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U.S. Department of Education

 

Dominican Republic

 
Prepared April 2015
 
Background
 
In October 1997 the National Committee on Foreign Medical Education and Accreditation (NCFMEA) first determined that the accreditation standards used by the Dominican Republic to evaluate medical education programs leading to the M.D. or equivalent degree were comparable to standards of accreditation used to evaluate medical education in the United States.

The NCFMEA reaffirmed its prior determination of comparability in October 2012 after requesting additional information from the country regarding various issues of concern, including: collection and analysis of outcome measures, and data regarding student retention. At that time, the NCFMEA also requested that the Dominican Republic submit an update report for review at the Spring 2014 meeting. The country's report on its activities and student outcomes data is the subject of this analysis.

 
Summary of Findings
 
Based on its review of the report submitted by the Dominican Republic, Department staff concludes that the Dominican Republic has provided the information requested by the NCFMEA. It appears that there have been no major changes in the standards and processes that were last determined to be comparable by the NCFMEA in October 2012. Department staff also concludes that the accreditation activities during the past two years appear to be consistent with the NCFMEA guidelines.
 
Staff Analysis
 
 
Current status of medical schools
 
Country Narrative
Currently, there are twelve (12) medical schools operating in the country. Exhibit 1 presents a list of these schools, indicating the most recent date each school has gone through the accreditation review process and the school's current accreditation status. (Exhibit 1: Medical Schools and Accreditation Status in the Dominican Republic)
 
Analyst Remarks to Narrative
The country has provided a list of its twelve, currently-operating medical schools as well as each school's current accreditation status. However, the most recent date that each school has gone through the accreditation review process is not evident from the chart provided. In the following section, the country states that 11 of the 12 medical schools will be reviewed during "this period" but more information is needed regarding the schedule of each school's review of accreditation.

Exhibit 5 suggests that 11 of the 12 schools will be reviewed in 2016.
 
Country Response
The Schools of Medicine accredited in 2008 remain in compliance with the standards. This has been determined through the annual follow-up visits and reports, which have been submitted by MESCyT to DOE.

In 2015 Schools must submit their self-study reports to MESCyT (see Exhibit 1 for an updated schedule). External Evaluations, which include on-site visits, will take place during 2015 and 2016, in accordance to the dates in which self-studies are received at MESCyT.

Exhibit 1: Calendar for evaluation and accreditation of Schools of Medicine in the Dominican Republic.

Exhibit 2: Letter and report sent by MESCYT to UCNE´s School of Medicine with returned The Self-Assessment
 
Analyst Remarks to Response
The agency provided documentation clarifying the most recent dates that each school has gone through the accreditation review process and the schedule of each school's review of accreditation.
 
Staff Conclusion: Comprehensive response provided
 
Overview of accreditation activities
 
Country Narrative
The National Standards for the Approval, Regulation, and Accreditation of Medical Schools defines the follow up visits that must performed to medical schools.(See excerpt below)

CHAPTER 6: INSTITUTIONAL IDENTITY

e. Likewise, annual follow up visits shall be performed to accredited medical School in order to verify that they maintain compliance with these rules and to follow up on improvements; these visits include the national and international clinical facilities used by the institution for its practices.


All accredited schools, as well as the clinical clerkships sites, both those located in the Dominican Republic and abroad (Puerto Rico and New York) were visited each year to verify continued compliance with the standards. (Exhibits 2. – 2.9), clinical sites (Exhbits 2.10-2.16), and international clerkship sites (Exhibits 2.17-2.21.2)

During 2013 MESCyT developed and revised the evaluation form used for the self-study, which is based on the National Standards for the Approval, Regulation, and Accreditation of Medical Schools, Revised and Updated Version 2012.

In 2014, MESCyT sent provided evaluation forms stating the deadline established by the Accreditation System of Medical Schools of the Dominican Republic to chancellors and deans of medical school (EXHIBIT 3).

Also in 2014, MESCyT offered technical assistance to medical schools undergoing the self-study process.

2.5.1 PHASE I: Internal evaluation or Self-Assessment

The Department of Medical Education provides medical schools with a self-assessment instrument that must be completed and supported with documented evidence, in a time frame not greater than one (1) year. The self-assessment allows the school the opportunity to demonstrate it compliance with the quality standards for Medical Schools. Schools must submit information on the students´ and graduates’ performance.

The schools must also establish an Internal Self-Assessment Committee for the self-study process, consisting of members representing the various department of the institution (both academic and administrative).

MESCyT provides evaluation forms used as basis of the self-assessment, and offers technical support to institutions throughout the process.
When schools have completed the self-evaluation process, they are required to directly submit their report to MESCyT.

