Questions about a Caribbean MD and Caribbean Med School

[re33t]

Hey guys,

I am looking into Caribbean Med Schools SGU,ROSS, and AUC. I have been lurking on SDN for a while now but I have a few questions I would like to ask:

1) Looking at the NRMP data the match rates for the Big 4 Caribbean Schools for my intended specialty, Family Medicine, is around 66% for US IMGs, but this only takes into account if FM was the first ranked program, what would you guys estimate the actual match rate is for US IMGs into FM?

2) Do you see that match rate getting worse now that Allopathic and Osteopathic residencies are merging?

3) What generally causes someone from the Big 4 to not match to a residency(ie not applying to enough programs, etc)?

4) If one fails to match into a residency in the US, can the Caribbean MD be used to apply for residencies in the UK (I'm a dual US-UK citizen) or India?


Thanks for any information/opinions

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[midweststudent1]

What are your stats? If you're wanting to do residency and practice in the u.s. don't go to Caribbean schools. My wife and I were just talking about this earlier today. You'll be playing Russian roulette with your education. If it requires extra time to matriculate into a u.s. program, it will be time well spent

 

[re33t]

What are your stats? If you're wanting to do residency and practice in the u.s. don't go to Caribbean schools. My wife and I were just talking about this earlier today. You'll be playing Russian roulette with your education. If it requires extra time to matriculate into a u.s. program, it will be time well spent

My stats aren't that great: Total GPA 3.2 and Science GPA 2.8; I have the MCAT in a few months.
Practicing in the US would be ideal, but I wouldn't mind practicing in the UK or India.

 

[midweststudent1]

D.O. Schools allow for grade replacement, which means you can drastically improve your GPA very quickly. Look into, and consider, those options

 

[re33t]

D.O. Schools allow for grade replacement, which means you can drastically improve your GPA very quickly. Look into, and consider, those options

I was considering DO school, but I had second thoughts. I hope to practice in a developing country after paying off student loans, and I have noticed that the DO degree isn't as widely accepted in those countries as an MD.

 

[bedevilled ben]

Hey guys,

I am looking into Caribbean Med Schools SGU,ROSS, and AUC. I have been lurking on SDN for a while now but I have a few questions I would like to ask:

1) Looking at the NRMP data the match rates for the Big 4 Caribbean Schools for my intended specialty, Family Medicine, is around 66% for US IMGs, but this only takes into account if FM was the first ranked program, what would you guys estimate the actual match rate is for US IMGs into FM?

I think that is probably a low estimate. It's a sad commentary on our healthcare values, but historically Family Med is generally considered to be the least-desirable speciality due to poor compensation, frustrating practice environment, and lack of "sex appeal." For that reason, FM can become a "backup" residency for students that would otherwise be applying to programs like Peds, EM, Ob/Gyn. Until just recently, about 1/3 of SGU students secured residency programs outside of the NRMP. I imagine other schools have similar percentages. Those positions don't get reported in the NRMP match data (or probably anywhere, for that matter), so it's hard to say how many of those were in FM. I do know that many programs will "wheel and deal" for good residents that want to practice primary care in underserved/rural areas. I'd bet a fair number of those are FM. Despite the raging media shouting "doctor shortage!!!" at every opportunity, FM docs per capita have been increasing steadily for over a decade. This is probably from increasing numbers of IMGs and FMGs. However, that influx has started to plateau and it looks like demand will outstrip supply somewhere around 2020. There is also some hope that the ACA legislation will improve compensation for FM, but I wouldn't plan my career around possibilities like that. If you want FM, and your grades are decent, and you're willing to do your residency in a less-desirable location, I would say your chances are probably quite good to land a residency as a Caribbean grad.

2) Do you see that match rate getting worse now that Allopathic and Osteopathic residencies are merging?

Tough to say. I don't think it's going to send shockwaves through residency programs, but I could see some DO students get bumped into unfilled MD residencies, leaving some additional primary care spots unfilled for IMGs and FMGs.

3) What generally causes someone from the Big 4 to not match to a residency(ie not applying to enough programs, etc)?

Probably lots of reasons. The big ones would be poor Step scores, poor MS3 and MS4 evaluations, bad application process (too few, too prestigious, no backup, etc), bad interview.

4) If one fails to match into a residency in the US, can the Caribbean MD be used to apply for residencies in the UK (I'm a dual US-UK citizen) or India?

