Old thread says other medical schools won't know you were previously accepted?

[Redpancreas]

All over SDN, I've spread my opinion that you shouldn't decline an acceptance for an MD school to reapply and I've done so with confidence because I've seen so many threads in which people claim that MD school B in cycle 2014- 2015 can see an acceptance from MD school A in cycle 2013-14. I've even told this advice to close friends and one has withdrawn from a waitlist because of it. However, in light of that, I dug this up from a post in 2012 from a 200+ poster who's now in medical school and it seems legit because he claims he called AAMC. I never did this but come to think of it, it's probably the only way to confirm whether SDN conventional wisdom is right or wrong. If this is the case, it calls into question the advice I give my pre-med friends.


Here's the post in question:

" To answer the original question since I actually called AMCAS last year before applying to med schools.

Medical schools will know if you were accepted into medical school and declined ONLY if you apply to the same school twice. When you apply to a school, they make a file about you. Come May 1st (I forget the exact date) each school that you applied to will have access to where you have been accepted (not rejected, waitlitsted, or merely applied). If you then apply to that same school again, they can look you up in their database and see this acceptance data from the previous year. Thus, if you apply to Harvard during year 1, get rejected but get into another school, turn it down, and apply to Harvard again the following year, provided they kept your file, they will see that you turned down an acceptance the previous year. This will look REALLY bad.

So...technically, if the second time around you applied to a whole new slew of schools, they would have no way of knowing whether or not you declined any acceptances."


Basically, this guy is saying that unless you apply to school, there's no way of the school knowing if you were previously accepted elsewhere. Is this just flat out wrong information here...if someone showed it to me, I would say it would be but in this thread no one contradicted this guy. Could we maybe get a couple of people to confirm this?

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[Jagon]

I'm curious so I look forward to seeing responses. I can tell you that if you are accepted to A and B, they can definitely see it. I received an email in mid-April asking me to let them know as soon as I've made a decision out of consideration from others on the waitlist.

I'm particularly curious though about what med schools can see from other kinds of schools. E.g. can a US MD school see a US DO school, or a Canadian MD school?

USMD can't see usdo or Canadian for that matter. There is a question on amcas and many secondaries asking sbout previous acceptances I believe so if you chose not to disclose you'd be lying on amcas.

 

[blueharbor]

USMD can't see usdo or Canadian for that matter. There is a question on amcas and many secondaries asking sbout previous acceptances I believe so if you chose not to disclose you'd be lying on amcas.

The AMCAS only requires that you:
1. Say if you ever attended or matriculated at any medical school
2. Check "yes" or "no" to the question "Have you applied to this medical school in previous years?" for each medical school. Medical schools will only see your answer to that question for their own school.

Some secondaries ask about previous acceptances, but not all.

 

[Redpancreas]

So then what's all this fuss about declining an acceptance. In most cases, it's a stupid thing to do, but let's say flr example, if a friend of mine were to get into central mi and that was his only acceptance, and next cycle he had more SMP grades, more ECs, and a generally improved application, wouldn't it maybe make sense to apply again?

 

[efle]

So then what's all this fuss about declining an acceptance. In most cases, it's a stupid thing to do, but let's say flr example, if a friend of mine were to get into central mi and that was his only acceptance, and next cycle he had more SMP grades, more ECs, and a generally improved application, wouldn't it maybe make sense to apply again?

It's probably more that for many people, their best shot is with instate schools and the handful of private schools with accessible stats. If they cross off their 12-15 best options they'd better do a hell of a lot in their added year to have a decent second cycle

 

[blueharbor]

It's probably more that for many people, their best shot is with instate schools and the handful of private schools with accessible stats. If they cross off their 12-15 best options they'd better do a hell of a lot in their added year to have a decent second cycle

Edit: never mind.

 

[Redpancreas]

It's probably more that for many people, their best shot is with instate schools and the handful of private schools with accessible stats. If they cross off their 12-15 best options they'd better do a hell of a lot in their added year to have a decent second cycle

This is a fair point but I'm not sure if we've teased out the important thing which is if you applied to schools A through J, and got accepted to A, would schools B through J be aware of your previous acceptance? How? I was under the assumption that AMCAS made you check some sort of box, but now come to think of it, I don't remember any such box when I applied.


@Goro @LizzyM @gyngyn

 

[blueharbor]

This is a fair point but I'm not sure if we've teased out the important thing because the initial quote was vague in this regard, but if you applied to schools A through J, and got accepted to A, would schools B through J be aware of your previous acceptance? How?

