**GAO-10-412**                      Published: Jun 28, 2010. Publicly Released: Jun 28, 2010.                  

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## Highlights

Each year, the federal government makes a significant financial investment in the education and training of the U.S. physician workforce. A quarter of that physician workforce is composed of international medical graduates (IMG) and they include both U.S. citizens and foreign nationals. In fiscal year 2008, the federal government loaned $633 million to U.S. students enrolled in foreign institutions--including medical students--through the Federal Family Education Loan (FFEL) program. The government also makes a substantial domestic investment in the graduate training of the physician workforce. For example, in fiscal year 2008, federal support for residency training in the United States amounted to nearly $9 billion. As with medical students educated in the United States, this training is required of all IMGs--U.S. citizens and foreign nationals alike--who seek to practice medicine without supervision in the United States. The Department of Education (Education), which administers the federal student loan program, must also monitor foreign schools that seek to participate in the program with respect to specific statutory requirements. Among these is the statutory requirement that at least 60 percent of their students who take the U.S. medical licensing exam must pass the exam. Most recently, Congress increased the pass rate to 75 percent, effective July 2010. Little is known about IMGs with respect to how much they borrow overall, or the outcome of their medical studies, leading some policy makers to question the federal return on investment in IMGs. Therefore, Congress mandated that GAO study the performance of IMGs educated at these schools and other aspects of a foreign medical education, including the potential effect of the new 75 percent pass rate requirement on school participation in the federal loan program. This report examines the following questions: 1) What amount of federal student aid loan dollars has been awarded to U.S. students attending foreign medical schools? 2) What do the data show about the pass rates of international medical graduates on license examinations? 3) To what extent does Education monitor foreign medical schools' compliance with the pass rate required to participate in the federal student loan program? 4) What is known about schools' performance with regard to the institutional pass rate requirement? 5) What is known about where international medical graduates have obtained residencies in the United States and the types of medicine they practice?

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College studentsEducational facilitiesForeign medical studentsGraduate educationMedical educationMedical schoolsMonitoringPhysiciansSchoolsStudent financial aidStudent loansStudents