known to reach 30 percent. 


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1 (4) In 2022, residency match rates for foreign 

2 trained graduates averaged 61.4 percent compared 

3 to 92.9 percent for graduates of allopathic medical 

4 schools in the United States and 91.3 percent for 

5 graduates of osteopathic medical schools in the 

6 United States. 

7 (5) On average, students at for-profit medical 

8 schools operating outside of the United States and 

9 Canada amass more student debt than those at med10 ical schools in the United States. 

11 SEC. 4. REPEAL GRANDFATHER PROVISIONS. 

12 Section 102(a)(2) of the Higher Education Act of 

13 1965 (20 U.S.C. 1002(a)(2)) is amended— 

14 (1) in subparagraph (A), by striking clause (i) 

15 and inserting the following: 

16 ‘‘(i) in the case of a graduate medical 

17 school located outside the United States— 

18 ‘‘(I) at least 60 percent of those 

19 enrolled in, and at least 60 percent of 

20 the graduates of, the graduate med21 ical school outside the United States 

22 were not persons described in section 

23 484(a)(5) in the year preceding the 

24 year for which a student is seeking a 

25 loan under part D of title IV; and 


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1 ‘‘(II) at least 75 percent of the 

2 individuals who were students or 

3 graduates of the graduate medical 

4 school outside the United States or 

5 Canada (both nationals of the United 

6 States and others) taking the exami7 nations administered by the Edu8 cational Commission for Foreign Med9 ical Graduates received a passing 

10 score in the year preceding the year 

11 for which a student is seeking a loan 

12 under part D of title IV;’’; and 

13 (2) in subparagraph (B)(iii), by adding at the 

14 end the following: 

15 ‘‘(V) EXPIRATION OF AUTHOR16 ITY.—The authority of a graduate 

17 medical school described in subclause 

18 (I) to qualify for participation in the 

19 loan programs under part D of title 

20 IV pursuant to this clause shall expire 

21 beginning on the first July 1 following 

22 the date of enactment of the Foreign 

23 Medical School Accountability Fair24 ness Act of 2022.’’. 


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1 SEC. 5. LOSS OF ELIGIBILITY. 

2 If a graduate medical school loses eligibility to par3 ticipate in the loan programs under part D of title IV of 

4 the Higher Education Act of 1965 (20 U.S.C. 1087a et 

5 seq.) due to the enactment of the amendments made by 

6 section 4, then a student enrolled at such graduate med7 ical school on or before the date of enactment of this Act 

8 may, notwithstanding such loss of eligibility, continue to 

9 be eligible to receive a loan under such part D while at10 tending such graduate medical school in which the student 

11 was enrolled upon the date of enactment of this Act, sub12 ject to the student continuing to meet all applicable re13 quirements for satisfactory academic progress, until the 

14 earliest of— 

15 (1) withdrawal by the student from the grad16 uate medical school; 

17 (2) completion of the program of study by the 

18 student at the graduate medical school; or 

19 (3) the fourth June 30 after such loss of eligi20 bility. 

Æ 


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