Is there any truth to this about the Caribbeans...

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There are way more then a 100 AOA resendencies. As a DO you are at a small disadvantage at acgme resendencies but have a whole other group of resendencies to enter. With carribean you only have acgme and are at a huge disadvantage.

I meant 100 percent, not 100 total.

But I get what you're saying.
 
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Podiatry is now moving to 3 year PGY residency. A large percentage of these programs are run under or in conjunction with orthopedic residency programs with a few example below
http://ortho.osu.edu/education/residencyprograms/pod_residency/
http://www.stritch.luc.edu/depts/ortho/education/podiatry/
http://www.massgeneral.org/education/residency.aspx?id=70
http://www.med.upenn.edu/podiatricresidency/faculty.shtml

Being in vascular, I work with a fair number of podiatrists. While their training may fall under the purview of orthopedics, it is not the same as doing medical school/residency. This is not a slight on podiatrists. It is simply different. When on service I consult a couple of our podiatrists at least once a week, ortho foot/ankle a lot less than that.

This is what I have seen personally, and at only one hospital and certainly may not reflect the field as a whole... But, the reasons for consult are completely and totally different. If I need someone to follow a patient long term, do wound care, debridements etc, I call podiatry. If I need a surgeon, I call ortho. If I am overloaded and don't have staff to do a major amp, I call ortho. It doesn't happen often, but on occasion...
 
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Being in vascular, I work with a fair number of podiatrists. While their training may fall under the purview of orthopedics, it is not the same as doing medical school/residency. This is not a slight on podiatrists. It is simply different. When on service I consult a couple of our podiatrists at least once a week, ortho foot/ankle a lot less than that.

This is what I have seen personally, and at only one hospital and certainly may not reflect the field as a whole... But, the reasons for consult are completely and totally different. If I need someone to follow a patient long term, do wound care, debridements etc, I call podiatry. If I need a surgeon, I call ortho. If I am overloaded and don't have staff to do a major amp, I call ortho. It doesn't happen often, but on occasion...

Pretty much this. Pods can be a lifesaver if you can easily consult them... particularly when you've got a high load of indigent patients. Getting the foot stuff dealt with is extremely helpful to managing patient health... but MDs they ain't.
 
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The AOA match rate this year was 75% (2,179 of 2,907 applicants). This may reflect some of the gamesmanship that SoutherSurgeon mentioned above.

http://thedo.osteopathic.org/2015/02/aoa-match-pairs-medical-students-up-with-residency-programs/

https://www.natmatch.com/aoairp/ and click on "match statistics."

Not sure if I'm missing something here, but this is what is says in the press release for the 2014 NRMP

"The overall match rate to first-year positions was 75 percent, the highest since 2006. The match rate for U.S. seniors was 94.4 percent, 0.7 percentage points higher than last year.

Of the applicants who matched, 54 percent of U.S. seniors and almost 50 percent of all other applicants matched to their first choice for training."

How is this number so low?

And more more question; if SGU students supposedly finish their last 2 years in US with rotations, do they get some sort of a diploma or certificate after their first 2 years (I'm just wondering)
 
Not sure if I'm missing something here, but this is what is says in the press release for the 2014 NRMP

"The overall match rate to first-year positions was 75 percent, the highest since 2006. The match rate for U.S. seniors was 94.4 percent, 0.7 percentage points higher than last year.

Of the applicants who matched, 54 percent of U.S. seniors and almost 50 percent of all other applicants matched to their first choice for training."

How is this number so low?

And more more question; if SGU students supposedly finish their last 2 years in US with rotations, do they get some sort of a diploma or certificate after their first 2 years (I'm just wondering)

You don't get a degree till graduating.
 
Of the applicants who matched, 54 percent of U.S. seniors and almost 50 percent of all other applicants matched to their first choice for training."

How is this number so low?

It's competitive. Not everyone is going to get their first choice. Even the most competetive people since they're fighting against other top candidates for few spots at the best programs.
 
You don't get a degree till graduating.

So is the fact that they did their first two years of med school at SGU but last 2 years in the US the reason why it's so hard to get into residency?

It just seems a little strange to me how those 2 years can change everything.
 
It's competitive. Not everyone is going to get their first choice. Even the most competetive people since they're fighting against other top candidates for few spots at the best programs.

Not defending the Carribeans, but 54 percent and 50 percent is not that big of a difference between US grads and "others", which I assume includes the Caribbean.

