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DrModern

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Oy vey. Well since I'm procrastinating on my daily Uworld questions, I'll bite. What follows pertains only to my own experience at SGU.

1) The ranking of the big four. Including their average gpa and mcat. USMLE/ Complex passing rate. Success of matching into residency. Support from faculties.
They're all basically the same regarding USMLE pass rate. SGU and Ross have slightly better residency placement rates, I think. Uncertain how you would rank faculty support.
2) The type of degree earned after graduating from the big four.
From what I have gathered. Graduates earn IMG MD. Is that right?
It's a Doctor of Medicine (MD) degree. An "IMG MD" isn't really a recognized thing as far as I know.
3a) Where do graduates usually practice?
Mostly in the US, Canada, the UK, and the Caribbean.
3b) What do they usually specialize in?
About 60% go into primary care, the rest are well represented in most specialties. We seem to graduate an above-average number of ED physicians.
4) Where in US are graduates rejected from pacticing?
We have no practicing restrictions. Students that do the KBT program cannot do their clerkships in year 3 and 4 in New Jersey.
5) Benefit of attending the big four
Vetted schools with above average placement rates for residencies.
6) Negative of attending the big four
Compared to what? Not going to medical school at all? Going USDO? Going USMD? Going non-Big 4 Caribbean?
6) The average cost of attending the big four compared to MD or DO. (I heard that it costs A LOT)
I think SGU is the most expensive, about $270k for most students. I think average for a US school is about $200k for reference.
7) Availability of student loan/ financial aid
Accepts US federal loans and Canadian government loans. Don't need private loans.
8) Environment/ Weather/ social atmosphere/ the girls/ guys.
Hot, tropics, mosquitos, humid, wet rainy season and lengthy dry season with occasional droughts. Students are a huge spectrum, 19yo's to 59yo's. Some are partiers and some are studious. Lots of social events (too many, in my opinion). Lots of outdoor social events.
9) Are classes taught in spanish?
No.
10) Are there prerequisite courses that need to be taken? I know that for the carribean schools on AMCAS, 2 semesters of spanish are required.
Yes, pretty much the same as any US school. Bio, G-Chem, O-Chem, Anat, Gen physics, etc. I'm pretty certain Spanish isn't required. MCAT is also required.
11) How difficult are the classes
Not easy. I'm not sure what answers you expect from this question? Med school is hard. We all pretty much take the same courses because we all take the same licensing exams.
12) How strong are the student support groups? Are students actively helping each other via study groups or people are cut throat like Berkeley?
Virtually no gunners. Very helpful student body, plenty of study groups.
13) Staff/ professor availability ( according to dimsum: the big four typically have 4-5 professors)
Varies from class to class. We have lots of visiting professors from US schools. Classes like Pathology, Anatomy, and Physio have specialists teach each system. A class like Immuno may only have a single prof though.
SGU will accept students with lower scores into the MPH/MD program that they won't accept straight into the MD program. It's basically a way for the school to wring more money out of you. A Caribbean MPH is pretty useless outside of the Caribbean for residency and career prospects. Some people do it for personal interest in public health, though.
15) Language spoken by natives
Caribbean English with some local patois/slang.
16) Now for the question people hate to read the most: What is my chance of getting into the big four with my stat:
My GPA is a 3.1, MCAT is 29 (12 PS, 7 VR, 10 BS)
Assuming you're not brain-dead during the interview, you should be fine.
I have decent extracurricular activities:
-Shadowed doctor
-2 publications with three separate research experiences.
-Pre-med chapter officer for consecutive years
-Ambassador of 3rd world country outreach program. Actually traveled to 3rd world countries to shadow doctors and interact with locals
-Founded a healthcare initiative organization and led medical students lobby for healthcare reform in the CA capitol
-Camp counselor for children with muscular dystrophy.
-2000+ volunteer hours
-Hospital work
-Tutored underprivileged high school students.

LOR:
2 Strong Science Professor, 1 non-science, 2 MD doctors.
The quality of these things don't matter, just that you have them on your application.
 
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@bedevilled ben Thank you so much for your replies.
Your answers have been extremely helpful.
I have a couple questions regarding your replies:

"We seem to graduate an above-average number of ED physicians"
1) Do you mean ER physician? Because google doesn't tell me what ED stands for.

"Mostly in the US, Canada, the UK, and the Caribbean."
2) Could graduates practice outside of these regions?