Actually I retract the statement I just made because I'm not clear on the details.

Edit: thought you were replying to me.

 

[Redpancreas]

I'm curious so I look forward to seeing responses. I can tell you that if you are accepted to A and B, they can definitely see it. I received an email in mid-April asking me to let them know as soon as I've made a decision out of consideration from others on the waitlist.

I'm particularly curious though about what med schools can see from other kinds of schools. E.g. can a US MD school see a US DO school, or a Canadian MD school?

I don't know about Canadian but MD and DO are completely separate so you could literally violate the trafficking rules in one, and not face repercussions in the other. I know students who applied to DO schools as a back up with the plans of attending only if they were rejected from MD schools for two straight cycles (so they'd defer their acceptance by a year to the DO). Sounds terrible, but it apparently works...

If I were to make a guess about Canadian, I'd guess they would be a separate entity considering I could not apply to a Canadian school via AMCAS which is the AMERICAN medical college admission service.

 

[Redpancreas]

USMD can't see usdo or Canadian for that matter. There is a question on amcas and many secondaries asking sbout previous acceptances I believe so if you chose not to disclose you'd be lying on amcas.

I never saw this question and I applied to a good 20+ schools. Do you believe or do you know for sure? Not trying to be rude, it's just that I wants a solid answer here and I can't seem to access my own AMCAS to verify.

Edit: So AMCAS definitely doesn't because I just asked my friend and all it asks is:


"Have you ever matriculated at or attended any medical school as a candidate for a medical degree? "

 

[blueharbor]

Here is what AMCAS has to say:
https://www.aamc.org/students/applying/amcas/faqs/305002/canschoolsseeotherschools.html

"In April of the application year, medical schools will have access to the National Acceptance Report, which lists every applicant with an acceptance or matriculated action."

 

[blueharbor]

I never saw this question and I applied to a good 20+ schools. Do you believe or do you know for sure? Not trying to be rude, it's just that I wants a solid answer here and I can't seem to access my own AMCAS to verify.

My answer earlier was based on accessing my AMCAS and checking (and there is no such question).

 

[Redpancreas]

Here is what AMCAS has to say:
https://www.aamc.org/students/applying/amcas/faqs/305002/canschoolsseeotherschools.html

"In April of the application year, medical schools will have access to the National Acceptance Report, which lists every applicant with an acceptance or matriculated action."

Oh, right! I forgot about that amid all this...right so basically if they apply to school a, get accepted, school B will know the following year if they applied to it during the first year.

In other words, you'd have to apply to a completely new school.

 

[efle]

Oh, right! I forgot about that amid all this...right so basically if they apply to school a, get accepted, school B will know the following year if they applied to it during the first year.

In other words, you'd have to apply to a completely new school.

Yes this is what I was saying, if they apply to 12-15 schools and get in to ANY of them, all 12-15 find out and you'd need an entirely new list the next year

 

[TorpedoVegas38]

Yes this is what I was saying, if they apply to 12-15 schools and get in to ANY of them, all 12-15 find out and you'd need an entirely new list the next year

This is assuming that schools record this info and search the list based on the next years applicants. It might be different school to school. Also, if you turn down the acceptance before April and the National Acceptance List is made do you still show up?

 

[DokterMom]

From the linked (thank you!) information:

=================================================
Can schools see the names of or number of other schools that I applied to?
No. Schools will never know which other schools or how many other schools you applied to through AMCAS. In the February of each application cycle, schools will have access to the Multiple Acceptance Report, which will show them which of their accepted applicants are holding acceptances from other schools.

For example, let's say you applied to schools A, B, X, and Y. You were accepted by A and B. When the Multiple Acceptance Report becomes available, schools A and B will both see that you have been offered acceptance at the other school. You were rejected by school X, so they won't see any information about where you were accepted. No action has been taken by school Y, so they won't see any information about where you were accepted. If school Y accepts you a week later, school Y will then see that you are holding offers from A and B, and A and B will know that you now have an offer from Y as well.

In April of the application year, medical schools will have access to the National Acceptance Report, which lists every applicant with an acceptance or matriculated action.
=================================================

That last bit seems to imply that after April, School X, who never extended you an offer, will then be able to see that you got offers at A, B and Y. I would infer from the above that School Z, to which you never even applied, would also have access to that information, since selectively withholding your data from School Z is a lot more technically demanding than simply publishing a list of everyone's acceptances everywhere.

