A study by Signer and Crowley1 appearing in this issue of The Journal addresses important matters related to medical training. The students described seek clinical instruction in the United States to complement or finish their program of medical education while enrolled in foreign medical schools, primarily in the Caribbean Basin or Mexico.
These circumstances are of concern because they differ from the usual entry pathway to clinical experience and differ from the educational relationships common to most US medical schools. The requirements for enrollment, examination of the credentials, and evaluation of the performance of these students are variable. This raises important questions regarding readiness and outcome. Also in question is the comparability of credit derived from such experiences with the credit given students enrolled in an approved program of medical education evaluated by the Liaison Committee on Medical Education (LCME). Approval by the LCME requires the examination of admissions