Hello all,
Pitman alerted me to the questions in this thread as I am in a rather unique position to answer them. (This will be a somewhat long post)
First off, my name is Andrey Pavlov and I am currently the President of the Ochsner Medical Student Association (OMSA) which is the officially recognized student advocacy group for the Ochsner cohort of UQ students. Last year and the year before I was the Academic Officer of OMSA and I am currently in my final year of the program.
Both UQ and Ochsner recognize and liaise with us about Ochsner cohort specific issues, we are under the umbrella of Ochsner's 501(c)3 non-profit status, and have legal rights to use the Ochsner name and brand. As such we take our role very seriously and endeavor to make every effort to disseminate accurate information. Our website is currently up (
http://omsauq.org) but is still very much in development. As you can imagine, being a medical student makes extra curricular stuff like web editing and updating tough, but hopefully starting next week we will have more editorial access and control and much of the information and updates that are pertinent to these threads will be put up there. Our goal is transparency and clarity with what is actually going on and what that actually means for students.
Now to address the issues raised so far in this thread.
Firstly, there is a Facebook group for the class of 2017. It can be found here:
https://www.facebook.com/groups/488136277926647/
(I go by the handle of Docta Drey on FB)
Next, about recognition by CA and NY (and the rest).
This is a slightly complex issue that I will try and distill down to the fundamentals. First off one must realize where exactly the issue stems from. These are completely distinct between CA and NY.
CA: The CA Medical Board (MBC) views offshore degree granting institutions in two separate ways, each under section 1314 of the MBC rules and regulations. A 1314(a) school is one that is a foreign school that generates primarily foreign graduates. Flinders would be an example of a school that is unequivocally a 1314(a) school. A 1314(b) school is one that is created for the express purpose of generating medical graduates that will not be training or practicing in the country which the school is located. The Caribbean schools are prime example of 1314(b) schools.
The way MBC recognition works is based on the FAIMER /IMED list and a judgement as to whether a school is 1314(a) or (b). For (a) schools, the recognition becomes automatic with no further review necessary (as long as the school remains on the FAIMER/IMED list). A (b) school requires additional review that involves a submission of a Self Assessment Report (SAR) based upon which the MBC can decide upon 3 actions: approve, reject, or site visit. Once approval is made, then recognition is granted in the same manner as an (a) school with all graduates being fully recognized as long as the program is on the FAIMER/IMED list. This approval is instant and retroactive to the beginning of the school/program.
Now, here is where the MBC gets tricky and why this issue may not apply to other states that use CA's regs for approval. By all legal and technical standards, UQ and the Ochsner program is a 1314(a) program. The way in which accreditation for the program (necessary to maintain UQ on the FAIMER list at all) was done requires that we are eligible for Australian internship (which is why we have an extra 4 weeks tacked on to our Year 1 elective and have to return for a rotation in Year 4) and that Ochsner is a full clinical school of UQ. What this means is that, technically speaking, doing our clinical years at Ochsner is NOT doing them "outside of the country of our school" because, by all legal standards UQ now exists as a school in the US (like having a US embassy in a foreign country - technically that embassy is on US soil).
However, the MBC reserves the right to ignore the letter of the law and make a subjective judgement call on any program they wish. Which, honestly, is reasonable as long as they are intellectually honest about it and in this case is correct, regardless of the fact that we are technically a 1314(a) school. As such, the MBC has decided that we are more like a (b) school than an (a) school and thus required us to be reviewed. This is why I am unsure of what other states who follow the CA regs will do, because in most cases they either follow only parts of it or just the entirety of the regs and make their own assessments on individual schools (i.e. they don't approve or disapprove of schools based on the list generated by MBC but use the MBC regs to then make their own judgement calls on schools and programs). Furthermore, the reality is that when you apply to a program your degree comes from UQ and is no different than any Aussie student graduating so unless the program/state is told ahead of time that we are different they would have no reason to treat us any differently. So in a nutshell I would argue that most other states wouldn't be an issue since they don't even know to have it be an issue and because they use the same standards as CA but the issue with CA is not that we don't meet the standards but that they decided to exercise judgement BEYOND the standards to require a review of our program. (Hopefully that makes sense). I should add clearly that how other states that use some or all of CA regs/standards will view us is something I am speculating on and have not done the in depth research to be certain. However, when it comes to CA and NY specifically, I have indeed done the very in depth research and have been involved in the conversations about it at the highest levels at both Ochsner and UQ so I can speak confidently.
So, with all that, where do we stand? The reality is that this is (as was mentioned above) largely a non-issue. There is absolutely zero concern that MBC would approve the program. The only reason is hasn't happened yet is because CA is broke, they have been severely understaffed, and simply haven't actually done the review yet. That said, they did in fact do a preliminary review earlier this year and asked for more information. That was provided. Then in May, Dr. Bill Pinsky (the CAO and head of Ochsner Clinical School) went to Sacramento and explained to them in person more about the program. At that time they promised him that we would be reviewed at the next MBC meeting (which takes place starting today, July 18). Dr. Pinsky will be in attendance at the meeting to do whatever he can to have approval without a site visit, if possible. A site visit, should it occur, will be done and paid for by UQ/Ochsner and we once again have no doubt we will meet approval after that. It will merely be another delay in the process. Another point that Dr. Pinsky will directly raise to the MBC will be to ask if a graduate of the program can gain individual approval for residency/practice in CA prior to blanket approval of the program. As it stands, we believe that there is a means to do this, but the point is not clear and should be clarified by next week.
