II 118th CONGRESS 2d Session S. 4744 IN THE SENATE OF THE UNITED STATES July 23, 2024 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. Short title This Act may be cited as the Foreign Medical School Accountability Fairness Act of 2024 . 2. Purpose The purpose of this Act is to establish consistent eligibility requirements for graduate medical schools operating outside of the United States and Canada in order to increase accountability and protect United States students and taxpayer dollars. 3. Findings Congress finds the following: (1) Three for-profit schools in the Caribbean have historically received nearly ¾ of all Federal funding under title IV of the Higher Education Act of 1965 ( 20 U.S.C. 1070 et seq. ) that goes to students enrolled at foreign graduate medical schools, despite those three schools being exempt from meeting the same eligibility requirements as the majority of graduate medical schools located outside of the United States and Canada. (2) The National Committee on Foreign Medical Education and Accreditation and the Department of Education recommend that all foreign graduate medical schools should be required to meet the same eligibility requirements to participate in Federal funding under title IV of the Higher Education Act of 1965 ( 20 U.S.C. 1070 et seq. ). (3) The attrition rate at United States medical schools averaged 3.2 percent between 1998 and 2018, while rates at for-profit Caribbean medical schools have been known to reach 30 percent. (4) In 2024, residency match rates for foreign trained graduates averaged 67 percent compared to 93.5 percent for graduates of allopathic medical schools in the United States and 92.3 percent for graduates of osteopathic medical schools in the United States. (5) On average, students at for-profit medical schools operating outside of the United States and Canada amass more student debt than students at medical schools in the United States. 4. Repeal grandfather provisions Section 102(a)(2) of the Higher Education Act of 1965 ( 20 U.S.C. 1002(a)(2) ) is amended— (1) in subparagraph (A), by striking clause (i) and inserting the following: (i) in the case of a graduate medical school located outside the United States— (I) at least 60 percent of those enrolled in, and at least 60 percent of the graduates of, the graduate medical school outside the United States were not persons described in section 484(a)(5) in the year preceding the year for which a student is seeking a loan under part D of title IV; and (II) at least 75 percent of the individuals who were students or graduates of the graduate medical school outside the United States or Canada (both nationals of the United States and others) taking the examinations administered by the Educational Commission for Foreign Medical Graduates received a passing score in the year preceding the year for which a student is seeking a loan under part D of title IV; ; and (2) in subparagraph (B)(iii), by adding at the end the following: (V) Expiration of authority The authority of a graduate medical school described in subclause (I) to qualify for participation in the loan programs under part D of title IV pursuant to this clause shall expire beginning on the first July 1 following the date of enactment of the Foreign Medical School Accountability Fairness Act of 2024 . . 5. Loss of eligibility If a graduate medical school loses eligibility to participate in the loan programs under part D of title IV of the Higher Education Act of 1965 ( 20 U.S.C. 1087a et seq. ) due to the enactment of the amendments made by section 4, then a student enrolled at such graduate medical school on or before the date of enactment of this Act may, notwithstanding such loss of eligibility, continue to be eligible to receive a loan under such part D while attending such graduate medical school in which the student was enrolled upon the date of enactment of this Act, subject to the student continuing to meet all applicable requirements for satisfactory academic progress, until the earliest of— (1) withdrawal by the student from the graduate medical school; (2) completion of the program of study by the student at the graduate medical school; or (3) the fourth June 30 after such loss of eligibility.