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U.S. Department of Education

 

Special Report

 
Prepared April 2017
 
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 requested that the Dominican Republic submit an update report for review at the Spring 2014 meeting. At the Spring 2016 NCFMEA meeting, the committee requested the Dominican Republic submit a report on US Medical Licensing Examination (USMLE) data. The country's report on additional information about USMLE data is the subject of this analysis.

 
Summary of Findings
 
None
 
Staff Analysis
 
 
Outstanding Issues
US Medical Licensing Examination (USMLE) pass rate and residency placement data for the one medical program which the MECSyT was not able to obtain for the Spring 2016 meeting; and
 
Country Narrative
At the NCFMEA spring 2016 meeting, the Dominican Republic presented data and information about the medical schools in the country, including student and graduates pass rates on the USMLE exams and residency placement data. The report submitted to the Committee on March 23, 2016 by MESCyT included data provided by the Autonomous University of Santo Domingo (USAD) on residency placement for the period of 2012 to 2015.

At that time, however, the Universidad Autónoma de Santo Domingo (USAD) had not been able to provide USMLE data. Since the last NCFMEA meeting, UASD has strengthened its follow-up mechanisms for students and graduates of the Medical School though its Office of Credential Validation and Student Follow-up in its Faculty of Health Sciences. In addition, USAD established an agreement on April, 2016 with the Educational Commission for Foreign Medical Graduates (ECFMG) to receive official USMLE results.

This additional report, provided as Exhibit 1, completes the data on the results of students and graduates who took the USMLE between years 2012-2016 reported by UASD.

Exhibit 1: UASD’s USMLE pass rate and residency placement for 2012-2016
Exhibit 1.1: UASD´s List of residency placement for 2012-2016
Exhibit 2: Copy of report submitted by MESCYT on March 23, 2016 to NCFMEA.
Exhibit 2.1: Copy of Exhibit 11.1 provided by MESCyT to the NCFMEA in the report submitted on March 23, 2016: Universidad Autónoma de Santo Domingo (UASD) list of residency placement.
 
Analyst Remarks to Narrative
The Country provided United States Medical Licensing Examination (USMLE) pass rate and residency placement data for the Universidad Autonoma de Santo Domingo (USAD), which was not able to be obtained for the Spring 2016 meeting (exhibits 1 and 1.1). The data provided in exhibit 1 displays USMLE pass rate information for 2015 and 2016 only. In addition, it appears that no US students took the USMLE in 2016. The agency information provided for the USMLE data also demonstrates that information is not available for 2012-2014 US students. The country should provide additional information explaining if and when USMLE data will be available for 2012-2014 and when that data could be provided to the NCFMEA.
 
Country Response
The Universidad Autonoma de Santo Domingo, UASD, obtained an Aggregate Performance Data for USMLE results provided by The Foundation for Advancement of International Medical Education and Research, FAIMER, and presented a report to the Ministerio de Educacion Superior, Ciencia y Tecnologia in order to complete the USMLE data for 2012-2014.

Please find attached as EXHIBIT 1 USMLE results for 2012 to 2014 for UASD.
 
Analyst Remarks to Response
In response to the draft staff analysis, the country provided aggregate USMLE performance data for the Universidad Autonoma de Santo Domingo to address the request for additional information (exhibit1).

Department staff accepts the country's additional documentation, and no additional information is requested at this time.
 
Staff Conclusion: Comprehensive response provided
 
Any additional information about if and how MESCyT considers USMLE pass rates and residency placement data in the context of MESCyT's review of medical programs.
 
Country Narrative
MESCyT has established within its National Standards for Approval, Regulation and Accreditation of Medical School in Chapter 15 “Results of the formative program” that a Medical School must develop mechanisms which allow them to identify and demonstrate the achievement of its educational objectives. For this purpose it will establish a data base which will allow the authorities of the Medical School to evaluate program´s effectiveness and graduate performance. In that sense, it will obtain and analyze results of its students and graduates on national and international exams, including the USMLE. MESCyT requires that Schools use this data, along with additional data that indicate the results of the academic program to enhance their curriculum and keep it up to date, improve the teaching and learning processes, define staff development plans, among other activities. The Schools inform MESCyT during the follow-up visits regarding these different aspects.