That's the real question, isn't it?

 

[Glandzburg]

I seem to remember somebody mentioning that adcoms can see information about past acceptances via the student clearinghouse. Would need confirmation from an adcom however.

 

[Redpancreas]

From the linked (thank you!) information:

=================================================
Can schools see the names of or number of other schools that I applied to?
No. Schools will never know which other schools or how many other schools you applied to through AMCAS. In the February of each application cycle, schools will have access to the Multiple Acceptance Report, which will show them which of their accepted applicants are holding acceptances from other schools.

For example, let's say you applied to schools A, B, X, and Y. You were accepted by A and B. When the Multiple Acceptance Report becomes available, schools A and B will both see that you have been offered acceptance at the other school. You were rejected by school X, so they won't see any information about where you were accepted. No action has been taken by school Y, so they won't see any information about where you were accepted. If school Y accepts you a week later, school Y will then see that you are holding offers from A and B, and A and B will know that you now have an offer from Y as well.

In April of the application year, medical schools will have access to the National Acceptance Report, which lists every applicant with an acceptance or matriculated action.
=================================================

That last bit seems to imply that after April, School X, who never extended you an offer, will then be able to see that you got offers at A, B and Y. I would infer from the above that School Z, to which you never even applied, would also have access to that information, since selectively withholding your data from School Z is a lot more technically demanding than simply publishing a list of everyone's acceptances everywhere.

That's the real question, isn't it?

Yup,
This is really complex lol.


So far we've established that schools you've applied to previously HAVE THE ABILITY to see whether you were accepted that year.

However, we don't know if schools you've never applied to have seen this list because we don't know who has access to this national acceptance list. I would also assume every medical school administrators should be given access otherwise, it would require a lot of technicality to only release information for the applicants of their school. It could be done with neat programming, but I doubt it is.

Also, as torpedo says, who knows if it's even common practice for adcoms to check this national acceptance list that comes out in April.

 

[DokterMom]

Yup,
This is really complex lol.


So far we've established that schools you've applied to previously HAVE THE ABILITY to see whether you were accepted that year.

However, we don't know if schools you've never applied to have seen this list because we don't know who has access to this national applicant list. I would also assume every medical school administrators should be given access otherwise, it would require a lot of technicality to only release information for the applicants of their school. It could be done with neat programming, but I doubt it is.

Also, as torpedo says, who knows if it's even common practice for adcoms to check this national acceptance list that comes out in April.

That last sentence:

"In April of the application year, medical schools will have access to the National Acceptance Report, which lists every applicant with an acceptance or matriculated action."

suggests to me that after April every school can see every acceptance. That's certainly the easiest report to run, and generically, the most useful.

Now we know that AMCAS applicants have one number that stays the same even over multiple cycles. If those numbers are roughly sequential, it would be fairly simple to suspect who's a reapplicant in general from an earlier AMCAS number, from an older MCAT score (suspect, not know) especially if the 'last year' activities were more of a 'fill-the-time productively' rather than a 'can't pass this up, so wait-a-year to apply' nature, or from an MCAT retake that jumps from 'low-tier' to 'top-tier' caliber.

If I saw an application that caused me to wonder -- "Looks like this guy could have applied and been accepted somewhere last year - wonder why not?" I might very well check last year's report. If I never wondered, I'd never check.

 

[efle]

"Looks like this guy could have applied and been accepted somewhere last year - wonder why not?" I might very well check last year's report. If I never wondered, I'd never check.

Hah, so improving a lot in the added year could actually be detrimental - better to fly under the radar as just another decent app!

 

[DokterMom]

Hah, so improving a lot in the added year could actually be detrimental - better to fly under the radar as just another decent app!

Only if you turned down a low-tier school in hopes of landing a top-tier based on the new results the next cycle. Otherwise, big improvements are highly desirable --

 

[premed_noob]

There are 3 separate issues that are going in this thread this I want to make sure people understand.

1) All Canadian Medical Schools are members of the AAMC though they do not participate in the AMCAS system. I do not know how much information they regularly review such as the National Acceptance Reports. The Osteopathic application run by AACOMAS is fully separate from AMCAS. However, there is certainly some movement to have to share data in order to get better statistics for long term workforce planning.

2) The National Acceptance Report for each year does show all your acceptances to all schools and can be viewed by all schools: "in April of each year, a medical school can view the school or schools that have accepted you, even if you have not yet been accepted by the medical school " (AMCAS Instruction 2016 p 81).