Someone above commented about concern for Ochsner being able to accommodate 240 students in the program. This is not a concern at all. They have been accommodating numbers like that for many years with LSU, Tulane, and other visiting students. As the program is ramping up the number of outside students will be decreasing to ensure the quality of our clinical education.
TL;DR: I am looking at a CA residency and am not worried about approval. It is a purely bureaucratic hangup that has delayed it thus far, and more answers will be known after the currently ongoing MBC meeting is completed. It seems possible for individual exemptions, though that will be clarified, and certainly none of this should be a concern for anyone just beginning the program. People in my year are the only ones that should have even an inkling of concern and even then, I am not.
Now, as for NY:
NY has a different schema for approval of offshore schools. This came about ENTIRELY because of the Caribbean school model with so many of them doing their clinical training at NY hospitals (NB that this is doing your clinicals in a "hospital outside your school's country" because the Carib school only CONTRACT with hospitals, which is fundamentally different than Ochsner as "belonging" to UQ in a legal sense). NY complained that their own home grown grads were getting shoehorned out by the Carib students and so it was deemed that no schools who did their training offshore would be approved and must go on a special "list" in order to be considered for licensure. This was purely to dissuade hospitals from granting clinical spots to offshore schools for money and encourage more opportunities for the homegrown med students.
That said, we once again technically fall under that umbrella. There is already an application for review to get on that "list" with NY for our program. However, the process is one that is even longer than CA and was actually not started until after CA so it is further away from approval at the moment (realistically looking at 2ish years, possibly sooner). That said, individual allowances for residency/licensure in NY are indeed currently possible despite not have blanket approval yet. Yes, it does mean that the process is a bit more onerous, but Ochsner is geared up and ready to help in any way possible in the interim, including phone calls to individual programs as necessary.
Once again, this is something that is of some concern to current Year 3 and 4 (and possibly 2) students, but should not be a concern for anyone starting the program next year or currently in first year.
TL;DR: While nothing can be 100% certain, it is quite reasonably safe to say that for anyone currently in Australia and certainly anyone looking to start the program next year there should be absolutely minimal concern about licensure in all 50 states.
More specifically JohnSnow's comment:
"The reasons UQ-Ochsner requires separate approval is because the program does not allow Australians to participate in the program, and the clinical school is located outside of Australia, and outside of the Medical Board of Australia's jurisdiction."
Is actually quite incorrect. The clinical school is in every sense a part of UQ and the Australian Medical Council (AMC - the accrediting body for all Aussie med schools) DOES have jurisdiction over Ochsner and has indeed reviewed it, done a site visit, and deemed it acceptable *as a part of UQ*.
Traditional students (which is what we call those not in the UQ-O program) can do up to 2 rotation or 4 months at Ochsner, in Years 3 or 4.
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Now for some other points that were raised:
"Do people end up paying twice in rent when you have to go back to Australia for 8 weeks at the end of year 4? Or can you plan it out so your lease in New Orleans ends before you go back?"
That is entirely your kettle of fish. The SoM has nothing to do with how you make your arrangements. In certain cases, depending on what you do and where you go back in Australia you *MAY* be able to get free or subsidized housing in Oz. You can potentially sublet your place in NoLa to a traditional student coming back here for a rotation (something that OMSA helps facilitate and will be part of the forum currently being built for our website). You could couch surf with friends you made in Years 1 and 2 (which is what I did when I went back). But ultimately it is entirely up to you and in the worst case should expect to pay double rent.
"Ok. And then should I not send any DO secondaries? Just a few MD secondaries and if I don't get in american MD by early December go UQ?"
As was commented on this is also an entirely personal decision. I personally abjured going to a DO school because of my own pride and ego. In retrospect I am genuinely glad that I made the decision I did, but must admit I did it for largely the wrong reasons. Especially now that the AOA and ACGME are merging into a single unified GME accrediting structure I would argue that DO is increasingly an attractive option. There is still a tiny bit of the old quackery of osteopathy left in DO programs but, unlike chiropractics which is still fundamentally based in quackery, it is truly historical and minimal and continuing to diminish. Once that is gone DO and MD will be truly a meaningless distinction. Currently is a practically meaningless distinction despite some historical stigma that lingers.
Hopefully that answers any questions people had and clears up some very reasonable concerns. Once I learn more about the results of the current MBC meeting I will post them up here. In the meantime please feel free to PM me any questions. Also PM me sometime at the end of next week if I haven't posted anything up by then. I may lapse on checking this thread since I am starting a new rotation on Monday and have no idea how busy I will be.
