The in house CRAs (monitors) for pharma companies make decent money if you are worried about paying back loans. There's a lot of travel involved and there isn't too much room for growth but it's certainly a means to an end. You'd have to start off in research at a hospital and collect a certain amount of experience before applying.
Getting ECFMG certification and finishing your degree are two very different things, although with a Caribbean school these things are intertwined. Is your degree accepted in Europe? Do you have any ties to the UK, Australia, New Zealand? I'm not saying these places accept bad doctors but they are more forgiving than the US when it comes to Step scores and exam attempts. You will still have to pass exams, there is no escaping from them.
I looked at your post history and I'm impressed by your dedication. At this point I would avoid the sunk cost fallacy and withdraw especially if rotations are expensive and in the US. You'll need to rethink your career choice.