For example, Medical Schools design and implement faculty development initiatives, undergo curriculum redesign, and provide advising and mentoring programs for students on how to adequately prepare for the USMLE in order to obtain satisfactory results, and how to apply to residency programs in the US.
MESCYT considers that USMLE and residency placement results are important as they contribute to evaluate the impact of the academic program.


EXHIBIT 3: National Standards for Approval, Regulation and Accreditation of Medical School, 202, MESCYT
EXHIBIT 4: Clinical Skills Mock Simulation Blueprint UNIBE
EXHIBIT 5: Academic Advising and Mentoring Program. UNIBE
EXHIBIT 6: Behavioral Science Lecture. INTEC.
EXHIBIT 7: Universidad Católica Nordestana resolution regarding USMLE
 
Analyst Remarks to Narrative
In response to the National Committee on Foreign Medical Education Accreditation's (NCFMEA) request, the Country provided additional documentation on how consideration is given to USMLE pass rates and residency placement data in the context of the Country's review of medical programs. The country provides exhibits 3-7 as supporting documentation to the criteria, however, the Country does not provide explanations within the narrative of how the documents relate to this question. Specifically, the Country states that they have "established within its National Standards for Approval, Regulation and Accreditation of Medical School in Chapter 15 "Results of the formative program" that a Medical School must develop mechanisms which allow them to identify and demonstrate the achievement of its educational objectives," however, Chapter 15 of the National Standards for Approval, Regulation and Accreditation of Medical Schools provided is the same submission of 2015 and has not been updated with this information.

The Country should provide additional information explaining how the USMLE pass rates and residency placement data of medical programs is reviewed and how consideration is given to USMLE pass rates and residency placement data in the context of the Country's review of medical programs. It is also unclear how the exhibits provided relate to this consideration and review.
 
Country Response

MESCYT establishes standards, policies and procedures to evaluate medical schools and the quality of the medical education provided (National Standards for Approval, Regulation and Accreditation of Medical School, 2012). Compliance with the standards is expected to enable graduates to practice nationally and internationally with high professional standards, as well as to continue postgraduate training, and meet the requirements of the national licensing body and the different international licensing agencies.

In the Dominican Republic the USMLE is not used as a requirement to enter in a residency program nor to obtain a license. MESCYT does not mandate specific benchmarks for USMLE outcomes. MESCYT considers the USMLE pass rate and residency placement data as one of several tools that can provide indication of quality, and includes these data within the review of medical program. Schools are requested to report and analyze these results in their assessment of the effectiveness of its academic program, as well as graduates performance.

Schools are required to annually obtain and submit to MESCYT the results of its students and graduates on national and international exams, including the USMLE, as well as residency placement data both in the country and internationally. MESCyT requires that Schools use this data to improve their program. When institutional goals are not being met, schools must provide MESCYT with action plans, that may include initiatives to enhance their curriculum, improve the teaching and learning processes, design staff development plans, strengthen administrative structure, among others. The Schools should inform MESCyT during the follow-up visits regarding these different aspects. Exhibits 4-7 presented in the previous report are evidence of the information provided by schools to satisfy this requirement, as they are examples of resources and initiatives produced and used by schools to help students obtain satisfactory results.
 
Analyst Remarks to Response
In response to the draft staff analysis, the country provided additional explanation regarding the country’s medical schools. In particular, the country explains that although USMLE is not a requirement for residency programs or licensure, USMLE pass rates and residency placement data is considered as one of several tools used to assess quality, effectiveness, and graduate performance of the medical program. The country evaluates the quality of medical education provided and compliance of the medical school with the established standards, policies and procedures of the country (exhibit 1). The country further explains that the evidence included in the previous report demonstrates information provided by schools to satisfy the aforementioned compliance requirements and resources and initiatives produced and used by schools to help students obtain satisfactory results (exhibits 4-7).

Department staff accepts the country's additional documentation, and no additional information is requested at this time.
 
Staff Conclusion: Comprehensive response provided