It's true that Caribbean students have a much less supportive environment, but that doesn't change the fact that the clinical education at Caribbean school is sub-par. All you're proving is that Caribbean students can study, not that they have been educated/trained well enough in their clinical years to be prepared for residency.
Everything You Needed to Know about Caribbean Medical School
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It's true that Caribbean students have a much less supportive environment, but that doesn't change the fact that the clinical education at Caribbean school is sub-par. All you're proving is that Caribbean students can study, not that they have been educated/trained well enough in their clinical years to be prepared for residency.
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From what I gather, a low GPA student has a few options:
That's a lot better than gambling $300K to come out with nothing to show and no way to pay my debt back. Or, taking anything available in terms of residency.
However, I can see some justification in extreme circumstances. Someone who has the academic potential, but severely messed up in undergrad. They would have to essentially do their entire four years of college over again before they even had a chance at DO school. Personally, I would be damn sure that I could kill it in the Caribbeans.
It seems, from my personal experience, most of the people that go to the Caribbeans didn't have the potential to eventually get in the U.S. They had the 'special snowflake' syndrome. Once they got in 'things would turn around' and they would 'beat the odd'.
P.S. I think this blog is an excellent read for anyone thinking about going overseas: https://milliondollarmistake.wordpress.com/
- Retake and DO
- Post-Bacc
- SMP
- Some permutation of 1,2, and 3
- Wait until you've been out 10 years. Become a resident of Texas. Do Academic Fresh start.
- Go to the Caribbean
That's a lot better than gambling $300K to come out with nothing to show and no way to pay my debt back. Or, taking anything available in terms of residency.
However, I can see some justification in extreme circumstances. Someone who has the academic potential, but severely messed up in undergrad. They would have to essentially do their entire four years of college over again before they even had a chance at DO school. Personally, I would be damn sure that I could kill it in the Caribbeans.
It seems, from my personal experience, most of the people that go to the Caribbeans didn't have the potential to eventually get in the U.S. They had the 'special snowflake' syndrome. Once they got in 'things would turn around' and they would 'beat the odd'.
P.S. I think this blog is an excellent read for anyone thinking about going overseas: https://milliondollarmistake.wordpress.com/
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Being that most of the folks who head there are from an Asian American/Indian background, I definitely can attest to the bolded from folks I personally know.
One girl's reasoning for attending Ross was that one of the doctors who appeared on the Kardashian's TV show graduated from Ross.
It was then I knew that a piece of bird poop on a windshield would amount to much more than she would.
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Nice data, but one thing I am taking away from this is the mantra that "things used to be different" that is often times repeated on this forum in regards to the caribbean is untrue. The match % now is virtually identicle to the match% for people who went to med school in the 90s.
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But its not the same. Not even close. You think all those IMGs and FMGs who graduated from the Caribbean or some random med school in another country a decade or more ago who are now cardiologists/nephrologists/etc etc would have even matched Family Medicine now? They got into mid to higher tier IM residenices in and then got into fellowships when things were a lot less competetive.
Things are much harder than they were before all the way from medical school admissions to residency admissions to fellowship admissions.
No way, things are totally different now.
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The only caribbean doctors we see from "the past" are the ones who made it. We dont see the 50% who failed from the 90s, and they wont see the 50% who fail today, in the future. The data shows they are matching at the same rates. Possibly in less desirable specialties, but if that was the case I would expect the match rates to be different as well. After all if less people today were matching competitive specialties, you would expect a lower match rate overall.(Another way of looking at it, if the same % of IMG matching uncompetitive specialties today were matching competitive specialties in the 90s, you would think at least another 10% would be able to match into the true bottom tier residencies)
Also keep in mind these schools turn out a ton of grads, so even if most go into IM/FM percentage wise, absolute numbers wise there will be a decent amount getting the more competitive stuff.
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Oh my goodness. In order for me to figure out what you are talking about, I would have to plow through multiple residency data sheets and statistics to explain to you why its different nowadays. What I will say is that the bottleneck has changed to get into a competitive residency or any residency at all.
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The match percentage may be steady, but you have to interpret the numbers in a broader context. For instance, before the all-in policy, residency programs could fill some of their positions outside the match. An undetermined number of US-IMG's obtained training that way. Also consider what happens after the match. In 1995 one of the mere 394 unmatched US-IMG's could try and scramble into one of 3,670 unfilled slots, including 378 in family medicine.
