Medical schools without walls. Self-instruction abroad.

A fraction of American citizens who are denied acceptance to domestic medical schools complete all or part of their education abroad. The different modes of instruction these students experience are discussed, as well as possible factors that lead a student to use one mode above another. The role of self-instruction in medical education is examined. Additionally, preclinical subject matter taught in a domestic institution is compared quantitatively in 4,067 categories with a curriculum offered in a foreign institution, as well as with a self-designed curriculum. Based on test performance on part 1 of the National Board of Medical Examiner's examination, we conclude that self-instruction can be an effective method for learning the basic science aspects of a medical school curriculum.