A stiff battle is raging between medical schools in New York and their Caribbean counterparts over the established practice, in many among the latter, of sending their students to hospitals in the state for practical training or internships, according to a recent report in The New York Times.

For a long time now, leading med schools in the Islands - such as the schools in Ross University and St. George's University in Grenada - have been luring students from the U.S. and elsewhere with the promise of providing crucial clinical experience in American (and particularly New York) hospitals during the third and fourth years of study. But now, 16 med schools from New York are reportedly launching an aggressive campaign with the NY State Board of Regents, which supervises all educational activity within the state, to make it significantly more difficult for the Island schools to partner with state hospitals and use the latter's facilities to offer a critical part of the curricular training.

According to the report, graduates of foreign medical schools in the Caribbean and elsewhere constitute more than a quarter of the residents in United States hospitals. Medical schools in New York complain that Caribbean students, while qualitatively inferior to graduates from domestic schools compete on an equal basis for clinical slots in hospitals; they also pay for these slots whereas traditionally New York schools have never paid anything as hospitals considered it a privilege to be associated with universities.

The anger and frustration are also partly caused by the perception that students studying in the foreign schools have poorer academic and professional merit as the entry requirements and rigor of the course are both substantively lower. Neither do the schools have to go through the same accreditation process as US schools. A June 2010 report from the Government Accountability Office claimed that 27 percent of international medical school graduates failed to pass the USMLE Step 1 Basic Sciences exam during the first attempt while only 6 percent of students from US medical schools failed. These scores are a significant parameter for getting into a US residency.

The lobbying schools from New York now demand that the state should impose the position of the American Medical Association in this regard which lays down that the core clinical curriculum of a foreign medical school should be provided by that school and that U.S. hospitals should not provide substitute core clinical experience.  This would mean that Caribbean med students could only come to New York for elective study during the fourth year and not for clinical training in the third.