In 2015 one of the 2,507 unmatched US-IMG's might enter the SOAP to compete for one of 1,306 unfilled slots, 475 of which were surgery prelim years. FM was down to 156 open positions. So yes, things have gotten worse.
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Add to that concerns re: the quality of the clinical programs available to the student that chooses this route.
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What I don't understand is why not wanting to waste 2 years building up an application to apply for medical school is seen as such a bad thing. I'm planning on applying this coming cycle, and if I don't get in anywhere, I wouldn't want to spend one or two years doing boring stuff (e.g. research assistant, menial hospital volunteering) to buff up my app.
This is anectodal, but a family member of mine (Canadian), scored 27-29 on the MCAT after half-assed studying and obviously didn't get in to any Canadian medical schools despite a 3.8 gpa, so he went to SGU instead. He could've taken a year off after undergrad and retaken the MCAT in the hopes of getting in the year after, but the thought process is something like this:
What if I don't get in the next year? That would literally be a waste of a year. If you get in, great. If not, that's a year or two you won't ever get back, which to some people may not seem like such a big deal. But my cousin knew he'd probably be working some soul-sucking research assistant position, doing some research he only vaguely cared about, while attending to the PI's every beck and call. Running around groveling for hospital volunteering positions that involve patient contact, and begging physicians for shadowing positions. Basically, an extended year of pre-med life.
All those numbers about the "attrition rate" at Caribbean and "omg look how many people fail out!!!!" are definitely true (my cousin mentioned that a good portion of his class had dropped out) BUT that's doesn't really mean much if you're someone who KNOWS you can do well. If you've gotten this far, you're probably thinking like, "Well if you couldn't get into med school the traditional way, then you clearly haven't demonstrated the skills required to succeed." But I think the point most people sell short is the importance of hard work. In general, if you haven't gotten into medical school and are contemplating Caribbean, the most important things you have to ask yourself is:
1. If I work hard, will I be able to succeed? It's the unfortunate truth that some people have a limit to how much they can study and how fast they can learn. I go to a top 15 US undergrad (not super relevant, but I just don't want you guys to think I'm saying this as someone who only knows CC academics) and some of my classmates just don't understand super basic material. When I was a freshman, I knew people who straight up failed Chem 101 despite studying almost every single day. I also knew people who just barely glanced at the material and received As. I'm not saying the people who failed Chem 101 are dumb -- they just aren't good at science and math. If you were the type that literally skipped every single class, studied for exams the night before, and somehow still pulled B-/B/B+ (which are not competitive grades for med school) in competitive environments, then you will be okay in the Caribbean if and only if you work your ass off in medical school. In general, most people should have an idea of how good they are at school.
2. Am I willing to put 200-300k down as a gamble that will pay off if I work hard? In my cousin's case, his parents are rich, so money was not an issue. But he also buckled down, and really studied while he was on the island, and scored over 260 on his step 1. I visited him over the summer and he was literally studying day in and day out prepping for his step.
Honestly, Caribbean schools just accepts a lot of students for $$ -- they don't care if you've prepared yourself or are able to handle the material. The people who fail out are those that either just aren't good enough academically or weren't able to apply themselves because they didn't have enough discipline or just didn't care enough (e.g. parental factors are what lead them there). But if you are reading this and have reason to believe that you can succeed, the attrition rate doesn't matter.
What DOES matter is, if you know you want to go into some super competitive residency (e.g. Derm or something), chances are you won't be able to match, or the likelyhood is tiny. In general, it seems like for Caribbean grads to match into the same residencies as USMD's, they have to have significantly higher step scores. My cousin knows a surgery resident who is an SGU graduate and scored a ~255 on his step and is in the same residency program as a USMD grad who only scored ~230 on the step. It does seem like an uphill battle -- you basically have to outperform USMDs to get the same position. But maybe it's worth it if you don't want to spend the extra couple years doing menial premed labor, aren't interested in super competitive residencies, and have the money and self-ambition to take the risk.
Having said all this, I don't know much about the MD-DO merger or how that will affect matching rates. I just typed this because it did kind of seem like OP was getting attacked. He was probably just feeling like all the anti-Caribbean hate was invalidating his hard work, which is never a good feeling.
Last thing, my cousin is in his rotations (M3), and I've never heard him mention anything about the "goodie bags" that someone brought up earlier in this thread. He also seems to be on call at least every other week. This is anecdotal evidence, so maybe other Caribbean MD students are being given goodie bags, but it's important to note that whoever observed the goodie bags being given out was also giving his anecdotal experience.
