IT IS estimated that there are presently 3,715 American-born students who are forced to leave the United States to study medicine in a foreign country, in a foreign tongue. 1(p912) These students are highly motivated to study medicine. In many cases, they would have gained admission to a US medical school had there been enough places. Many come from affluent families, as do their brothers in US medical schools. Others scrape or borrow to meet the financial obligations to complete their studies. Depending on the school to which they are admitted, students may have to begin their training at the premedical school level, eg, in Italy, France, and Belgium (some schools), or they may receive one year's credit exemption for the premedical work performed during their four-year US bachelor's program. In many cases, they are helped in their admission to French medical schools by commercial entrepreneurs using a "packaged plan"