This legislation, titled the Foreign Medical School Accountability Fairness Act of 2026, seeks to amend the Higher Education Act of 1965 to establish fair and consistent eligibility requirements for graduate medical schools located outside the United States and Canada. Its primary purpose is to increase accountability and protect United States students and taxpayer dollars by ensuring all foreign medical schools adhere to the same standards for participation in federal student loan programs. Congress found that some for-profit Caribbean schools historically received substantial federal funding despite being exempt from eligibility requirements applicable to most other foreign medical schools, leading to concerns about high attrition rates and lower residency match rates. A key provision of the bill is the repeal of grandfather provisions that previously allowed certain foreign medical schools to bypass specific eligibility criteria. Under the new requirements, foreign graduate medical schools must ensure that at least 60 percent of their enrolled students and graduates are not U.S. citizens or permanent residents, and at least 75 percent of their students and graduates pass the examinations administered by the Educational Commission for Foreign Medical Graduates (ECFMG). For schools that lose eligibility due to these changes, students already enrolled on the date of enactment may continue to receive federal loans for a limited period, specifically until withdrawal, program completion, or four years after the loss of eligibility.