Policies on U.S. citizens studying medicine abroad are reviewed, based on visits to six foreign medical schools in the Caribbean, Mexico, and Europe, which have about 5,400 U.S. citizens studying medicine, or about half of the total estimated number. The following areas are considered: education and training provided, clinical training in U.S. hospitals provided by U.S. citizens studying in foreign medical schools, avenues available for entering the American medical system, and federal financial assistance in the form of guaranteed student loans and educational benefits provided to these students. It is found that many U.S. citizens attend foreign medical schools with the goal of returning to practice in this country; however, the education and training provided by some of these schools vary greatly and may not be comparable to that offered in U.S. schools. It is recommended that more appropriate mechanisms be developed to ensure that all students who attend foreign medical schools demonstrate that their medical knowledge and skills are comparable to those of their U.S.-trained counterparts before they are allowed to enter the mainstream of American medicine. Alternatives to be considered in accomplishing this objective are suggested, including admission with advanced standing. Recommendations concerning guaranteed student loans and educational benefits, and U.S. hospital clinical training of foreign medical school students are also offered. Appendices include information on qualifying examinations, foreign medical schools, accrediting organizations in the United States, and communications among agencies. (SW)