Schools do not see if/where you may have previously applied to except to their own school via the AMCAS Primary Application System. However, every school in fact can see that you were accepted or matriculated via the National Acceptance Report. While it would seem unlikely that a school would go thru the effort, more and more schools are moving to AAMC processing tools . That may mean any school may automatically search and populate with your AMCAS ID and see previous any acceptances.

3) There have been some schools asking on secondaries a more inclusive form of the question of previous acceptances such as "have you previously been accepted or matriculated at any medical school, osteopathic medical school, or foreign medical school."

What if you get say a first acceptance much after April, after the national list is released? Like getting off a waitlist in May or June for your first acceptance. Would medical schools that you are (re-)applying to in the upcoming cycle still see the acceptance? Is it still as detrimental turning down the acceptance from the waitlist to apply again after that list has been released? Or is the list something that keeps getting added to with waitlist data? I'm assuming that a matriculation is basically the student accepting the acceptance.

Here's a scarier thought - what if one has already applied the second time - and then gets in off the waitlist from the first cycle say in June or July. Will medical schools know about that (late) acceptance? Is it detrimental to turn down the acceptance in this case and continue with secondaries, etc?

 

[gyngyn]

What if you get say a first acceptance much after April, after the national list is released? Like getting off a waitlist in May or June for your first acceptance. Would medical schools that you are (re-)applying to in the upcoming cycle still see the acceptance? Is it still as detrimental turning down the acceptance from the waitlist to apply again after that list has been released? Or is the list something that keeps getting added to with waitlist data? I'm assuming that a matriculation is basically the student accepting the acceptance.

Here's a scarier thought - what if one has already applied the second time - and then gets in off the waitlist from the first cycle say in June or July. Will medical schools know about that (late) acceptance? Is it detrimental to turn down the acceptance in this case and continue with secondaries, etc?

We do check the National Acceptance Report.

 

[Glandzburg]

What if you get say a first acceptance much after April, after the national list is released? Like getting off a waitlist in May or June for your first acceptance. Would medical schools that you are (re-)applying to in the upcoming cycle still see the acceptance? Is it still as detrimental turning down the acceptance from the waitlist to apply again after that list has been released? Or is the list something that keeps getting added to with waitlist data? I'm assuming that a matriculation is basically the student accepting the acceptance.

Here's a scarier thought - what if one has already applied the second time - and then gets in off the waitlist from the first cycle say in June or July. Will medical schools know about that (late) acceptance? Is it detrimental to turn down the acceptance in this case and continue with secondaries, etc?

Why would getting off a waitlist be scary? Don't apply to schools that you wouldn't want to attend!

 

[Goro]

If I may add to my learned colleague's comment, I believe other people turn down acceptances after having been turned off by the school by it's facilities, demeanor, or location (it's one thing to know Yale is in a high crime area, it's another thing to actually visit and see it's an armed camp).

But teaching moment here: we are leery of people who turn down acceptances in the hope of getting into a better school later. This shows poor choice making.

We are even more leery of people who have been accepted and been dismissed or left, for reasons other than dire family emergencies or health.


All of the above begs the question, why would you apply to a medical school that after acceptance you would choose not to attend. The few applicants I know about who turned down an acceptance and reapply and go later have been either extreme family/medical circumstances or have an outstanding educational/fellowship/research opportunity come up that is longer than a deferment. These are very rare cases.

 

[NeuResurgens]

(it's one thing to know Yale is in a high crime area, it's another thing to actually visit and see it's an armed camp).

Interesting - I wasn't aware of this. I've heard Hopkins is somewhat similar, although it has supposedly been improving.

 

[deleted390966]

2) The National Acceptance Report for each year does show all your acceptances to all schools and can be viewed by all schools: "in April of each year, a medical school can view the school or schools that have accepted you, even if you have not yet been accepted by the medical school " (AMCAS Instruction 2016 p 81).

Man, I don't think this is good, because when a school that has NOT accepted you sees that you've been accepted somewhere, they may think "let's extend an acceptance to ANOTHER candidate instead!"

 

[gyngyn]

Man, I don't think this is good, because when a school that has NOT accepted you sees that you've been accepted somewhere, they may think "let's extend an acceptance to ANOTHER candidate instead!"

We cannot see where you are accepted until we have made a decision on your application.
If that decision is a waitlist, we will be able to see where you have been accepted in April.

 

[efle]

Man, I don't think this is good, because when a school that has NOT accepted you sees that you've been accepted somewhere, they may think "let's extend an acceptance to ANOTHER candidate instead!"

