Caribbean Med schools

Hi


I am looking for thoughts on the plans I have been thinking about… I was looking online, almost just for fun, at first, at the Caribbean med schools. Then I realized that if I went to a Caribbean school, I could possibly be done 18 months earlier than if I went to a US MD or DO school. In addition, it could even be 2.5 years sooner, if I didn’t get accepted my first round in US schools.


My concern is the one that all my friends are asking, and that is, will it get you a residency and a job in the end. Will it be “good enough” or “Competitive enough” for getting a residency/job at the end of school. To me, 18 months is enough time to take a serious look at this, because it’s the difference between being done in my 30’s and being done in my 40’s… My husband is on-board with whatever I need to do… Let me know thoughts/comments/suggest ions/ideas etc… Thanks!

I surely have looked into it, but my first choice is a US school - as I want to practice medicine in US … so it only makes sense. And when being a doctor is all you can imagine for yourself, another year to get there to me does not sound too bad anymore!


So, having stated that I want to go to a US school … I still asked my advisor’s input on what she thought about Caribbean Med Schools? Here is what she said: you should only consider Top-4 schools out there if you really want to… and that means you need all the pre-reqs and MCAT. The med school as much as I know is still 4 years, with 2 years clinicals in US. And then is the residency.


I am not sure how that will save any time?

It depends on what you want to do. If you are pretty sure that you want to do one of the less competitive specialties - IM, Family Medicine, Psych in particular, you could be fine with the Caribbean. You will still be at at competitive disadvantage even in those specialties if you want to go to a competitive residency program.


There are a few threads on here discussing some of the pros/cons of the Caribbean. You might want to search for them. Yes, you can get done sooner (at least with the clinical part), but they have some disadvantages. The Carib schools do not provide nearly the support that US schools do in terms of academic support for years 1/2, preparing for the boards, preparing your residency application, etc. They tend to have a rather high failure/withdraw rate. You may have to do a lot of your own leg work when looking for clinical rotations (although a couple of the schools have pretty strong ties for them in some locations).


To paraphrase a popular saying around here: Do you want to be a doctor fast or do you want to be a doctor in a specialty of your choosing completing residency at a location of your choosing?



I completely agree with the above posters, but wanted to add that it might appear that rolling admissions gives you a jump when it doesn’t necessarily do that. I know that when I looked into the big 4 myself, the appeal of a shorter application process was a big factor for me. After looking more closely into it though, I found that a January or May start date (which are the less competitive entrance dates) might not coincide with Match Day correctly and delay things there. For me, that defeated the purpose of starting sooner. The fall entrance dates obviously don’t apply to that, but they’re much more competitive to get a spot in.


Another factor (based on what I’ve read/heard) is that some of the schools are having issues with clinical rotation placement and there are more potential delays there. I’ve seen stories about bottle-necking happening and people going into loan repayment while waiting for a spot. Also, you have to wait for your step 1 scores before starting clinicals which is another delay. From what I’ve seen on ValueMD, it appears that you finish your didactics and then go back home and take your first board exam. As far as I can tell, that can be as quick as a month later, or as long as a year, depending on what you do to prep for the test. That’s assuming you pass it the first go round.


Bottom line is that there are a few portions of the program where you could hit a snag and be delayed back to where you’d be if you’d just waited and tried for a US medical school. It seems dicey at best, which is why I’m going to try to apply to US schools first. Since I don’t want to complete a second application cycle, my plan is to wait until I know if I’ve received any invitations to interview with US med schools. If it appears I’m not getting any “bites” I’ll go ahead and apply for a spot in a big 4 school for either January or May. HTH. Best wishes to you!