"We have no practicing restrictions. Students that do the KBT program cannot do their clerkships in year 3 and 4 in New Jersey."
3a) What's a KBT program?
3b) I have also heard that Texas doesn't accept Caribbean students, is that true?

"Vetted schools with above average placement rates for residencies."
4) I have been browsing around SDN forum. People seem to suggest otherwise. They say that Caribbean students have lower chance of matching into residencies than MD and DO. Where did you get this info?

"Negatives of attending Caribbean schools"
5a) If there is no downside to attending Caribbean schools, how come there are stigmas and people usually avoid them?
5b)There has to be reasons why people would choose USMD and DO over Caribbean, do you know some of these reasons?
--> Quoting @JaggerPlate (http://forums.studentdoctor.net/threads/interesting-thread-comparing-carib-sgu-to-do.796926/):
DO > Caribbean. Still ... and always.
5c) Also, I have heard that Caribbean schools have alarming low pass rate for USMLE/ complex. And especially low graduation
--> Quoting @Seth Joo (http://forums.studentdoctor.net/thr...bashes-do-school.1050379/page-3#post-14869633) :
"Caribbean schools accept students knowing that a very large percent will not graduate and will not become doctors."
--> Quoting @Ibn Alnafis MD (http://forums.studentdoctor.net/thr...bashes-do-school.1050379/page-3#post-14869633):
70% (overall match rate for Caribbean schools)is extremely low, especially if we take in consideration that this rate is AFTER 30-50% attrition rate. All in all, those who went to the Caribbean, be it SGU or Saba, have a 50% chance of never practicing medicine in the US.
5d) Could you address this 30-50% attrition rate? Is this common?
ED is what people that didn't learn about medicine from TV call an Emergency Department in the United States. In most Commonwealth countries, they're referred to as A&Es, accident and emergency departments.
 
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"We seem to graduate an above-average number of ED physicians"
1) Do you mean ER physician? Because google doesn't tell me what ED stands for.
No, I mean an ED physician. As MadJack said, ED = emergency department. Also called an emergency medicine/EM physician. Emergency rooms were staffed by internists and ceased being just "rooms" a long time ago, so the name has changed as the speciality differentiated itself. It just hasn't filtered down into the general vernacular yet. I blame Crichton's late 90's TV show ER for this.
"Mostly in the US, Canada, the UK, and the Caribbean."
2) Could graduates practice outside of these regions?
Of course. We're licensed to practice everywhere, this is just where the vast majority of students end up.
"We have no practicing restrictions. Students that do the KBT program cannot do their clerkships in year 3 and 4 in New Jersey."
3a) What's a KBT program?
3b) I have also heard that Texas doesn't accept Caribbean students, is that true?
KBT is the Keith B. Taylor global scholars program, a study abroad program that SGU offers. Students complete MS1 of basic sciences in Newcastle in the UK at a sister university and then join the MS2 class on the island of Grenada in the Caribbean the following year. Because they do not complete their first 2 years of basic science education in the same country, they are ineligible to do their MS3 and MS4 clerkships in New Jersey because of some bizarre wording of their state regulations. Caribbean IMGs from the Big 4 schools can all practice in all 50 states, including Texas.
"Vetted schools with above average placement rates for residencies."
4) I have been browsing around SDN forum. People seem to suggest otherwise. They say that Caribbean students have lower chance of matching into residencies than MD and DO. Where did you get this info?
Sorry, I should have clarified. Compared to other Caribbean schools, the Big 4 graduate and match students into residencies at a much higher rate than other Caribbean schools, and they are unfairly often all grouped together as just "Caribbean graduates".
"Negatives of attending Caribbean schools"
5a) If there is no downside to attending Caribbean schools, how come there are stigmas and people usually avoid them?
5b)There has to be reasons why people would choose USMD and DO over Caribbean, do you know some of these reasons?
--> Quoting @JaggerPlate (http://forums.studentdoctor.net/threads/interesting-thread-comparing-carib-sgu-to-do.796926/):
DO > Caribbean. Still ... and always.
5c) Also, I have heard that Caribbean schools have alarming low pass rate for USMLE/ complex. And especially low graduation
--> Quoting @Seth Joo (http://forums.studentdoctor.net/thr...bashes-do-school.1050379/page-3#post-14869633) :
"Caribbean schools accept students knowing that a very large percent will not graduate and will not become doctors."
--> Quoting @Ibn Alnafis MD (http://forums.studentdoctor.net/thr...bashes-do-school.1050379/page-3#post-14869633):
70% (overall match rate for Caribbean schools)is extremely low, especially if we take in consideration that this rate is AFTER 30-50% attrition rate. All in all, those who went to the Caribbean, be it SGU or Saba, have a 50% chance of never practicing medicine in the US.
5d) Could you address this 30-50% attrition rate? Is this common?

