The Dominican Medical Association denounced there is an increasing number of foreigners practicing medicine illegally in the DR. To practice medicine here, a foreign graduate needs to validate medical studies with a local university and to carry out a year of service at a public hospital. At that point, legally the Executive Branch grants the person an "exequatur" or authorization to practice. At present, the Ministry of Health is in charge of regulating practitioners. In reality, exceptions to the rule are being made. The Universidad Central del Este of San Pedro de Macorís has been assisting some foreigners that have shown an interest in regularizing their status by validating their educational curriculum and providing them with medical service training in their center in Santo Domingo. Several of those going through this program have been granted "exequaturs", according to medical sources Now, Dr. Rafael Collado, president of the local Dominican medical organization, complained that there is no way to reinforce this. He said that Cubans make up the largest segment of illegal practitioners. There is concern about the quality of the training of some of the Cuban doctors. The AMD wants to make it mandatory that physicians register with that organization to be allowed to practice medicine. The AMD would oversee that the mandatory requirements are fulfilled.