Robert F. Sabalis, PhD

1
Criminal Background Checks forApplicants
AcceptedtoHealth Professions Schools

• Robert F. Sabalis, PhD
• Associate Vice President
• Student Affairs and Programs
• March 16, 2006

2
AAMC Executive Council Action

• In June 2005, the AAMC Governance approved the
  Group on Student Affairs (GSA) proposal that
  criminal background checks be completed on all
  applicants accepted annually to medical school
• Four major purposes for checks
• Maintain the public trust in medicine
• Ensure the safety and well-being of patients
• Assist applicants/students to enter clinical
  clerkships and be licensed as physicians
• Limit schools and hospitals liability

3
Medical School Involvement

• A need for active medical school involvement in
  defining criminal background check (CBC)
  requirements
• Affiliated clinical institutions policies are
  mandating CBCs
• States statutes are mandating CBCs
• Applicants need accurate information
• Admission decisions are a faculty responsibility

4
Other Health Professions?

• CBCs discussed at a 2/1/06 FASHP meeting
• General interest and concern expressed
• Different approaches to the CBC challenge
• Some associations have promoted a decentralized
  approach to CBCs
• Other associations only now beginning this
  discussion
• Cost of CBC identified as a factor
• Some professions leaving the CBC decision to
  licensing boards rather than schools

5
AAMC Background

• Expectations of the public?
• Two-fifths of state medical boards require (or
  can require) CBCs of licensure applicants
• But school employees, volunteers, and others must
  have them
• In the face of societal stressors and recent
  medical school events, the public is seeking
  reassurance where it can
• Federation of State Medical Boards recommended
  that member boards seek legislation to permit
  CBCs for licensure applicants

6
GSA Recommendations

• One year in development, 2004-2005
• 1/4 of schools currently performing CBCs
• Others schools are considering them, but waiting
  for guidance
• Schools want national process through AAMC
• Cost-effective for applicants, with
• Consistent and comprehensive results
• Schools want to retain authority for
  decision-making, but desire guidelines for
  interpretation of CBC data

7
GSA Recommendations

• CBC be completed upon first school acceptance
• Same CBC report be available to all schools that
  later accept the same applicant
• CBCs be part of post-acceptance matriculation
  process, not of application/interview process
• Matriculation decision follow schools review of
  CBC report
• Applicant authorize CBC and receive report
• Each schools faculty develop relevant CBC
  policies in collaboration with clinical
  affiliates

8
GSA Recommendations

• Factors to be considered when CBC reveals
  information of concern include
• Nature, circumstances, frequency of offense(s)
• Length of time since offense
• Documentation of successful rehabilitation
• Accuracy of information provided by applicant
• One comprehensive CBC be done, with each school
  getting all data that it desires and permitted by
  law
• Each school should develop guidelines for CBC
  data handling

9
GSA Recommendations

• CBCs should
• Be based on past areas of residence
• Include in-person search at local county level
• And search at state and national levels
• Not be completed solely via computer databases
• Include sex offender search
• Include search for dishonorable discharge from
  Armed Forces

10
GSA Recommendations

• CBC should involve
• All levels of offense
• All types of adjudications
• All unresolved legal processes
• All types of offenses
• Arrest data only when case has not been fully
  adjudicated otherwise only conviction data

11
GSA Recommendations

• CBCs should not be limited to specific time
  period, given age range of applicants
• GSA should develop guidelines for consideration
  by schools about use of CBC data
• Schools should consider the uneven administration
  of justice in the US for minority and
  disadvantaged persons in decision-making
• School policies on CBCs should be developed
  separately from policies about medical and
  psychiatric conditions and disabilities

12
Unanswered Questions

• Where should CBC data be housed?
• Which school officials should have access?
• Should data be shared between school offices?
• Should terrorist search be included?
• What about juvenile/expunged records?
• Should CBCs include fingerprinting, search for
  professional license revocation, and/or drug
  screening?

13
Current Status

• 18-member AAMC CBC Advisory Committee met
  2/13-14/06 in DC
• Composed of AAMC constituent and external,
  medically related groups
• Adopted nine goals for CBCs
• Simplicity Transparency
• Equity Affordability
• Accuracy Risk mitigation
• Community involvement
• Ownership by medicine
• Effectiveness/success

14
Current Status

• CBC Advisory Committee recommended
• An AAMC-sponsored centralized, national CBC
  service
• Implementation of the GSA recommendations
• Revision of AMCAS application to collect
  additional self-report criminal history
  information to be checked against CBC report
• CBC reports should exclude
• Juvenile offense data
• Arrest (without conviction) data

15
Current Status

• CBC Advisory Committees recommendations will be
  presented to AAMC Governance in June 2006
• Earliest implementation date fall 2007 for fall
  2008 entering class
• Information being sought about schools, states,
  and clinical affiliates requirements
• GSA starting to develop best practice
  guidelines for use by schools

16
Lessons Learned

• An emotionally charged topic requiring more time
  for discussion and working through than
  expected
• Potential exists for a wide variety of
  requirements from schools, states, and affiliated
  facilities
• Schools must get out ahead of this discussion
  before others mandate widely divergent
  requirements and systems
• The complex decision for or against checks is
  only part of the equation implementation is also
  very complex

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