As I mentioned above, negatives with respect to what? The pecking order of desirability basically goes USMD > USDO > Caribbean MD from the Big 4 > Everybody else. There are some international schools that are viewed better than some of the Big 4, but generally if you're going to go international and want to ultimately practice in the US it's usually best to pick one of the Big 4. There are plenty of negatives of the Big 4 compared to USMD/USDO, search around the forums or look through some of my old posts if you want specifics. Compared to other Caribbean schools, the only downside of the Big 4 is cost (in the case of SGU) and they require slightly better stats for applicants. Personally, I don't think there are any good reasons for picking a non-Big 4 Caribbean school, though I know plenty of students that have and are success stories. The USMLE first time pass rate for the Big 4 are the same as US averages. I think SGU and Ross have a higher first-time pass rate than US school averages. I don't have information about the others. The residency rates for these schools is somewhere in the 80%'s, whereas in other Caribbean schools it is anywhere from 0-50%. That is why these schools are singled out as "The Big 4", because they are radically different than the other medical schools in the Caribbean. Grouping them all together gives an unclear picture of the situation. I am only familiar with SGU's attrition rate, which I estimate to be about 15%-20% over the first 2 years. This includes students that repeat a term, that ultimately go on to finish the program. Actual attrition rate of students that never complete the program is probably more like 15%, which is admittedly much higher than a US school. That is the price you pay for admitting students with low scores that can't cut it.

edit: formatting
 
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Oh wow, thank you, I didn't know that.

This question is for @bedevilled ben.
So I asked around the SDN forum, somebody pointed this out as a "negative" aspect of Caribbean schools, it would be awesome if you could address/ counter this issue:
In the Caribbean, 50% of your class will be gone by 2nd year. Of those remaining, 50% will get a residency. As a Caribbean student, you have a 75% chance to end up in debt with no job. If you're in the luck 25%, which will diminish with all the new MD and DO schools opening, you're pretty much stuck into primary care or psychiatry. If that's your ambition, no problem, but if you find out that you really love Urology or Otolaryngology, that will never happen. At least with DO school you have a chance. Yes, there are some that make it into EM or Gas, but I assure you that for a Caribbean graduates that's the equivalent of a DO matching into a top specialty.

Getting into DO school right now is open field for anyone willing to put in the work to increase their GPA, EC and MCAT. Lucky for you, you only need to work on your GPA. Don't waste your time in the Caribbean just because you're desperate to get into medical school. Getting in is exciting and fun, but it won't matter if you can't make it into a residency. Also, getting an MD from the Caribbean is useless in terms of how other physicians see your MD. Sure, you may avoid the 1 or 2 odd conversations a year to a patient explaining what a DO is (You can always just get your coat to read "Dr. X Y" instead of "X Y, DO"), but aside from that, all physicians will see you went to a Caribbean school when you apply to a job (or anyone Googling you to be honest). It doesn't give you an advantage over a DO, so it can't be a "pro."

This is wildly inaccurate, and the reason why I spend so much time posting on these boards. This is exactly what I was referring to earlier by grouping all Caribbean schools together. The stats and percentages that follow are for SGU, but I think they're similar for the other Big 4 schools (SGU, Ross, Saba, AUC).

SGU's actual attrition rate is complicated. If a student fails a midterm, they are given the option to "decel" the course, which basically means they drop it and retake it the following term with following class. They become a part of that graduating class. Since we are on rolling admissions with 2 classes, we are losing and gaining students every term. The January class, however, is usually much smaller, a few hundred students, and the August class is large, around 900 students. So consider a January starting class that loses 5% of their 300 students, but gains 5% from the previous class of 900. You can see how this becomes difficult to suss out.