This is anectodal, but a family member of mine (Canadian), scored 27-29 on the MCAT after half-assed studying and obviously didn't get in to any Canadian medical schools despite a 3.8 gpa, so he went to SGU instead. He could've taken a year off after undergrad and retaken the MCAT in the hopes of getting in the year after, but the thought process is something like this:
What if I don't get in the next year? That would literally be a waste of a year. If you get in, great. If not, that's a year or two you won't ever get back, which to some people may not seem like such a big deal. But my cousin knew he'd probably be working some soul-sucking research assistant position, doing some research he only vaguely cared about, while attending to the PI's every beck and call. Running around groveling for hospital volunteering positions that involve patient contact, and begging physicians for shadowing positions. Basically, an extended year of pre-med life.
All those numbers about the "attrition rate" at Caribbean and "omg look how many people fail out!!!!" are definitely true (my cousin mentioned that a good portion of his class had dropped out) BUT that's doesn't really mean much if you're someone who KNOWS you can do well. If you've gotten this far, you're probably thinking like, "Well if you couldn't get into med school the traditional way, then you clearly haven't demonstrated the skills required to succeed." But I think the point most people sell short is the importance of hard work. In general, if you haven't gotten into medical school and are contemplating Caribbean, the most important things you have to ask yourself is:
1. If I work hard, will I be able to succeed? It's the unfortunate truth that some people have a limit to how much they can study and how fast they can learn. I go to a top 15 US undergrad (not super relevant, but I just don't want you guys to think I'm saying this as someone who only knows CC academics) and some of my classmates just don't understand super basic material. When I was a freshman, I knew people who straight up failed Chem 101 despite studying almost every single day. I also knew people who just barely glanced at the material and received As. I'm not saying the people who failed Chem 101 are dumb -- they just aren't good at science and math. If you were the type that literally skipped every single class, studied for exams the night before, and somehow still pulled B-/B/B+ (which are not competitive grades for med school) in competitive environments, then you will be okay in the Caribbean if and only if you work your ass off in medical school. In general, most people should have an idea of how good they are at school.
2. Am I willing to put 200-300k down as a gamble that will pay off if I work hard? In my cousin's case, his parents are rich, so money was not an issue. But he also buckled down, and really studied while he was on the island, and scored over 260 on his step 1. I visited him over the summer and he was literally studying day in and day out prepping for his step.
Honestly, Caribbean schools just accepts a lot of students for $$ -- they don't care if you've prepared yourself or are able to handle the material. The people who fail out are those that either just aren't good enough academically or weren't able to apply themselves because they didn't have enough discipline or just didn't care enough (e.g. parental factors are what lead them there). But if you are reading this and have reason to believe that you can succeed, the attrition rate doesn't matter.
What DOES matter is, if you know you want to go into some super competitive residency (e.g. Derm or something), chances are you won't be able to match, or the likelyhood is tiny. In general, it seems like for Caribbean grads to match into the same residencies as USMD's, they have to have significantly higher step scores. My cousin knows a surgery resident who is an SGU graduate and scored a ~255 on his step and is in the same residency program as a USMD grad who only scored ~230 on the step. It does seem like an uphill battle -- you basically have to outperform USMDs to get the same position. But maybe it's worth it if you don't want to spend the extra couple years doing menial premed labor, aren't interested in super competitive residencies, and have the money and self-ambition to take the risk.
Having said all this, I don't know much about the MD-DO merger or how that will affect matching rates. I just typed this because it did kind of seem like OP was getting attacked. He was probably just feeling like all the anti-Caribbean hate was invalidating his hard work, which is never a good feeling.
Last thing, my cousin is in his rotations (M3), and I've never heard him mention anything about the "goodie bags" that someone brought up earlier in this thread. He also seems to be on call at least every other week. This is anecdotal evidence, so maybe other Caribbean MD students are being given goodie bags, but it's important to note that whoever observed the goodie bags being given out was also giving his anecdotal experience.
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The actual bottom line is the whole process and continuation into and through medicine is demanding enough. If a foreign approach is your last resort, and you have the money to take the risk, it's your life. So whatever. In medicine, there is constantly looking at benefits vs. risks. If you get to the point where the actual benefits are not too risk heavy, giving you other options and all things considered, no one is going to pound on you for going this route. There are just better ways over all to get you up and moving as a practicing physician, if that is really your goal.