There are approximately 18,000 US-based MD and DO graduates a year for about 26,000 residency slots. So the USA has to import 8,000 PGY-1’s a year. Sounds good until you compare the actual data. I did some data analysis on this for the 2009 match data


about 93% of MD seniors get matched


about 70% of DO senior get matched into allopathic


(this is misleading data as it doesn’t take into account DO who apply to both and who then go a DO residency which are not reported here match has remained consistent at about 70% for past 5 years)


about 47% of US citizens who go to foreign medical schools get matched (which has dropped from 54% in 2005. This would indicate that the expansion in medical school graduates may be taking a toll on Carib grads already).


about 41% of non-US citizens who apply for residency get matched. (in 2005 this was about 45%, so all grads from Carib medical schools, citizen and non-citizen are losing ground and the spread between citizen and non-citizen is getting thinner)


Ross, SGU and AUC historically have the better rates but I still want to see data from a source outside the school. Not all SGU, Ross, and AUC grads apply for US residency programs. SGU is making a big push into the student market from India.


In sum, it still seems from the senior medical school students from off-shore schools who do apply for US based residency programs do have a significantly worse match rate than US based medical school seniors and the rate has been steadily decreasing for the past 5 years.


I am including a link to a previous forum entry on a specific example in matching that goes across MD, DO, and FMG


http://www.oldpremeds.org/fusionbb/showtopic.php?t…



Thanks for your input. From what I’ve been told, it isn’t worth going Caribbean unless I have no other option. Also, it was pointed out that the matching won’t work unless the clinicals are done back to back to back, leaving no time for studying, etc… Then you’re out of the game for a year waiting for a residency… I like a sure thing, not so much of a gambler… So, I will apply, but it will not be my first choice… yes, I am planning on going to a primary care specialty, but still, I want to get a spot in a location of my choosing, not where its a last resort…

The Big 4 is really now only the Big 3 (Ross, SGU, AUC), if you attend SABA you cannot get government loans. The three Caribbean schools should only be considered if you want to become a MD in a non-specialty area (IM, FP, etc.) and you do not have the GPA and MCAT scores to get into US MD medical school.

Another thing to consider: unless something has changed recently, many states will not license foreign med graduates until they complete three years of residency (offshore included). Licensing is a tedious process under any circumstance, and best done during residency ASAP after passing Step 3.


I agree with the other posts regarding primary care specialties – we are facing a critical shortage of FMs, IMs and Gen Peds. All other things being equal, i.e. grades, LORs and evaluations from your stateside clinical rotations, graduating from an offshore school will not put you at a disadvantage if you intend to pursue primary care. In my experience, these residents tend to be very reliable and self-sufficient, precisely because they did not get the close supervision and hand-holding through med school as their US counterparts.

  • jmdmd Said:
Another thing to consider: unless something has changed recently, many states will not license foreign med graduates until they complete three years of residency (offshore included). Licensing is a tedious process under any circumstance, and best done during residency ASAP after passing Step 3.

I agree with the other posts regarding primary care specialties -- we are facing a critical shortage of FMs, IMs and Gen Peds. All other things being equal, i.e. grades, LORs and evaluations from your stateside clinical rotations, graduating from an offshore school will not put you at a disadvantage if you intend to pursue primary care. In my experience, these residents tend to be very reliable and self-sufficient, precisely because they did not get the close supervision and hand-holding through med school as their US counterparts.



The issue with licensing becomes even more problematic and more of a gamble when you examine the nuances of what goes on. In every state, the law creates a medical board or other administrative entity to make specific rules/standards, review applications, and issue licenses. Some years ago, California's medical board starting reviewing the off-shore medical schools, including occasional site visits, to establish if the schools should be on their approved list ( Link to California Medical Board Approved List). This list is dynamic as 10 years ago, St. Matthews was on the list but was removed about 5 years ago. So a medical school on the list now, may not be when you graduate. Several state medical boards, such as vermont, michigan, and kansas, have adopted the California list as part of their licensing standard. Many others have similar lists, usually school's whose graduates are banned from obtaining a licenses. Yet with the physician shortage, some states, such as Arkansas, are removing prohibitions on IMG/FMG licensing (Link to article on Arkansas Medical Licensing for IMG). Its all rather confusing really.