Correct me if I'm wrong, but iirc @gyngyn has said this is a myth. For you to be in this situation, the school has already expended the resources to review your app and interview you. It costs them nothing more to bump your waitlist to accept, and so statistically the smartest thing to do is what they do, move down the waitlist accepting people in order of their attractiveness as candidates until they hit the approx target matriculant number.

 

[efle]

We cannot see where you are accepted until we have made a decision on your application.

Oh I assumed he was talking about decisions on waitlisted people

 

[gyngyn]

Oh I assumed he was talking about decisions on waitlisted people

You may be right.

 

[gopatsgo]

Is it correct, then, that all of the above only applies to AMCAS (and possibly Canadian?) schools, and does not apply to DO schools?

For example, a future AMCAS applicant could be accepted to and even matriculate to an osteopathic school, drop out, and reapply to a medical school, without medical schools seeing the osteopathic acceptance and (if applicable) matriculation?

Also, would this apply to Caribbean medical schools?

 

[gyngyn]

Is it correct, then, that all of the above only applies to AMCAS (and possibly Canadian?) schools, and does not apply to DO schools?

For example, a future AMCAS applicant could be accepted to and even matriculate to an osteopathic school, drop out, and reapply to a medical school, without medical schools seeing the osteopathic acceptance and (if applicable) matriculation?

Also, would this apply to Caribbean medical schools?

AMCAS requests all transcripts. A DO matriculation will appear there.

 

[starspells]

AMCAS requests all transcripts. A DO matriculation will appear there.

Just to expand, AMCAS requires course work from any medical school regardless of country

AMCAS Instruction, page 48 (see bottom of page)
Medical School Coursework
Courses taken in any medical school program at any institution regardless of
country must be listed. Include the institution in the Schools Attended section.
Enter coursework, transcript grades and credit hours.

Additionally, while there is no formal mechanism for an off-shore school to allow verification for such attendance, with most of the larger off-shore schools having rotations in the US, they may have some contractual obligation to provide info if requested. Certainly it would be in their best interest to do so as they rely on the good graces of some states, California and New York especially, and they would want to add to their being dislike by AMA/AAMC/AMCAS as it is.

Would matriculation to a Caribbean school show up? since they're not accredited?

 

[starspells]

2) Your question mildly implies that since the Caribbean schools are not part of the system AMCAS or AACOMAS system that if you go to one of them, you could get away with not reporting it. However, that would be starting your career as a prospective physician in an unethical manner into a profession that tries to maintain a high ethical standard. The idea of that truly bothers me. I know that isnt what you meant, isnt it?

I was just curious if someone went there but dropped out after their first year and reapplied to US MD/DO that they could probably get in here if that record doesn't show up? I've read some blogs of people doing this (as in going to med school here after failing out there/dropping out there). Lol I wasn't asking for myself! I would never go to one of those schools...

Interesting that those "schools" are on there! That means SGU, online schools like UoPheonix, Devry probably are too...

 

[Goro]

Keep in mind that if one matriculates into a Carib school, that one will have a gap in their record of activities for the time they were at said school.

This gets noticed.

I was just curious if someone went there but dropped out after their first year and reapplied to US MD/DO that they could probably get in here if that record doesn't show up? I've read some blogs of people doing this (as in going to med school here after failing out there/dropping out there). Lol I wasn't asking for myself! I would never go to one of those schools...

Interesting that those "schools" are on there! That means SGU, online schools like UoPheonix, Devry probably are too...

 

[Noni Mousse]

I never saw this question and I applied to a good 20+ schools. Do you believe or do you know for sure? Not trying to be rude, it's just that I wants a solid answer here and I can't seem to access my own AMCAS to verify.

Edit: So AMCAS definitely doesn't because I just asked my friend and all it asks is:


"Have you ever matriculated at or attended any medical school as a candidate for a medical degree? "

The AMCAS only requires that you:
1. Say if you ever attended or matriculated at any medical school
2. Check "yes" or "no" to the question "Have you applied to this medical school in previous years?" for each medical school. Medical schools will only see your answer to that question for their own school.

Some secondaries ask about previous acceptances, but not all.

FYI for those using TMDSAS for Texas schools, TMDSAS does ask "Have you ever been accepted to ANY medical, dental, or veterinary school?"