DO is a great example. Though it is a big more challenging for DOs in some respects regarding specialties, I will tell you that I know CT surgeons and ophthalmologists that have thriving practices, and they are DOs. Was it harder for say the CT surgeons? Yes, but they have done it and have succeeded and have achieved awards and such. In fact the one surgeon was, by my observation, hands down one the most skilled, adept, and talented surgeons. Some people are just IMHO, more naturally gifted toward surgery. Of course this is only one aspect of being a surgeon, but when you get to see the work a lot, firsthand, you understand this. It's like ballet. A person can learn the movements, even develop the right muscles, and work very hard. It doesn't mean that they will be art in motion. There are times where natural proclivity and talent matter.
Other options: there are also the programs for GPA enhancement. Expensive and risky in their own right, but not nearly as such when compared with Carib.
The most reasonable thing people can say is if you have no other recourse and you have loads of money to potentially blow into oblivion, then go Carib, break your butt w/ limited support, score top of the class on everything and all the licensing exams, and find ways to network with good programs. But you are up against a lot if you want a strong residency program in many cases. This path just makes a long, hard process, even more difficult and potentially a lot more expensive w/ higher risks than other paths. But do what you want; b/c it's your life. Most of us aren't judging people for their choices. But hopefully they are exceedingly well informed.
DO is a great example. Though it is a big more challenging for DOs in some respects regarding specialties, I will tell you that I know CT surgeons and ophthalmologists that have thriving practices, and they are DOs. Was it harder for say the CT surgeons? Yes, but they have done it and have succeeded and have achieved awards and such. In fact the one surgeon was, by my observation, hands down one the most skilled, adept, and talented surgeons. Some people are just IMHO, more naturally gifted toward surgery. Of course this is only one aspect of being a surgeon, but when you get to see the work a lot, firsthand, you understand this. It's like ballet. A person can learn the movements, even develop the right muscles, and work very hard. It doesn't mean that they will be art in motion. There are times where natural proclivity and talent matter.
Other options: there are also the programs for GPA enhancement. Expensive and risky in their own right, but not nearly as such when compared with Carib.
The most reasonable thing people can say is if you have no other recourse and you have loads of money to potentially blow into oblivion, then go Carib, break your butt w/ limited support, score top of the class on everything and all the licensing exams, and find ways to network with good programs. But you are up against a lot if you want a strong residency program in many cases. This path just makes a long, hard process, even more difficult and potentially a lot more expensive w/ higher risks than other paths. But do what you want; b/c it's your life. Most of us aren't judging people for their choices. But hopefully they are exceedingly well informed.
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Thank you for this. I am going to print it out and distribute it to our screeners.
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Your cousin sounds like a smart fellow! Good for him! So he is in rotations? Well you should ask him his take on it once he reaches the Match next year and is applying to well over 100 programs (I wish him the best for sure).
Unless you are contempt with doing Internal Medicine, Family Medicine, Psych, or General Surgery, and you don't care if you are in the middle of nowhere and hope to land wherever you can, then Carib is a great option.
But what if... what IFFFF... God forbid you find something great other than the four areas I mentioned above and you know it is closed off to IMGs? Then your cousin is stuck at a job that he hates and is only doing to do because he can't do anything else and will be one of those angry docs who tells people that shadow him... " ahhh.. bah humbug.. don't do medicine! blah blah!"
Btw... your position on "CC academics" is pretty funny. It's great you go to a top 15 undergrad... but top 15 in what? In research? In college life? top 15 in cost? lol I don't get when people mention the rank of undergrad to justify their position on something.
Just like it didn't matter if you went to a fancy high school where kids drove Benzes and Ferraris to school, or a school in the hood where there were cops on campus during lunch breaks to break up fights between gangs... That's why they have the SAT and AP classes to put peeps the same level.
Undergrad rank/status doesn't mean **** in the med school process my friend.. despite what you may think.
A 3.8 from Santa Margarita University (made up no-name college) trumps a 3.4 from a Top-whatever (given you have the equal MCAT and equal experiences).
It's not about where you are from, it's about where you are at.
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This whole is anecdotal nonsense. If we look at raw stats cost benefit it is quite clear that md>do>Caribbean. The correct answer is always do post bac and grade replacement. If you can't accomplish this then you don't belong in medicine simple as that.
