By Lorraine Blasor
Special to News is my Business
Reeling from its sudden loss of accreditation, Caguas-based San Juan Bautista School of Medicine is considering all its options, including going to federal court to fight back against what it considers a “precipitated and unfair” decision by the national accrediting authority for medical education programs in the U.S. and Canada, News is my Business has learned.
Seeking an injunction would buy the school more time and allow it to retain accreditation until the court rules on the matter, according to information made available by a source. Another option is to ask the accrediting authority, known as the Liaison Committee on Medical Education, to extend the accreditation at least until the end of the year so as not to affect the current graduating class.
Loss of accreditation means that students at the school will not be able to take licensing tests and apply for residencies in specialized fields, either in Puerto Rico or the U.S. Beyond the immediate career implications for already enrolled students, especially those nearest to graduation who plan to further their medical education in specialty fields, there are serious financial concerns.
Many students now face having to repay school loans without being able to adequately complete their schooling.
Medical student Maria Román Delgado, now in her final year, felt cheated by the decision.
“I entered San Juan Bautista because it was accredited and now I will end my fourth year in a non-accredited school,” she said with frustration.
General Student Council President Ismael Ortiz Cartagena described the mood on campus as tense.
“Students are stressed out. It’s not just the students, but also their families,” he said.
School will not shutter
Despite the unexpected reversal, school authorities tried to put on a brave face before the situation. The school will not shut down and will continue to function as it did during the decades when it did not have accreditation, said Academic Dean Miriam Marquez.
One of four medical schools in Puerto Rico, San Juan Bautista opened in 1978 and in 2007 gained a 5-year accreditation, which would have been up for review in 2012. Marquez said the school graduates a diversity of students, including general practitioners who do not go on to specialization. Also known as a family doctor, a general practitioner can practice in Puerto Rico after taking a test and obtaining a local license that some mainland states, though not all, accept through reciprocity agreements.
“We have a group (of graduates) who works in federal programs, others have devoted themselves to clinical and translational research. The opportunities to practice medicine are diverse,” she said. ” Furthermore we have other programs such as a masters in public health and nursing.”
But Puerto Rico does not need general practitioners right now, countered Ortiz Cartagena, pointing to the dire need for specialists in the face of the serious flight of talent the island has been experiencing in recent years.
“No student at the school would have enrolled if the school had no accreditation,” he said, adding that more than 80 percent or more of the student body goes on to pursue residencies here or on the mainland
No reason given
The decision “to withdraw accreditation from the education program leading to the MD degree at the San Juan Bautista School of Medicine,” effective Oct. 3, 2011, came in a letter that said it was final but that the school could file an official comment with the U.S. Department of Education, with copy to LMCE.
While the letter itself did not specify the reason for the action, an official announcement on the LMCE website stated that it “was based primarily on the LCME’s assessment of inadequate clinical resources.”
Contacted by e-mail, LMCE Secretary Barbara Barzansky declined to comment, referring instead the matter directly to the school.
“The decision was unfair and precipitated,” said Marquez, going on to explain that it is tied to the problems of the San Juan Bautista Medical Center which operates in conjunction with the school.
The center, formerly the Caguas Regional Hospital, is based on the school campus but operates as a separate corporation. On March 18 of this year, the medical center filed for court protection under Chapter 11 because of a long-running dispute with the Puerto Rico Electric Power Authority, which threatened to shut off electric service. A story in businessweek.com said the hospital has a debt in excess of $10 million and is sorely underused. The average number of beds occupied per day is 85, out of a total of 375.
Marquez said representatives from LCME visited the school in April and expressed concern that if the hospital went into bankruptcy, the medical school would lose a site for clinical rotations, which provide students with practical clinical experience in different medical specialties.
In response to this finding, the school immediately scrambled to find alternate sites for clinical rotations, eventually lining up some 40 medical facilities, including hospitals, where students could do their required clerkships.
“We have evidence that we have these clinical facilities,” she said.
Apparently, LCME was not satisfied. ” We have no idea why they made that decision,” said Marquez.
San Juan Bautista could apply once again for accreditation sometime in the future, according to Marquez. However, she could not say how long the mandatory wait period is.
A costly decision
“Students can’t afford to wait months, they need the situation to be resolved now,” reacted Ortiz Cartagena, a third year medical student who wants to specialize in the field of nephrology. The impact of the accreditation loss is already being felt, he said: students who were preparing for licensing tests are getting e-mails notifying the cancellation of exams.
San Juan Bautista has an enrollment of 270 students, more or less on par with the Universidad Central del Caribe and the Ponce School of Medicine, whose accreditation is reportedly under probation. The main medical school on the island is at the University of Puerto Rico.
While the school administration ponders its options with stateside advisers, students also are looking for alternatives such as transferring to other institutions. The American Association of Medical Colleges has offered to provide assistance in relocating students, according to Marquez.
Meanwhile, at least one Caribbean medical institution appeared ready to muscle in and gain advantage of the situation, if comments posted on an online student doctor network are to be taken at face value. One posting by a person identifying himself as
“Charles, assistant vice president of Xavier University School of Medicine (in Aruba),” invited anyone who knew students from San Juan Bautista to refer them to his university.
He wrote: “We offer $500 for every student that you refer, if they enroll with us. You can visit our website at www.xusom.com or call our admission department toll free.”