In addition to Ben's excellent (and spot on) posts on this thread, I would only add the following:
1) If you make the decision to go, do
not second-guess yourself. Go "all in", in that you will be determined to succeed from the moment you hit the island (whichever one you choose).
2) Start planning before you go. Figure out what the cost will be. Get all your ducks in a row. If you have the time, money, and inclination, take a few days to travel to the island before you make the decision and scope it out in person (not everyone has the time or money to do this). This may answer a lot of lingering questions.
3) Learn to study the right material for the tests. You will be completely lost the first semester before your first test about what is the important information to commit study time to. One way of helping with this is to get the "BRS" or "PreTest" series for each of the subjects that help condense the material and provide some sample questions. If you can get copies of the old tests, use those too. Start using these as your study aids to focus on what the profs will tell you is important. There are a lot of free online sites with pictures and databanks of questions. WebPath is one that was key for me 2nd year. (
http://library.med.utah.edu/WebPath/webpath.html)
4) Don't get distracted. There are people there who just, quite frankly, don't want to be there. They are not doing it for themselves. They are doing it because their families want them to be a doctor. These people will not be a good influence.
5) Have some fun. It is important after the tests to blow off some steam. When the steam is blown-off that weekend, get back to work.
6) Be realistic. You're not going to get Derm or Plastics or Neurosurgery. You'll hear some people say that this is what they are going to pursue after school. You know what they'll likely be? Primary care. Yes, some will get choice residencies. But, this will not likely (based on the numbers) be most of you. But, you can get a good Internal Medicine residency, do well, and the door will open for fellowships for you. I've said before, I'm amazed at how well a lot of my classmates have done from Interventional Radiologists, Cardiologists, surgical attending staff at major Universities to people, like myself, killing it in private practice and living the good life.
7) I lost a ton of weight down there. This was a combination of stress and bad food. Also, at least as far as Ross goes, live as close to campus as possible. This is your safest option.
Good luck. Make your decision. Stick by it. And, be prepared. It's not easy. But, it's also worth it in the end.
-Skip