I just thought the number would be higher for US students, I guess.
 
Not defending the Carribeans, but 54 percent and 50 percent is not that big of a difference between US grads and "others", which I assume includes the Caribbean.

I just thought the number would be higher for US students, I guess.

Only 53percent of carribean students match at all. And 50 percent of carribean grads certainly don't ger there first choice residency.

"This year only 53 percent of United States citizens who attended foreign medical schools (most of them in the Caribbean) were placed through the National Resident Matching Program, compared with 94 percent of students from U.S. schools."

http://mobile.nytimes.com/2014/08/03/education/edlife/second-chance-med-school.html?_r=0
So is the fact that they did their first two years of med school at SGU but last 2 years in the US the reason why it's so hard to get into residency?

It just seems a little strange to me how those 2 years can change everything.

No this isn't the reason its hard to get a residency. The reason its difficult for carribean grads to get a residency is that there is a limited number of spots and enough qualified US grads to fill them. So carribean grads applications don't see the light of the day. Plus they have substandard training.

Here are some numbers from Ross. Since you like numbers

FAST FACTS

Ross University School of Medicine

For-profit, foreign medical school in Dominica (also has sister veterinary school in St. Kitts)

Founded: 1978

Owner: DeVry Inc. (acquired in 2003 for $310 million)

Enrollment: about 3,500

Student profile: 56 percent male, most U.S. residents, average age 27 (two years older than U.S. medical students)

Tuition: More than $40,000 per year

Percent of revenue from federal student loans: 81 percent

Four-year graduation rate: 30.6 percent

Six-year graduation rate: 66 percent

Percent of graduates who secure residency training: 80 percent (2006-07)

http://www.tampabay.com/news/health...e-quality-of-offshore-medical-schools/1061189
 
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Only 54 percent of carribean students match at all. And 50 percent of carribean grads certainly don't there first choice residency.



No this isn't the reason its hard to get a residency. The reason its difficult for carribean grads to get a residency is that there is a limited number of spots and enough qualified US grads to fill them. So carribean grads applications don't see the light of the day. Plus they have substandard training.

Here are some numbers from Ross. Since you like numbers

FAST FACTS

Ross University School of Medicine

For-profit, foreign medical school in Dominica (also has sister veterinary school in St. Kitts)

Founded: 1978

Owner: DeVry Inc. (acquired in 2003 for $310 million)

Enrollment: about 3,500

Student profile: 56 percent male, most U.S. residents, average age 27 (two years older than U.S. medical students)

Tuition: More than $40,000 per year

Percent of revenue from federal student loans: 81 percent

Four-year graduation rate: 30.6 percent

Six-year graduation rate: 66 percent

Percent of graduates who secure residency training: 80 percent (2006-07)
Two things that surprised me were:
1. After 6 Years the grad rate was still only 66

2. How did that residency percentage get all the way to 80? They are probably counting those students who have been applying every year since they graduated years ago. Because we saw that only 55 percent of RU students found residency in 2014.

You're right, I do like numbers.
 
Two things that surprised me were:
1. After 6 Years the grad rate was still only 66

2. How did that residency percentage get all the way to 80? They are probably counting those students who have been applying every year since they graduated years ago. Because we saw that only 55 percent of RU students found residency in 2014.

You're right, I do like numbers.

That includes a ton of preliminary spots and they are mostly likely non competitive resendencies in poor locations. That was also in 2007 and there is more of a crunch and those numbers have been going down. That article is an interesting one if you want to read it (tampa bay one) . In contrast touro college of osteopathic medicine has very little attrition and 98% residency placement.

So Ross is one of the best carribean schools. About half that start get a residency (not good ones) and have two extra years of debt on them. The other half just have debt. Tons in prelim spots gonna have to be general practioners.
 
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Going to the Caribbean could mean 200-300k of debt without residency. At the end, this is the biggest issue I see.
 
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So is the fact that they did their first two years of med school at SGU but last 2 years in the US the reason why it's so hard to get into residency?

It just seems a little strange to me how those 2 years can change everything.

It's not two years it's 4. All four years of med school are still being done through SGU. That school has contracts with community hospitals in the US where you can do rotations, but you don't get to claim those as a separate med school, and no residency will regard them as such.
 
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Not defending the Carribeans, but 54 percent and 50 percent is not that big of a difference between US grads and "others", which I assume includes the Caribbean.