This I'm uncertain about. My instinct is to say that you probably can, but that you most likely won't. By that I mean there is probably no regulatory stipulation that you cannot do that, but the chances of actually doing it are slim. A UK program is going to want people that are familiar with the UK healthcare system, and a US program will want people familiar with US healthcare. If you do your MS3 and MS4 clerkships in the US, fail to get a US residency, you will probably find it difficult to find a UK residency. You will also have to navigate the licensing transition, of which I know nothing so I'm not even going to speculate how that works. Much better, I think, to figure out where you want to end up and then focus your energies more efficiently to get there. Also as a small note, some Caribbean schools are expensive and you will have a significantly reduced income as a GP in the UK compared to the US. You may find it burdensome to pay off your loans.

 

[re33t]

I think that is probably a low estimate. It's a sad commentary on our healthcare values, but historically Family Med is generally considered to be the least-desirable speciality due to poor compensation, frustrating practice environment, and lack of "sex appeal." For that reason, FM can become a "backup" residency for students that would otherwise be applying to programs like Peds, EM, Ob/Gyn. Until just recently, about 1/3 of SGU students secured residency programs outside of the NRMP. I imagine other schools have similar percentages. Those positions don't get reported in the NRMP match data (or probably anywhere, for that matter), so it's hard to say how many of those were in FM. I do know that many programs will "wheel and deal" for good residents that want to practice primary care in underserved/rural areas. I'd bet a fair number of those are FM. Despite the raging media shouting "doctor shortage!!!" at every opportunity, FM docs per capita have been increasing steadily for over a decade. This is probably from increasing numbers of IMGs and FMGs. However, that influx has started to plateau and it looks like demand will outstrip supply somewhere around 2020. There is also some hope that the ACA legislation will improve compensation for FM, but I wouldn't plan my career around possibilities like that. If you want FM, and your grades are decent, and you're willing to do your residency in a less-desirable location, I would say your chances are probably quite good to land a residency as a Caribbean grad.

Tough to say. I don't think it's going to send shockwaves through residency programs, but I could see some DO students get bumped into unfilled MD residencies, leaving some additional primary care spots unfilled for IMGs and FMGs.

Probably lots of reasons. The big ones would be poor Step scores, poor MS3 and MS4 evaluations, bad application process (too few, too prestigious, no backup, etc), bad interview.

This I'm uncertain about. My instinct is to say that you probably can, but that you most likely won't. By that I mean there is probably no regulatory stipulation that you cannot do that, but the chances of actually doing it are slim. A UK program is going to want people that are familiar with the UK healthcare system, and a US program will want people familiar with US healthcare. If you do your MS3 and MS4 clerkships in the US, fail to get a US residency, you will probably find it difficult to find a UK residency. You will also have to navigate the licensing transition, of which I know nothing so I'm not even going to speculate how that works. Much better, I think, to figure out where you want to end up and then focus your energies more efficiently to get there. Also as a small note, some Caribbean schools are expensive and you will have a significantly reduced income as a GP in the UK compared to the US. You may find it burdensome to pay off your loans.

Thank you for the information =)

 

[Mr.MG]

I think that is probably a low estimate. It's a sad commentary on our healthcare values, but historically Family Med is generally considered to be the least-desirable speciality due to poor compensation, frustrating practice environment, and lack of "sex appeal." For that reason, FM can become a "backup" residency for students that would otherwise be applying to programs like Peds, EM, Ob/Gyn. Until just recently, about 1/3 of SGU students secured residency programs outside of the NRMP. I imagine other schools have similar percentages. Those positions don't get reported in the NRMP match data (or probably anywhere, for that matter), so it's hard to say how many of those were in FM. I do know that many programs will "wheel and deal" for good residents that want to practice primary care in underserved/rural areas. I'd bet a fair number of those are FM. Despite the raging media shouting "doctor shortage!!!" at every opportunity, FM docs per capita have been increasing steadily for over a decade. This is probably from increasing numbers of IMGs and FMGs. However, that influx has started to plateau and it looks like demand will outstrip supply somewhere around 2020. There is also some hope that the ACA legislation will improve compensation for FM, but I wouldn't plan my career around possibilities like that. If you want FM, and your grades are decent, and you're willing to do your residency in a less-desirable location, I would say your chances are probably quite good to land a residency as a Caribbean grad.

Would you say that, so long as one gets good step scores, they would be able to get an IM or FM residency coming from the Big 4, or would you agree with midweststudent1 in saying that the Caribbean is like Russian Roulette with your future?