I'll add a few other quick thoughts on foreign schools (I'll provide full posts at a later time on these issues)

1. It is almost meaningless when schools that say they are "accredited" and/or push that they are certified for students to take USMLE. It is like the used car salesman saying "this car comes with 4 tires and a steering wheel." Almost anyone, and literally I mean anyone can create a school, get some form of government charter, such a business license from the local city, get UN-WHO recognized, and thus can have their students site for USMLE.



2. Some schools are great, some are crap, most are for-profit, some run by large companies, others by convicted crooks Link SA Times article on mexican medical school. Full disclosure, current poster is quoted in article)

3) Residency programs: Some will not consider any IMG/FMG, regardless if they are a citizen. Some will consider them for their secondary programs in the St. Elsewhere not in the University Hospital, such as Stony Brook. Yet some,like Stony Brook, seemingly have a long standing relationship with a few specific foreign schools. For example, Saba, a small school in Netherland Antilles seems to have this with one of Stony Programs. It may be due to friendships across faculty but that is purely speculative.

4) Data on matching is readily available. Link NRMP data



Attached files 1284315874-Matchresultsanddata2009.pdf (472 KB)Â

One way to get more information about the caribbean schools is to attend a school specific information session. There, one will have the apportunity to ask questions about important issues such as clinical site, match for residency ect. Ross University has several of these meetings year round in major us cities. Go to the scholl website and to learn more about date and site of information sessions. By- the - way, i have not heard of any Caribbean school where a student can finish the medical school program 18 months shorter than US schools. However, here in the US one school offers a three year program. LECOM is opening up that program for nontraditional students who are already physician assistance.

Although I think information sessions provided by ANY entity can be helpful, I would be leary of the info provided. You have to assume that it is biased. The purpose of providing information sessions is basically to sell you on the product, so even negative info/stats will be spun in a positive manner. For example, a school might tout a high board pass rate, but in reality not let everyone sit for the boards unless they meet certain criteria. They then count the pass rate based on those who they actually allowed to sit for the boards, and not on total number of students. This is true in all kinds of scenarios - not just foreign medical schools. Many formal post-bacc programs state they have very high med school acceptance rates, but they calculate their rates after excluding people in the program who didn’t meet all the criteria set out for getting full support of their application.

I have to concur with Emergency!. Those “information” sessions are in all reality sales pitches designed to scare and dishearten potential students in the audience into believing that their only hope in becoming a physician lies in attending that particular Caribbean medical school being presented. Oftentimes, I’ve heard at these sessions: “You’re too old.” “You’ll have no chance at a US medical school with your GPA/MCAT.” “Look at the odds of getting into a US medical school. Do you think you’re the top X% of applicants?” “You didn’t go the right undergraduate college to be competitive.” “US medical schools won’t consider you because your prerequisites have expired.” “Nurses (or whatever health care occupation) aren’t allow in US medical schools because selecting nurses (or whatever health care providers) will worsen the shortage.” The list goes on and on. Former poster DRFP was a Caribbean medical student who mimicked this type of thinking in his postings.





A cautionary note, though. Caribbean medical schools do like to target and recruit older premeds because older premeds tend to have more money, better credit, a higher net worth, and more resources in general than younger premeds. Simply put, older premeds are more able to afford the high costs of Caribbean medical schools. As an older premed, don’t be surprised at the special attention you’ll receive at these sessions.

  • Idalyn Said:
One way to get more information about the caribbean schools is to attend a school specific information session. There, one will have the apportunity to ask questions about important issues such as clinical site, match for residency ect. Ross University has several of these meetings year round in major us cities. Go to the scholl website and to learn more about date and site of information sessions. By- the - way, i have not heard of any Caribbean school where a student can finish the medical school program 18 months shorter than US schools. However, here in the US one school offers a three year program. LECOM is opening up that program for nontraditional students who are already physician assistance.