I just thought the number would be higher for US students, I guess.

To rank a program one has to get an interview at that program, so there is another level of selection at work here.

For example:
Candidate A applies to 30 programs, gets 25 interview offers (all from university programs), attends 12 of them, ranks 10 of them, and gets his/her top choice.
Candidate B applies to 200 programs, gets 3 interview offers (all from community programs), attends all of them, ranks all of them, and gets his/her top choice.

Both candidates matched, both got their top choices, but their experiences were not synonymous.
 
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The only middle ground to not having a residency is to apply to another transitional internship, which IMGs also do. Once they have enough years (usually 2-3), they can be employed by a hospital in certain states as a general practitioner (your licensed but not board certified, thus cannot set up shop by yourself). However, you can't count on this either because hospitals are wanting more and more doctors that are board certified (completing the residency and speciality boards as well). This pathway of practicing, without a residency, may also be closed in the near future.

You don't have to be board certified to practice as a physician. You can open your own clinic if you want and be unboarded. However, many insurance companies will only pay you a reduced rate or won't allow you on their plans at all if you aren't boarded in something.
 
You don't have to be board certified to practice as a physician. You can open your own clinic if you want and be unboarded. However, many insurance companies will only pay you a reduced rate or won't allow you on their plans at all if you aren't boarded in something.

Somehow I keep getting the message from medical students or residents on the forum that setting up shop is not possible. I guess I might have misinterpreted what they meant. Thank you for the clarification.
 
The choice competitive specialties will get scooped up by allo grads coming up short for derm, ortho, plastics, etc initially. I don't think the allo people falling to soap after applying for noncompetitive things are going to displace better stat DOs though. In a few years, things will be more integrated.
My bet is that most MDs won't even enter the DO match, because the ones that have stats high enough to gun for derm aren't going to piss away their chances at an ACGME residency by applying for some middle of nowhere office-based DO derm practice. Once the match gets integrated, competitive DO programs will probably give a few spots to MDs though.
 
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Keep in mind that the majority, if not all, of the Caribbean schools teach to the USMLE. They'll drill you with internal exams meant to simulate the Step 1 and based on your performance would they even allow you to take the real thing and advance to the next year.

They also give you a ridiculous amount of study time for Step 1. Students have told me they studied 4-6 months for it (dedicated study time), while my stateside friends study in about 1/4 that time. I'm never impressed with a Caribbean grad with good board scores. With that amount of time and practice, the least of my expectations is for them to break 240+.
We consistently complain at my school about how non-board focused my school is. The professors shrug off our concerns, tell us we're "supposed to be learning how to be good doctors, not how to do well on some test." On the one hand, it kind of sucks, but on the other hand, I'd rather have that focus than what the Carib students get. We are perceived extremely well on rotations, as that is what we're trained for from day 1.
 
Actually technically speaking that's not true. You can rank any program you want to. It's simply a matter of typing in the code in the NRMP website. I could have ranked dermatology at Harvard #1 on my rank list if I felt like it.

*This is just a minor technical point, since of course any program that didn't interview you is not going to rank you, so yes the rank list is a surrogate for the interviewed at list in the 99% of cases. There are I'm sure some random people out there who put together a rank list that includes programs they didn't interview at but I don't know what is going on in their heads

You are correct, that is a minor technical point.;)
 
My bet is that most MDs won't even enter the DO match, because the ones that have stats high enough to gun for derm aren't going to piss away their chances at an ACGME residency by applying for some middle of nowhere office-based DO derm practice. Once the match gets integrated, competitive DO programs will probably give a few spots to MDs though.
Ortho (and Derm...)will go wherever they might be able to match. They will just put them at the bottom of their rank order list.
 
But my logic makes sense. I am almost certainly not going to go to Caribbean schools, but for the sake of argument:

* Thousands of med school graduates from countries like India, Pakistan, Egypt, etc. get into US residency programs. I am sure you will agree here that clinical rotations in these countries is hardly 'great' as the US-MD people insist their own rotations were/are. I would think that Caribbean rotations are better, and if you have been to a university (public) hospital in India (as i have) you will certainly agree with me.

* These schools are very corrupt as anyone familiar with them will attest.

* So how do these graduates get into US residencies? Through USMLE scores.