 

[AndrewBizz13]

Hello Everyone,

I am aware you are all talking solely about the Big 4 in terms of Caribbean schools, however I was hoping someone had some knowledge on other schools in the Caribbean that aren't as accredited or prestigious. I have recently been accepted into St. James School of medicine, have applied to American University of Antigua (AUA) and just heard back from Medical University of the Americas (MUA) that they accept me into their two semester pre-med program and if I complete it with a 3.0 will then be accepted into the MD program. Has anyone come into contact with these schools and know anything on their competitiveness in terms of USMLE scores and gaining U.S residencies? Any advice would be helpful.

 

[bedevilled ben]

Would you say that, so long as one gets good step scores, they would be able to get an IM or FM residency coming from the Big 4, or would you agree with midweststudent1 in saying that the Caribbean is like Russian Roulette with your future?

Well, those aren't the only things you would need to do. For FM, I would say getting average or above Step scores, working hard, and being from the Big 4 will probably land you somewhere. IM is a little more competitive, because it can be a branching off point to lots of different specialities. So the applicants are going to be much more varied. But again, if you score well and are willing to work hard in underserved or undesirable areas, you will probably be able to find something.

I don't agree that going to a Big 4 is playing Russian Roulette with your future. It is significantly riskier than going to a USMD/DO, but if you are well-informed ahead of time, diligent in your studies/work, and proactive in seeking out and preventing pitfalls in your way, I think you can pretty-heavily stack the deck in your favor. I think going to a Non-Big 4 is playing Russian Roulette. Even doing well and excelling in the programs does not offer you great odds of practicing as a physician in the US.

Edit: missed the second part of your question.

 

[bedevilled ben]

Hello Everyone,

I am aware you are all talking solely about the Big 4 in terms of Caribbean schools, however I was hoping someone had some knowledge on other schools in the Caribbean that aren't as accredited or prestigious. I have recently been accepted into St. James School of medicine, have applied to American University of Antigua (AUA) and just heard back from Medical University of the Americas (MUA) that they accept me into their two semester pre-med program and if I complete it with a 3.0 will then be accepted into the MD program. Has anyone come into contact with these schools and know anything on their competitiveness in terms of USMLE scores and gaining U.S residencies? Any advice would be helpful.

I am obviously biased as I'm an SGU student, but I only encourage people to go to the Big 4+ AUA and to steer clear of any other Caribbean schools. I would very strongly encourage you to read this whole thread as it is relevant to your question, but in particular, this post by Del Caribe provides an excellent breakdown of how the Caribbean schools vary in their accreditation. Your chances of successfully navigating the program and securing a residency drop off rapidly after Tiers 1 and 2.

Recommended schools other than the big 4

 

[AndrewBizz13]

I am obviously biased as I'm an SGU student, but I only encourage people to go to the Big 4+ AUA and to steer clear of any other Caribbean schools. I would very strongly encourage you to read this whole thread as it is relevant to your question, but in particular, this post by Del Caribe provides an excellent breakdown of how the Caribbean schools vary in their accreditation. Your chances of successfully navigating the program and securing a residency drop off rapidly after Tiers 1 and 2.

Recommended schools other than the big 4

Ok, could you please ease my mind in terms of the possibility I have of becoming a U.S. resident if I were to go to AUA because I have been very skeptical over these past few weeks and reading people bash the Caribbean schools have really made me rethink my plan and maybe attempt SMP's.

 

[bedevilled ben]

Ok, could you please ease my mind in terms of the possibility I have of becoming a U.S. resident if I were to go to AUA because I have been very skeptical over these past few weeks and reading people bash the Caribbean schools have really made me rethink my plan and maybe attempt SMP's.

No, I won't do that. In general, I try to remain as objective as I can when it comes to offering advice. I try to provide information and access to data, and leave the drawn conclusions up to those asking the questions. Only you can decide your best course of action. If you want my personal, biased feelings on the subject, click below for the next 2 paragraphs. If not, you should probably skip them. The relevant data upon which my feelings are based can be found in the link below.

Spoiler: Click this if you want to know how I really feel.

If you're at all uneasy about going to the Caribbean, you shouldn't do it. If you haven't exhausted every opportunity you have to get into a USMD/DO program, you shouldn't go to the Caribbean. If you only applied to AUA and none of the Big 4 schools, you shouldn't go to the Caribbean. If you're younger than ~26 I would strongly dissuade you from going to the Caribbean. If your GPA is <3.0 or your MCAT is <22 I would strongly dissuade you from going to the Caribbean. If you can see yourself happy and fulfilled in any other career, I would strongly dissuade you from going to the Caribbean.