 

[Noni Mousse]

Huh, I've also heard of someone initially at caribbean later getting into medical school in the states a few years ago. I guess things have changed since then? Or perhaps they were accepted and matriculated into the Caribbean after they already submitted their amcas/tmdsas application so that it wasn't lying when they initially submitted the application; they just never updated the schools with the info - this is what I initially imagined when I heard this. This would also prevent the gap in activities problem because they wouldn't have the gap until after they submitted

 

[Goro]

You are under the assumption that if an applicant told a US MD/DO school they left an offshore, it would be an instant rejection. I have had several students who have jumped from off shore to US. They simply were up front about it and explained their reasons

Even my school has taken some people who first went to a Carib school. The caveat was that they all left Carib for health reasons.

 

[Noni Mousse]

You are under the assumption that if an applicant told a US MD/DO school they left an offshore, it would be an instant rejection. I have had several students who have jumped from off shore to US. They simply were up front about it and explained their reasons

Well, I don't know what a good reason that medical schools would accept would be. And for this person, no one in his class knew for quite awhile so it seemed like the student did it secretly but I guess he could have been upfront with admissions and then neither admissions nor the student told anyone else. I see Goro said 'health' reasons. Does living on an island cause health problems or they have a family member with a medical problem to take care of or they suddenly have a health problem that for some reason can be taken care of in the states or what do you mean by 'health'?

 

[Noni Mousse]

And I don't suppose medical schools would accept 'financial' reasons since we all get loans haha I might consider applying to my state schools again this cycle if that's the case. It would half my tuition!

 

[Goro]

Well, I don't know what a good reason that medical schools would accept would be. And for this person, no one in his class knew for quite awhile so it seemed like the student did it secretly but I guess he could have been upfront with admissions and then neither admissions nor the student told anyone else. I see Goro said 'health' reasons. Does living on an island cause health problems or they have a family member with a medical problem to take care of or they suddenly have a health problem that for some reason can be taken care of in the states or what do you mean by 'health'?

Living on the islands made the students sick, literally.

 

[Noni Mousse]

Living on the islands made the students sick, literally.

How? Is this just their excuse? Do they get allergies? Homesick? Sick of the ugly island and school? Sick from eating bad food? How does living on the island make them sick? Sick of abuse from the school? Panic/anxiety? lol I don't understand

 

[person777]

How? Is this just their excuse? Do they get allergies? Homesick? Sick of the ugly island and school? Sick from eating bad food? How does living on the island make them sick? Sick of abuse from the school? Panic/anxiety? lol I don't understand

Probably related to the food or bug bites.

 

[Goro]

How? Is this just their excuse? Do they get allergies? Homesick? Sick of the ugly island and school? Sick from eating bad food? How does living on the island make them sick? Sick of abuse from the school? Panic/anxiety? lol I don't understand

Allergies or tropical diseases.

 

[mwsapphire]

Allergies or tropical diseases.

Aren't allergies generally a manageable issue though I don't know many people who move bc of allergies? Am I missing something? Do they not have allergists down there?

 

[Goro]

Aren't allergies generally a manageable issue though I don't know many people who move bc of allergies? Am I missing something? Do they not have allergists down there?

Haven't a clue. Allergists?? Keep in mind that these are 3rd World countries.

 

[mwsapphire]

Haven't a clue. Allergists?? Keep in mind that these are 3rd World countries.

Pakistan is also a 3rd world country. They have allergists. Doctors ( even specialists!) can actually exist in poor countries.
You're really ruffling my feathers, here.

 

[FlowRate]

Pakistan is also a 3rd world country. They have allergists. Doctors ( even specialists!) can actually exist in poor countries.
You're really ruffling my feathers, here.

The population of Pakistan is 200 million.

Dominica, 75,000.

The nicest looking hospital on Dominica, based on a 30 second google search:

Compare that to the Aga Khan:

Tell me again how tiny Caribbean islands are going to support tertiary referral center levels of subspecialist availability. There's a reason Carib students don't do clinical rotations on the islands...

 

[mwsapphire]

The population of Pakistan is 200 million.

Dominica, 75,000.

The nicest looking hospital on Dominica, based on a 30 second google search:

Compare that to the Aga Khan:

Tell me again how tiny Caribbean islands are going to support tertiary referral center levels of subspecialist availability. There's a reason Carib students don't do clinical rotations on the islands...

Okay, sorry. It's just something I'm sensitive about -- (" They have * blank civilized thing* in Pakistan!?"), so Idk just people saying that third world countries are always lacking is just...a sensitive subject for me.
I'll let myself out.