I think much of the negativity here is overstated. I have seen Caribbean graduates do fellowships at Baylor, Mt Sinai and Cleveland Clinic and I hardly know anyone in medicine.
A handful of good matches out of the thousands of students that get pumped out of the Caribbean each year isn't impressive in the slightest. It's akin to those convenience stores with the "We had a $10,000 winner!" lottery signs on their windows- plenty of people play, and a lot of people win small amounts, but someone winning big is rare. On the whole though, the majority people are losing money and wasting their time. This doesn't apply as much to the Big 4, but as time moves on, it's going to get worse, guaranteed.
 
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Ortho (and Derm...)will go wherever they might be able to match.
It's more an issue of the time difference between the DO match and the MD match. A lot of the DO derm residencies are criminally bad. An MD that has a good chance of matching MD derm would be foolish to forego the MD match just to secure a DO derm spot (which would deprive them of the ability to participate in the NRMP match and have a shot at MD derm positions). Less competitive MD applicants might apply, but they'll be competing with top-tier DOs that have likely rotated throughout he program (basically all DO derm programs require an audition rotation for consideration), so I'm betting that until the match is unified, the majority of these spots will keep going to DOs.

Ortho might see a few decent MD applicants early on, as DO ortho spots are fairly decent.

Gas and rads can't even fill with DO applicants because they are considered subpar enough that a lot of groups won't hire AOA trained anesthesiologists and radiologists (this is more true on the rads side than the anesthesia side).

I could definitely see some encroachment by MDs on urology before a merger though. Like all competitive DO specialties though, that MD app is going right in the trash 9 out of 10 times if they haven't done an audition at the site though.
 
It's more an issue of the time difference between the DO match and the MD match. A lot of the DO derm residencies are criminally bad. An MD that has a good chance of matching MD derm would be foolish to forego the MD match just to secure a DO derm spot (which would deprive them of the ability to participate in the NRMP match and have a shot at MD derm positions). Less competitive MD applicants might apply, but they'll be competing with top-tier DOs that have likely rotated throughout he program (basically all DO derm programs require an audition rotation for consideration), so I'm betting that until the match is unified, the majority of these spots will keep going to DOs.

Ortho might see a few decent MD applicants early on, as DO ortho spots are fairly decent.

Gas and rads can't even fill with DO applicants because they are considered subpar enough that a lot of groups won't hire AOA trained anesthesiologists and radiologists (this is more true on the rads side than the anesthesia side).

I could definitely see some encroachment by MDs on urology before a merger though. Like all competitive DO specialties though, that MD app is going right in the trash 9 out of 10 times if they haven't done an audition at the site though.
It is my understanding that the merger will eliminate the need to choose one application system over another due to timing.
 
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It is my understanding that the merger will eliminate the need to choose one application system over another due to timing.
From what I gather, they aren't changing the match for at least 5 years. Because the match occurs through the NRMP and not the ACGME, any changes to the match will have to be dealt with separately from the merger. DO students generally want a merged match, but our leadership is dragging their feet because they know that a merged match will likely hurt their lower-tier programs, since we'll be able to rank ACGME programs higher for the first time in ever.
 
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From what I gather, they aren't changing the match for at least 5 years. Because the match occurs through the NRMP and not the ACGME, any changes to the match will have to be dealt with separately from the merger. DO students generally want a merged match, but our leadership is dragging their feet because they know that a merged match will likely hurt their lower-tier programs, since we'll be able to rank ACGME programs higher for the first time in ever.
I see.
 
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My bet is that most MDs won't even enter the DO match, because the ones that have stats high enough to gun for derm aren't going to piss away their chances at an ACGME residency by applying for some middle of nowhere office-based DO derm practice. Once the match gets integrated, competitive DO programs will probably give a few spots to MDs though.

I'm pretty sure that the DO match is going to go away at the same time these residencies are opened up. You wouldn't ever have US grads applying to the osteo match, or taking the comlex etc -- that's not what is being bargained for at all.
 
Somehow I keep getting the message from medical students or residents on the forum that setting up shop is not possible. I guess I might have misinterpreted what they meant. Thank you for the clarification.

Not per se "impossible" once you are licensed. However, it may be unrealistic. (1) as mentioned you may have hurdles with your insurance providers and get paid less, (2) may have issues in a medmal case when the lawyers play up that you aren't even board certified and thus maybe not as adequately qualified to practice in whatever specialty you so chose, (3) my have credentialing issues in terms of privileges in local hospitals, (4) without having gone through a full residency might not actually be competent to do some of the things one who is fully trained does.