I am not exaggerating: this decision will change the course of your life, it shouldn't be an emotional one. It needs to be cold and calculating. You need to sit down in a quiet room by yourself and ask yourself hard questions about what prevented you from getting into a US school. Then you need to really think about what you've done to fix those things before going down there. The curriculum is the same (arguably harder) than US schools and you have less time and less support to master the material. The volume of material and the difficulty of the tests only increases. The Caribbean is easier to get into than a US school, but much harder to get out of. Most people aren't capable of asking these questions, especially young people. Everybody wants to think they're going to be the exception and not the rule. Pre-med students are notoriously over-confident, and humans in general are prone to overestimating their abilities and likelihood of success. Chances are good that you will be average. If you're going to take these risks, you should be well-informed about the consequences of doing so, and I don't get the impression that you are.

Charting Outcomes in the Match: International Medical Graduates

I urge you to familiarize yourself with this data. I would draw your particular attention to Chart 15, which lists match rates by country. Note that for US-IMGs in Antigua and Barbuda -- that is, US citizens that graduated from a medical school in Antigua & Barbuda -- the residency placement rate into first-choice speciality was 180/387, or about 47%. Less than half were placed in their preferred specialty.

 

[edgerock24]

Hello Everyone,

I am aware you are all talking solely about the Big 4 in terms of Caribbean schools, however I was hoping someone had some knowledge on other schools in the Caribbean that aren't as accredited or prestigious. I have recently been accepted into St. James School of medicine, have applied to American University of Antigua (AUA) and just heard back from Medical University of the Americas (MUA) that they accept me into their two semester pre-med program and if I complete it with a 3.0 will then be accepted into the MD program. Has anyone come into contact with these schools and know anything on their competitiveness in terms of USMLE scores and gaining U.S residencies? Any advice would be helpful.

Just wondering: what are your stats? Why are you applying so broadly to these [terrible] Caribbean schools?

 

[AndrewBizz13]

Just wondering: what are your stats? Why are you applying so broadly to these [terrible] Caribbean schools?

My GPA is 2.3 I am taking the MCAT in October where I hope to really increase my hopes a little more and my volunteer work consists of a internship in a hospital shadowing Orthopedic surgeons, along with shadowing urology doctors whom I work for currently as a phlebotomist and cytologist. I assume there really isn't a second option for me as an MD hopeful because no U.S. medical schools accept class retakes and I honestly have been through the ringer with my horrible undergraduate University so retaking classes there to apply for DO schools really isn't an option I would like to pursue. Also I have heard decent stories about the top tier Caribbean schools and some alumni actually practice in my town.

 

[edgerock24]

My GPA is 2.3 I am taking the MCAT in October where I hope to really increase my hopes a little more and my volunteer work consists of a internship in a hospital shadowing Orthopedic surgeons, along with shadowing urology doctors whom I work for currently as a phlebotomist and cytologist. I assume there really isn't a second option for me as an MD hopeful because no U.S. medical schools accept class retakes and I honestly have been through the ringer with my horrible undergraduate University so retaking classes there to apply for DO schools really isn't an option I would like to pursue. Also I have heard decent stories about the top tier Caribbean schools and some alumni actually practice in my town.

If you are dead set on the Carib I'd only recommend the Big 4. SGU or AUC preferably. Ross' attrition rate is scary.

However, retaking classes at a community college (no need to go back to your university) and taking advantage of grade replacement for DO schools would be the best (in my opinion) option.

 

[opsurgeon]

The curriculum is the same (arguably harder) than US schools and you have less time and less support to master the material. The volume of material and the difficulty of the tests only increases. The Caribbean is easier to get into than a US school, but much harder to get out of. Most people aren't capable of asking these questions, especially young people. Everybody wants to think they're going to be the exception and not the rule. Pre-med students are notoriously over-confident, and humans in general are prone to overestimating their abilities and likelihood of success. Chances are good that you will be average. If you're going to take these risks, you should be well-informed about the consequences of doing so, and I don't get the impression that you are.