None of that really matters, though, because whoever posted that pulled those numbers out of thin air and things asserted without evidence can be dismissed without evidence. We lose a lot of students, they're not wrong about that. It's more like 15% but it doesn't matter, it's still a lot. Our residency placement rate is more like 90%, and that does matter a lot. Yes, the Caribbean will basically lock you out of some high-demand specialities like Derm & Optho. But we graduate plenty of EM, gas, rads, Obs/Gyn, surg, etc. The only people that look down on Caribbean MDs are pre-med students. We all take the same classes and licensing exams. Once you're through basic sciences and working in the trenches alongside other junior doctors, where you went to school just becomes a footnote.

The take home message is that you should exhaust every avenue you have to get into a US school, be it MD or DO. If you've done that a few times, and you're starting to eat into your 30's, and you're positive nothing else is going to fulfill you as a person but becoming a physician, there are ways to make it work. It's a messy solution, but it can be done successfully.

A more succinct way to address this would probably just have been a link to our residency placements:
SGU Residency Appointments By Year
 
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This is wildly inaccurate, and the reason why I spend so much time posting on these boards. This is exactly what I was referring to earlier by grouping all Caribbean schools together. The stats and percentages that follow are for SGU, but I think they're similar for the other Big 4 schools (SGU, Ross, Saba, AUC).

SGU's actual attrition rate is complicated. If a student fails a midterm, they are given the option to "decel" the course, which basically means they drop it and retake it the following term with following class. They become a part of that graduating class. Since we are on rolling admissions with 2 classes, we are losing and gaining students every term. The January class, however, is usually much smaller, a few hundred students, and the August class is large, around 900 students. So consider a January starting class that loses 5% of their 300 students, but gains 5% from the previous class of 900. You can see how this becomes difficult to suss out.

None of that really matters, though, because whoever posted that pulled those numbers out of thin air and things asserted without evidence can be dismissed without evidence. We lose a lot of students, they're not wrong about that. It's more like 15% but it doesn't matter, it's still a lot. Our residency placement rate is more like 90%, and that does matter a lot. Yes, the Caribbean will basically lock you out of some high-demand specialities like Derm & Optho. But we graduate plenty of EM, gas, rads, Obs/Gyn, surg, etc. The only people that look down on Caribbean MDs are pre-med students. We all take the same classes and licensing exams. Once you're through basic sciences and working in the trenches alongside other junior doctors, where you went to school just becomes a footnote.

The take home message is that you should exhaust every avenue you have to get into a US school, be it MD or DO. If you've done that a few times, and you're starting to eat into your 30's, and you're positive nothing else is going to fulfill you as a person but becoming a physician, there are ways to make it work. It's a messy solution, but it can be done successfully.

A more succinct way to address this would probably just have been a link to our residency placements:
SGU Residency Appointments By Year
Wildly inaccurate? Do you have any sources to any of your claims or you'll just state that my claims are wrong? Unfortunately, all the links on the website are down, but I've seen those lists and there are not 900+ matches on it. Also, how do you lose 5% and then say you lose 15%?

What the hell "plenty" anyway? The 17% that's not in primary care or transitional year (using the pie chart)? And how do you not know OB/Gyn is primary care?

While I'm ready to accept that once your training is over everyone is pretty much treated equivalently (which I have said so myself), there is absolutely no doubt that Caribbean graduates are the bottom choice for residency and fellowship; that is what the quote was about. The OP was also referring to having an "MD" as an advantage of the Caribbean, which it is not aside from maybe avoiding a conversation or two about "what's a DO?"
 
I don't think I claimed that. If I have, I will withdraw my statement right away.
I have stated that the initial behind your name doesn't matter, it is the quality of your health care delivery that matters.


Lets keep the tone of the conversation civil and classy okay?

I appreciate @bedevilled ben very much for taking his/ her time to address all of my questions.
Seriously, just please go to the Caribbean.
 
Wildly inaccurate? Do you have any sources to any of your claims or you'll just state that my claims are wrong? Unfortunately, all the links on the website are down, but I've seen those lists and there are not 900+ matches on it. Also, how do you lose 5% and then say you lose 15%?

My source is that I'm a student there. As I'm sure you can imagine, I follow the statistics pretty closely since I have a vested interest in them. You're correct, there are not 900 students on those lists. Students matching in 2014 would have started in 2010, when class sizes were about half of that. Furthermore, those lists are from NRMP data, and historically about 1/3 of SGU students obtain residencies outside of the NRMP. Those placements are self-reported to the office of clin-ed, which means they're unlikely to be reported at all. You'll also note that I said we lose about 5% per term, and we ultimately end up losing about 15% total over the course of the program. A 15% attrition rate and a 90% residency placement rate are pretty "wildly" different than your 50% attrition, 50% placement statistics.