And don't talk about us md schools like you know anything about them. There is no "hand holding" (whatever that even means),and students learn almost entirely independently(very few even attend class)
And don't talk about us md schools like you know anything about them. There is no "hand holding" (whatever that even means),and students learn almost entirely independently(very few even attend class)
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Yeah, it is important to note that my cousin is an M3 and hasn't undergone the whole matching process yet, but feel free to ask me how it goes in 1.5 years, since I'll probably still be around here stressing about medical school acceptances.
Also, I don't want to start anything that's "my undergrad vs. your undergrad"-related, so I will link @WedgeDawg's post that I read some time ago and think it was a good representation of how my school is: http://forums.studentdoctor.net/thr...-vs-high-gpa-elsewhere.1151209/#post-16736634. I think a good point of comparison for what counts as "top schools" is the amount of financial aid they're willing to give. I know some people (including my freshman year roommate) who don't even have to pay the absurd tuition here thanks to need-based aid. HYP/top 5 schools give even more money to their students. The only reason I mentioned my school was to point out that some of my classmates who performed well in high school just couldn't keep up with sciences when it was presented to them at a faster pace and in more detail.
Sorry, the whole point of my post was to show that if you're an individual person considering the Caribbean (most people who ask for guidance about Caribbean), the "raw stats" at those schools aren't fully representative because there will always be people who, whether they know it or not, can't keep up with the material being presented to them and end up failing out (since Caribbean accepts people for $$). If you go into the Caribbean knowing that you'll just be the average student there, then you might be in trouble. You should only go there if you're sure you can be top of your class and do well on the USMLE exams, and aren't gunning for top competitive residencies. A post-bacc and reapplying is fine and all, if you're willing to spend the two extra years for a "maybe, how about you apply next year?".
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Well "cost benefit analysis" is somewhat contingent on your degree of risk aversion -- how much do you care about the cost in comparison to the benefit. If you are welling to pay a high premium for very poor but above zero odds (essentially buy a lottery ticket or play a slot machine), for the benefit of becoming a doctor even though the US MD/DO route isn't going to happen for you no matter what rehabilitation you do, there's really nothing "wrong" with that, as long as you do it with an understanding of the longshot nature of the bet you are placing.
As for "hand holding" I would suggest it's kind of the wrong phrase. A US grad may be better at throwing sutures or putting in a line or be more prepared to participate in a Code because at some point in his training he will be up all night with the residents doing those things. The offshore grad will have gone home from his Lite rotation at 5pm. So it's less about hand holding in a friendly sense and more about holding someone's hand over a flame that you get from the US schools.
And it's self perpetuating because of the money -- no offshore school is going to pay a rotation tons of money if the students all come back to their classmates saying "man it was brutal, you are going to hate it, go someplace else if you can". Sadly a lot of the same mindset that kept many offshore students from closing their library each night during undergrad will keep them as a group from selecting the more intense rotations for their schools to contract with.
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My advisor once told me a story where the dean at his old medical school gave an introductory talk to the first years and asked, "how many of you think that you will be in the top 20% of your class?" 90% of the class raised their hand. Point is you can never be sure that you will be in the top of your class. I'd rather go the route where the odds aren't stacked ridiculously against me like that.
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The "extra year" thing is really a red herring. Many offshore grads lose years in the process for a variety of reasons, ranging from internal hurdles within the school, to an inability to get every rotation when you need it and having to wait a year until a slot opens, to having to do one or more "dead end" prelims to having to spend a "research year" someplace, making connections to help get into a residency. Some people hit more than one of these snags, and would have been far better off spending the time rehabilitating their credentials for a year or two.
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Of course. Nobody is going offshore thinking "D= MD". They are ALL thinking "if I just had one more chance". Or they are thinking "all of these people are crummy students while I am just a late bloomer who will do well by comparison". The notion that someone is going offshore expecting to be average or worse is laughable. This is totally a Hail Mary play and you had better believe everyone thinks they have it in them to throw that winning TD.
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Although some of this thread did devolve to school yard bullying , there were some good points brought up that I hadn't realized when I originally wrote the thread. I'll edit my original post to include some of the things mentioned here and fix some of the things , that on second read, were a bit too positive and were a reflection of my own bias as the Caribbean has done me pretty well overall. Good luck to everyone going into the field of medicine. Wish you all nothing but the best in your careers.
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