Yes, I agree with Ben that a lot of people are "over-confident and overestimate their abilities and likelihood of success". I think it's wise to NOT GO to a "Big 4" considering that many will fail a course or 2 or 3 and get kicked out, and will end up in one of these 2nd, 3rd, 4th...tier school anyway, lol. You'll be on here asking what should I do after getting kick out of a "Big 4" and you'll get the response of "You're done, that's it! No more second chances, this what your second chance!" Personally, I don't think it's the end of the world if you fail a course, but it will be if you go to a "Big 4". I know people from both SGU and Ross who had good USMLE scores and didn't match. There are no guarantees with these schools and you're fooling yourself if you think you'll have betters chances if you graduate from a "Big 4" even if you have subpar scores. SGU and Ross love to bombard you with "high school projects" to take precious time away from your USMLE preparation, umm sorry I don't miss those, but if you do have fun! And trust me they have a system in place to dismiss a lot of students because they can't possibly put them all in clinical rotations. Just my 2¢.

 

[Skip Intro]

SGU and Ross love to bombard you with "high school projects" to take precious time away from your USMLE preparation, umm sorry I don't miss those, but if you do have fun!

I'm not sure what you're talking about. Please expand. I certainly was not subjected to any "high school projects" while I was at Ross.

And trust me they have a system in place to dismiss a lot of students because they can't possibly put them all in clinical rotations. Just my 2¢.

Well, Ross lists 783 graduates in 2014 who started residency this July 1st. And, SGU lists 774 for 2014. That's 1,557 new doctors this year just from these two schools alone.

So, I'm not sure how many students were actually enrolled vs. how many were "dismissed" based on your assertion, but that's a pretty impressive number of graduates who've gone on to residency to start PGY-1. Certainly, these students fulfilled their clerkship requirements or they wouldn't have been allowed to graduate (i.e., and get a license to start residency).

-Skip

Sources:
http://www.rossu.edu/medical-school/residencyappointments.cfm
http://postgrad.sgu.edu/ResidencyAppointmentDirectory.aspx?year=2014

 

[bedevilled ben]

Yes, I agree with Ben that a lot of people are "over-confident and overestimate their abilities and likelihood of success". I think it's wise to NOT GO to a "Big 4" considering that many will fail a course or 2 or 3 and get kicked out, and will end up in one of these 2nd, 3rd, 4th...tier school anyway, lol. You'll be on here asking what should I do after getting kick out of a "Big 4" and you'll get the response of "You're done, that's it! No more second chances, this what your second chance!" Personally, I don't think it's the end of the world if you fail a course, but it will be if you go to a "Big 4". I know people from both SGU and Ross who had good USMLE scores and didn't match. There are no guarantees with these schools and you're fooling yourself if you think you'll have betters chances if you graduate from a "Big 4" even if you have subpar scores. SGU and Ross love to bombard you with "high school projects" to take precious time away from your USMLE preparation, umm sorry I don't miss those, but if you do have fun! And trust me they have a system in place to dismiss a lot of students because they can't possibly put them all in clinical rotations. Just my 2¢.

No, this is not at all what I am saying. Going to a Caribbean school is not a death sentence. Going to a Caribbean school without exhausting all of your other options and not being well-informed can be. It should be an informed, calculated risk. When 22 year olds with low MCAT scores and low GPAs start asking silly questions about residency placement for unaccredited Caribbean schools, it makes me want to cut somebody. There's like...at least 5 or 6 problems with that scenario that a few hours of googling could rectify.

Decisions like these should be based on evidence, not anecdotes. You should care about the data. There is a mountain of evidence that suggests that if you manage a good USMLE score and graduate from one of the Big 4, you have a very good chance of landing a residency. That doesn't hold for non-Big 4 schools, which is why we draw the distinction between Big 4 and non-Big 4 in the first place. From AUA you have about a 50/50 chance. From any other school, your chances drop off to anywhere from 10-30%. Jumping immediately to a school that is going to halve your chances right out of the gate indicates to me that people haven't done their homework. If you haven't done your homework before going to the Caribbean, you're going to have a bad time.

I don't know what you're talking about with the "high school projects" thing. Our last term at SGU has an entire rapid review-style class built around studying for the USMLE. You can also stay on the island and do a 6-week Kaplan review course free of distractions at a significantly reduced rate. Not to mention a full 7 weeks plus to study after the term ends. SGU has wonderful Step 1 studying resources.

Finally, SGU and Ross at least both have hospital agreements for their clinical placements. They can't not have enough spots. This rumor has been parroted around SDN for years now, and as far as I can tell there is no merit to it.