More med students facing background checks

Substance abuse and a murder in Arkansas are among the incidents that prompted schools to dig deeper into students' pasts.

By Myrle Croasdale — Posted Nov. 7, 2005

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Criminal background checks for medical students may one day be the norm.

Pressured by hospitals and health care organizations, more medical schools are checking out students' backgrounds before they start classes, medical educators say. While the issue has been on the table for a while, a 2004 murder by an Arkansas medical student heightened awareness.

At least 28 of the 145 U.S. medical schools are screening students this year. That number is expected to increase after the Assn. of American Medical Colleges recommended this summer that all of its members conduct background checks and as the American Assn. of Colleges of Osteopathic Medicine considers the issue.

"It's part of an overall attempt to clean up the profession," said Judith Westman, MD, associate dean for student affairs and medical education administration at Ohio State University College of Medicine and Public Health. "There is a better realization that medical students are people too, and we can't assume just because they're intelligent that they are immune from character flaws or other issues."

But the shift doesn't come without questions.

For example, Tom Levitan, AACOM vice president for research and applicant services, said schools need to decide whether to charge students for the background checks, which can cost between $40 and $100 per student.

Schools also need to consider how they will respond when something negative is discovered, he said.

"Juvenile data appears in some states; in others it doesn't," Levitan said. "What do you do with someone who is 25, but at 17 had a DUI arrest? Is reform possible? That's where all these questions start to get very complicated."

Schools in Ohio, Iowa checking records

Background checks gained more attention last year after Robert Howard, a student at the University of Arkansas for Medical Science College of Medicine, murdered his neurosurgeon wife and then committed suicide. Howard's violent history and first-degree assault guilty plea were available through a criminal background check, according to newspaper accounts.

A university spokeswoman said the school intends to add background checks but has not finalized plans.

A less high-profile incident at The Ohio State University prompted the med school there to start performing criminal background checks in 2004.

In June of that year OSU medical school officials discovered that two graduates would not be able to begin their residencies. The state denied their medical licenses because of substance abuse records that showed up during the medical board's routine criminal background check. While the new graduates would be allowed licenses once they documented their successful recovery, their training was delayed.

To prevent future surprises, the school now fingerprints the students it accepts and sends the data to Ohio State Police and FBI repositories, Dr. Westman said. Students with a record of violent crime, domestic abuse, child abuse, sexual misconduct or voyeurism are dismissed, she said.

Accepted students with DUI charges or other substance abuse issues are given the opportunity to deal with their problems. Appeals are allowed, and to date two incoming students with past substance abuse records are attending classes.

At the University of Iowa Roy J. and Lucille A. Carver College of Medicine, hospital pressure two years ago pushed the school to start checking newly admitted students for criminal histories. So far, students have taken the change in stride.

"We haven't had concerns expressed by applicants. Everybody understands it's there to benefit patient safety," said Catherine Solow, assistant dean of student affairs and curriculum. She advised other schools to "make sure your process and procedures are clear to applicants, so they understand what is required of them and how their information will be dealt with."

Leana Wen, president of the American Medical Student Assn. and a student at Washington University in St. Louis School of Medicine, hasn't undergone a background check herself, but said that if it's a way to promote ethical behavior, she supports the practice.

"It's important to foster professionalism throughout students' training," Wen said.

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