So are there guys out there who get just the license and set up Botox clinics or whatever etc? Sure. Are they lawsuits waiting to happen? Probably.
 
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From what I gather, they aren't changing the match for at least 5 years. Because the match occurs through the NRMP and not the ACGME, any changes to the match will have to be dealt with separately from the merger. DO students generally want a merged match, but our leadership is dragging their feet because they know that a merged match will likely hurt their lower-tier programs, since we'll be able to rank ACGME programs higher for the first time in ever.

No, they aren't dragging their feet because it will "hurt lower tier programs," although they certainly might be saying this. They are dragging their feet because once everything is merged, there isn't much reason for the DO leadership's jobs to still exist. You don't get to still be king once you've given away your kingdom. In any hostile takeover setting, the management team of the acquired company is going to try to stall things, give themselves time to earn a few more paychecks, etc. They may even try to put a positive spin on it, that they are doing it for someone else, but don't fall for it. This could all happen in a year if everyone was pulling in the same direction. They aren't.
 
No, they aren't dragging their feet because it will "hurt lower tier programs," although they certainly might be saying this. They are dragging their feet because once everything is merged, there isn't much reason for the DO leadership's jobs to still exist. You don't get to still be king once you've given away your kingdom. In any hostile takeover setting, the management team of the acquired company is going to try to stall things, give themselves time to earn a few more paychecks, etc. They may even try to put a positive spin on it, that they are doing it for someone else, but don't fall for it. This could all happen in a year if everyone was pulling in the same direction. They aren't.
It hurting low tier programs (and thus their PD cronies) is not the official story. The AOA leadership still has plenty to do outside of the match and overseeing programs- that was actually one of the smaller functions they had, and the ones involved in it have basically all been granted positions in the ACGME as the osteopathic representation. They're dragging their feet with this for the same reason they always have though- they want osteopathic PDs to get the best applicants possible, and, given that most osteo residencies are in primary care, those residencies would suffer if they were competing on equal ground with ACGME residencies. It's the same reason there has never been a unified match, despite students clamoring for one for over fifteen years. It's in our best interest as students, but not in the best interest of the people with pull in the AOA (PDs, senior leadership, and the hard-core DOs that want to keep the profession as separate as possible).

I would love a unified match, so I keep up on the topic pretty closely. The last bulletin posted by the AOA leadership last month said it was being explored, and could be a possibility between 2017 and 2022, if I remember correctly. Given that I'm class of 2018, I'm hoping it's on the earlier side, but knowing how we've been screwed in the past, I'm being it will be somewhere in the middle.
 
Two things that surprised me were:
1. After 6 Years the grad rate was still only 66

2. How did that residency percentage get all the way to 80? They are probably counting those students who have been applying every year since they graduated years ago. Because we saw that only 55 percent of RU students found residency in 2014.

You're right, I do like numbers.

It got all the way to 80% because according to this source that's the percentage of graduates matched, not incoming students. If you assume 66% of entering students actually graduate (the percent that graduate w/in 6 years) and 80% of those students match, then you will have ~53% of the incoming students matching through this process which is pretty close to the 55% of students who obtain a residency spot. The other 2% may be some error or it may be students obtaining placement outside the match.

I would love a unified match, so I keep up on the topic pretty closely. The last bulletin posted by the AOA leadership last month said it was being explored, and could be a possibility between 2017 and 2022, if I remember correctly. Given that I'm class of 2018, I'm hoping it's on the earlier side, but knowing how we've been screwed in the past, I'm being it will be somewhere in the middle.

Won't your field of choice play some influence in whether or not a unified match would benefit DOs? I understand how it would help DO students who are competitive for primary care or non-competitive specialties, but I would think it would hurt those who are not very strong applicants pursuing more competitive fields since MDs could be taking those places. Besides, if you're a strong candidate in non-competitive fields, I would think matching ACGME as a DO wouldn't be much of an issue if you apply wisely.
 
On their website,"RUSM was #1 in residencies, with more graduates matching into US residencies than any other medical school" (in 2014)

Can someone show me some evidence that "fact" this is due to preliminary aka dead-end spots and that they didn't get their first (or even second) choice residency?