What the hell "plenty" anyway? The 17% that's not in primary care or transitional year (using the pie chart)? And how do you not know OB/Gyn is primary care?
Snide remarks aren't necessary, if you have issues with what I said, simply address them directly. I didn't realize that I needed to quantify the word "plenty". Firstly, I don't believe I ever said that Obs/Gyn wasn't primary care, the words "primary care" don't even show up in my post. Primary care refers to those specialities that see a patient for chronic health needs and if necessary, refer them to a specialist. There are not, to my knowledge, any rigid standards to classify a speciality as primary care or not, though FP, general IM, and peds are pretty universally accepted as primary care. Obs/gyn, IM, and some others can be either primary or secondary care. An obs/gyn that specializies in L&D, or a hospitalist for example, would not be considered primary care. Considering that a non-trivial percentage of those doing IM continue on to subspecialize, I think its a fair estimate so say that 35-40% of SGU graduates are non-primary care. I would call this "plenty".
While I'm ready to accept that once your training is over everyone is pretty much treated equivalently (which I have said so myself), there is absolutely no doubt that Caribbean graduates are the bottom choice for residency and fellowship; that is what the quote was about. The OP was also referring to having an "MD" as an advantage of the Caribbean, which it is not aside from maybe avoiding a conversation or two about "what's a DO?"
On this we agree. I mentioned the proverbial pecking order above, and you'll see I placed Caribbean MDs squarely at the bottom. There is no question that we are at a disadvantage. The issue arises when all Caribbean schools are lumped together, because there are many that do have the abysmal statistics you posted initially and others that do not. It is always best to complete your training in the US. If that option isn't feasible, going to the Caribbean is not the death sentence that SDN so often makes it out to be. It is riskier, and the penalties for failure are severe, which is why I always encourage people to exhaust all possible means of getting into a USMD/DO program before considering the Caribbean.
 
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Question 10: Are there prerequisite courses that need to be taken? I know that for the carribean schools on AMCAS, 2 semesters of spanish are required.

Typically when the term "Caribbean Schools" is used, it is used to describe those schools that located in the caribbean, in foreign countries, that are not LCME accredited.

Using this term - there are no "Caribbean schools" that you can apply to through the AMCAS. The AMCAS deals only with schools within the borders of the USA and Canada.

If when you say "Caribbean school" you mean ANY school that is located within the geographic region of the caribbean, then Puerto Rican schools would be included. These are the only schools in the caribbean that are LCME accredited and on AMCAS due to it being a part of the USA. However, they are not usually given this qualifier because graduates of these schools are USMDs rather than IMG MDs.

They do conduct classes in Spanish and English, as well as have both English and Spanish prerequisite requirements.
 
I second what Ben has said and agree. Do I have links for you, no because I know from my experience as a graduate from SGU.

Pre-meds are not the best source for info on Caribbean schools because they have zero experience.

A Caribbean MD is an MD. We do not get a special IMG MD after our names.

The "big 4" should not be grouped with all other schools.

If you look at SGU list and see a lot of "prelim" or "transitional" programs, you can go to 2015 and click PGY 2. This will show advanced placement (rads, anesthesia, etc). Also you can see al the way up to pgy 7 for fellowships of those you have informed SGU (there are more that have not informed them).

Also, Caribbean grads do not automatically get placed at the bottom of rank lists in residency. The source? 3 years of being apart of ranking applicants. We have SGU and Ross students ranked above some USMD and DO students.

You can practice in Texas from the Caribbean. I have known many to match in that state. Where did you hear otherwise?

Any other questions?
 
To the OP; Are you an applicant to "somewhere"? As your title states "DO"? or POD (see you allover the POD forum)? or IMG? The amount of time in your researching here on SDN you could be filling out apps for your medical/Pod schools. Please inform all of us what or where you are thinking of attending....
 
You can do Campbell University DO school- it a new DO school opened up just recently.
 
Podiatry and medicine are very different pathways. While there's nothing wrong with choosing podiatry, you are basically shoe-horned (pun intended) into one specialty once you graduate. Medicine, on the other hand (whether U.S. MD, osteopathy, or Carib/IMG programs), offer you a lot more flexibility if you decide in a couple of years that you don't want to stare at feet for the rest of your life.

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