Of the 12 medical schools, 11 will be evaluated during this period:
1. Universidad Autónoma de Santo Domingo, UASD
2. Universidad Iberoamericana, UNIBE
3. Pontificia Universidad Católica Madre y Maestra, PUCMM
4. Universidad Católica Tecnológica del Cibao, UCATECI
5. Universidad Católica Nordestana, UCNE
6. Universidad Central del Este, UCE
7. Instituto Tecnológico de Santo Domingo, INTEC
8. Universidad Nacional Pedro Henríquez Ureña, UNPHU
9. Universidad Tecnológica de Santiago, UTESA, Santo Domingo
10. Universidad Tecnológica de Santiago, UTESA, Santiago
11. Universidad Eugenio María de Hostos ´´UNIREMHOS´´


The program of O&M medical school was initially approved in August 2013. Therefore per Chapter 6 of the National Standards for the Approval, Regulation, and Accreditation of Medical Schools, this school will be evaluated after two years of operation.

ACCREDITATION CONFERENCES OR TRAINING SESSIONS HELD, ETC.

See EXHIBIT 4.Participation in conferences and meetings.
 
Analyst Remarks to Narrative
The country has provided several attachments documenting monitoring visits, evaluation visits to clinical clerkships, and a listing of several conferences and meetings. Notably, it appears that the country made visits in 2013 to clinical sites throughout NYC, as well as monitoring visits in 2012, 2013, and 2014 to the two medical schools on "pending accreditation" status.
 
Laws and regulations
 
Country Narrative
There have been no changes since 2012 in the country´s laws or regulations regarding accreditation of medical schools.
 
Analyst Remarks to Narrative
The country states that there have been no changes to the country's laws and regulations that affect the accreditation of its medical schools.
 
Standards
 
Country Narrative
There have been no changes since 2012 in the accreditation standards that the Country uses to evaluate and accredit medical schools.
 
Analyst Remarks to Narrative
The country states that there has been no changes to their standards since 2012, when it was last before this Committee.
 
Processes and procedures
 
Country Narrative
There have been no changes since 2012 in the evaluation and accreditation processes and procedures that the Country uses to evaluate and accredit medical schools.
 
Analyst Remarks to Narrative
The country states that there have been no changes since 2012 to its evaluation and accreditation processes, though in a previous section, the country mentioned changes in 2013 to its site visit evaluation form to conform with the change in their standards in 2012.
 
Schedule of upcoming accreditation activities
 
Country Narrative
See EXHIBIT 5. Schedule of upcoming accreditation activities.
EXHIBIT 5.1 Letter from UCNE to MESCYT submitting the self-study.
 
Analyst Remarks to Narrative
The country has provided a schedule of upcoming accreditation activities which include a comprehensive visit to 11 of its 12 medical schools in 2016. It appears from the document provided, that medical schools are in the process of submitting their self-studies to the MESCyT at this time.

The remaining medical school, "O&M" is under a "pending accreditation" status and is subject to monitoring visits.
 
Outstanding Issues
Please provide data on USMLE performance of US students and residency placement.
 
Country Narrative
This report includes data for 2012 and 2013. Data from 2014 will be collected three months after the calendar year has ended, as established in the National Standards, Chapter 15. (Exhibit 6 – 8.1)
 
Analyst Remarks to Narrative
Exhibit 6 provides information by institution for USMLE pass rates of American students for Step 1, Step 1 CS, and Step 2 CK. Passage rates for Step 1 of the exam reflect a vast range among the institutions that host American students.

The country has further provided information regarding residency placement of graduates for 2012 and 2013 in Exhibits 8 and 8.1, respectively. However, the information is by individual student and the chart does not reflect which students are American students. It appears from the information provided that all graduates were placed in a residency, but further clarification is requested from the country.
 
Country Response
Data submitted in EXHIBITS 8 and 8.1 belongs to graduates from different cohorts who entered into a residency program in the years 2012 and 2013. However, the information is not classified by citizenship, year of graduation, nor it includes the amount of applicants in order to establish a placement rate, since these data was not requested to the schools at that moment.

In response to the Analyst remark and in order to supplement the information already submitted, MESCyT requested Schools to prepare and present a report showing US graduates from 2012 and 2013 who were placed in residency programs. See Exhibit 2 for data from schools that have been able to collect this information from the National Resident Matching Program. MESCyT does not have direct access to this information and is awaiting further response from the Schools.

It is important to take into consideration that the year of graduation may not be the same as the year in which graduates are placed in a residency program, since in order to be eligible to apply for residency in the U.S., International Medical Graduates (both U.S. and non- U.S.) must not only pass the USMLE, but also need to obtain the ECFMG certification. In order to be eligible in the Dominican Republic, graduates must complete a 1 Year Internship and acceptably complete the National Residency Program. Unfortunately, the number of available places is limited in both countries.

Exhibit 3: Graduates from Schools of medicine, years 2012 and 2013 who entered residency programs in the United States and Puerto Rico.
 
Analyst Remarks to Response
The agency clarifies why the information provided is by individual student and why the chart does not reflect which students are American students. In response to the Department's draft analysis MESCyT requested Schools to prepare and present a report showing US graduates from 2012 and 2013 who were placed in residency programs. See Exhibit 2 for data from schools that have been able to collect this information from the National Resident Matching Program. MESCyT does not have direct access to this information and is awaiting further response from the Schools.
 
Staff Conclusion: Comprehensive response provided