This can be VERY misleading

 
On their website,"RUSM was #1 in residencies, with more graduates matching into US residencies than any other medical school" (in 2014)

Can someone show me some evidence that "fact" this is due to preliminary aka dead-end spots and that they didn't get their first (or even second) choice residency?

This can be VERY misleading
Is this compared to other caribb schools? If so I believe it. However compared to other medical schools within the U.S.? That makes me laugh.
 
Is this compared to other caribb schools? If so I believe it. However compared to other medical schools within the U.S.? That makes me laugh.

Not necessarily. How big is the class at Ross? Even if only half were to match, that would still be more grads than the largest LCME school (Wayne State? IU/UIC depending if you count the multiple campuses as one school?)
 
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Take a look at Chart 15 on page 28. http://b83c73bcf0e7ca356c80-e8560f4...atch-International-Medical-Graduates-2014.pdf

This long document answers all questions about step scores and match for US and Non-US IMG/FMGs, including Ross (island of Dominica).

It looks like their 2014 numbers are 532 matched, 432 unmatched for a total of 964. This equates to a 55% success rate in the match.

Not sure how they inflate the numbers to 80% or 800+ matches a year, but it could include prelim spots or people who entered the match for a second time. What is crazy is the breakdown per speciality shows that even in Family Medicine (which is most likely what IMGs go into), the matched vs. unmatched rate is 367/462. So only 44% for those that ranked one speciality (family med- the least competitive) matched into it. It's even harder for non-US IMGs even though their Step scores seem to be significantly higher than US IMGs.
 
In the Science trade, we call it"lying".

Not sure how they inflate the numbers to 80% or 800+ matches a year, but it could include prelim spots or people who entered the match for a second time.

OK, Doc Turr, you've convinced me. It will be an excellent career choice for YOU to go to Ross or some other Carib school. Satisfied?
 
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Apparently, one got into RadOnc, which is actually impressive. A few into PM&R, which shouldn't be easy from a Caribb school (assuming this isn't a prelim year.)
 
In the Science trade, we call it"lying".

Not sure how they inflate the numbers to 80% or 800+ matches a year, but it could include prelim spots or people who entered the match for a second time.

OK, Doc Turr, you've convinced me. It will be an excellent career choice for YOU to go to Ross or some other Carib school. Satisfied?

"There are lies, damned lies and statistics."
 
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And these people won the Lottery, but I wouldn't recommend it as an investment strategy. Outliers don't equal the norm.


072414_lotto_va004.jpg



Apparently, one got into RadOnc, which is actually impressive. A few into PM&R, which shouldn't be easy from a Caribb school (assuming this isn't a prelim year.)
 
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All I'm asking is for a source that shows that those residency spots that Ross claims to have are either preliminary spots or undesirable ones.
I just looked at this match list: http://www.rossu.edu/medical-school/2014residencyappointments.cfm
Not one of my students even interviewed at any of these programs, much less matched into them.
Admittedly, I'm in CA so there may be regional differences, but my kids matched all over the country and to see no overlap at all??
 
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A lack of critical thinking, desperation and gullibility are phenotypes of people who go to Carib schools. The other differentials aren't pretty, either.


And over the 300 or so posts in this thread you have been given multiple sources, multiple times. You've been given match lists, match statistics from the NRMP, multiple news articles, links to previous threads on this topic, as well as personal experience from people who've done it and anecdotes from people who've seen others do it (both positive and negative anecdotes).

Yet you keep coming back with the same questions over and over.
 
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And over the 300 or so posts in this thread you have been given multiple sources, multiple times. You've been given match lists, match statistics from the NRMP, multiple news articles, links to previous threads on this topic, as well as personal experience from people who've done it and anecdotes from people who've seen others do it (both positive and negative anecdotes).

Yet you keep coming back with the same questions over and over.
I haven't been given a source that says most of the spots are preliminary spots.

If I get that, don't worry, I'll be out of your life for good.
 
I haven't been given a source that says most of the spots are preliminary spots.

If I get that, don't worry, I'll be out of your life for good.

It is your responsibility to make sure that you know what you are getting yourself into; not ours to persuade you down a certain path.
 
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I haven't been given a source that says most of the spots are preliminary spots.

If I get that, don't worry, I'll be out of your life for good.

Look, dude. Whatever your goal is: you're not convincing anyone that the Caribbean is a good idea, nor are you going to get encouragement from us to pursue that path.

Do what you want. Good luck.
 
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