The information sessions are good and OPM usually has a dozen or so reps at our yearly conference. What is hard to get are complete data on applicants, matriculants, dropout rates, match data, etc. So for example, Ross, St. George, & AUC are the big three and have well-established programs, good clinicals, board scores, match rates, all of which is self-reported and seemingly accurate. What I don't have are numbers of people who drop out, don't pass boards, etc. I have too many stories from people who have been accepted and attend and never finish. My discussions with most of these students indicate that they weren't ready for medical school


One of our FMG residents told me today that recently Georgia adopted the “California List” of foreign schools that are recognized for licensure. What it means is that if you attended one of the schools on the list, you can get an unrestricted license after internship and passing step 3, rather than having to complete 36 months of US residency. This allows for moonlighting and getting DEA certification, if you so desire. It’s also a huge timesaver in terms of not having to do all this after graduating from a 3-yr residency, when you’re trying to secure an employment contract and take boards.


Although there was no published explanation, the implication is that the GA board changed their policy in an attempt to address the physician shortage here. Look for other states to likely adopt a similar strategy.


It appears that at least the big 3 offshore schools are on the list, which can be viewed at:


http://www.mbc.ca.gov/applicant/schools.html

Hi,


Thanks for a very informative thread. The information provided, especially by gonnif and jmdmd is very helpful.


I have interviews coming up with SGU and Ross, so I’m quite excited about the possibilities. However, I am also reading about the challenges facing IMG’s. While it may be daunting, I have met many practicing physicians who are IMG’s in many different specialties during my 14 years as a locum tenen Clinical Laboratory Scientist. So, I do know that it can be done. The challenges facing matching residencies seem to be a recurring theme. So, it is something to keep in mind. Also, I hear that clinical rotations can be quite a bit of a challenge setting up, depending on which of the “Big 4” Caribbean schools you attend. (I still include Saba because its graduates can practice in all 50 states of the U.S., although federal loans does seem to be an issue).


So, for the OP, studying medicine off-shore will not reduce the amount of time to get your MD. It may actually prolong it, based on how you meet some of these challenges. However, when it comes to being “good enough” or “competitive enough,” I would have to agree with jmdmd, that it really depends on how hard you are willing to work to secure advantageous grades, LORs, and evaluations. I believe success can be reached via off-shore schools, since I’ve worked with quite a few IMGs. Good luck with your decision and endeavours!

  • mroller Said:
Hi,

Thanks for a very informative thread. The information provided, especially by gonnif and jmdmd is very helpful.

I have interviews coming up with SGU and Ross, so I'm quite excited about the possibilities. However, I am also reading about the challenges facing IMG's. While it may be daunting, I have met many practicing physicians who are IMG's in many different specialties during my 14 years as a locum tenen Clinical Laboratory Scientist. So, I do know that it can be done. The challenges facing matching residencies seem to be a recurring theme. So, it is something to keep in mind. Also, I hear that clinical rotations can be quite a bit of a challenge setting up, depending on which of the "Big 4" Caribbean schools you attend. (I still include Saba because its graduates can practice in all 50 states of the U.S., although federal loans does seem to be an issue).

So, for the OP, studying medicine off-shore will not reduce the amount of time to get your MD. It may actually prolong it, based on how you meet some of these challenges. However, when it comes to being "good enough" or "competitive enough," I would have to agree with jmdmd, that it really depends on how hard you are willing to work to secure advantageous grades, LORs, and evaluations. I believe success can be reached via off-shore schools, since I've worked with quite a few IMGs. Good luck with your decision and endeavors!



My only comment is that the clinical rotations, residency matching rates, licensing issues of IMG (both citizen and non-citizens) who insist on pursuing an MD degree, are non-issues if the DO route is pursued.

Can you share with me the big 4 medical school?


Thanks…

SGU, Ross, AUC, and Saba. However, if you are from the U.S., federal loans are no longer available for Saba (from what I’ve been reading). Canadians can still receive Canadian student loans for Saba.