Term 1 Caribbean medstudent dilemma

[Gavanshir]

Hey friends, I thought I'd get some advice from you in my most recent dilemma.

Background info:

B. Sc. in Cell & Molecular Bio & Political Science (GPA=3.15)
Canadian citizen, US permanent rez
MCAT: 26 (PS:8, VR:10, BS:8; R)
Good research, ECs, awards, work experience and LORs.
Age: 26

I'm currently a term 1 medstudent at Saint George's University in Grenada. I'm doing well and loving every second of it. But unfortunately the residency situation for Caribbean grads seems to be deteriorating and by the time I graduate I might be faced with quite a few difficulties when it comes time to selecting a field and training. I guess I also in some sense feel that I "deserve better" and know that I didn't give it my best when I applied to medschool back home. I never applied to Canadian schools because I knew I wasn't competitive, I did apply to my state school through AMCAS before coming down here. I'm a big fan of research and would like to have as many opportunities available to me as possible, this just isn't possible with a Caribbean education and while I don't know exactly what field I want to end up in, I don't think family medicine is for me.

I can stay here in the beautiful Caribbean and become an MD in 4 years, but recently I've been thinking about going back home and doing a second degree at McGill, and applying to North America again. I've already used up my provincial financial aid so I would be going through FAFSA (US Finaid) to finance a second bachelor's degree. If I do stay here I'll be in debt of around 300K USD which will factor into my choice for residency as well.

I'm wondering if anyone has been in a similar situation and can offer some advice. I should mention that I was working full-time when I took the MCAT and admittedly didn't put in enough prep time (although McGill and other QC schools don't require the MCAT). I've always found this forum to be a great source for advice and different perspectives so please don't hold back. Thank you.

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[Scottish Chap]

Hey friends, I thought I'd get some advice from you in my most recent dilemma.

Background info:

B. Sc. in Cell & Molecular Bio & Political Science (GPA=3.15)
Canadian citizen, US permanent rez
MCAT: 26 (PS:8, VR:10, BS:8; R)
Good research, ECs, awards, work experience and LORs.
Age: 26

I'm currently a term 1 medstudent at Saint George's University in Grenada. I'm doing well and loving every second of it. But unfortunately the residency situation for Caribbean grads seems to be deteriorating and by the time I graduate I might be faced with quite a few difficulties when it comes time to selecting a field and training. I guess I also in some sense feel that I "deserve better" and know that I didn't give it my best when I applied to medschool back home. I never applied to Canadian schools because I knew I wasn't competitive, I did apply to my state school through AMCAS before coming down here. I'm a big fan of research and would like to have as many opportunities available to me as possible, this just isn't possible with a Caribbean education and while I don't know exactly what field I want to end up in, I don't think family medicine is for me.

I can stay here in the beautiful Caribbean and become an MD in 4 years, but recently I've been thinking about going back home and doing a second degree at McGill, and applying to North America again. I've already used up my provincial financial aid so I would be going through FAFSA (US Finaid) to finance a second bachelor's degree. If I do stay here I'll be in debt of around 300K USD which will factor into my choice for residency as well.

I'm wondering if anyone has been in a similar situation and can offer some advice. I should mention that I was working full-time when I took the MCAT and admittedly didn't put in enough prep time (although McGill and other QC schools don't require the MCAT). I've always found this forum to be a great source for advice and different perspectives so please don't hold back. Thank you.

Hang in there.

Fiscally and personally, leaving medical school overseas to obtain better undergraduate level grades to get into a U.S. medical school doesn't make a lot of sense to me, but I don't know you or your personal motivation.

It's a long shot, but did you consider trying to transfer to a U.S. medical school? My school used to take a couple of students like you every year (places left over from those that entered the five-year M.D. or the rare person that left). I actually interviewed a student from St. Georges with a 25 on the MCAT; decent grades on the island and decent Step 1. This person had to repeat most of the third year, but did well. This is one case, but there are others.

In the end, honestly, nobody cares where you went to medical school. Yes, it's an added hurdle for people that want insanely competitive residencies, but that's not insurmountable either.

 

[0919mmk]

Agreed - it's a tough situation, but probably sticking it out is your best avenue right now. Just because, from what i hear, it's really tough to gain acceptance again after quitting a med school, whether that school was carrib, DO, or just the wrong school.

Having said that, I am not familiar with the residency situation for carrib - if it's really fam med or nothing, well then you might have a point... you'd be super-non-trad (like me and many others here), but if you worked your ass off, you could do it. Good luck to you!

 

[ruiner]

I think I would stick it out. And residency is going to be ok for awhile, but I wouldn't want to be doing what you are doing in 10 years when all these new schools start producing potential residents (In MI alone we have 3 new schools opening in the next 3 years).

 

[Gavanshir]

Hang in there.

Fiscally and personally, leaving medical school overseas to obtain better undergraduate level grades to get into a U.S. medical school doesn't make a lot of sense to me, but I don't know you or your personal motivation.

It's a long shot, but did you consider trying to transfer to a U.S. medical school? My school used to take a couple of students like you every year (places left over from those that entered the five-year M.D. or the rare person that left). I actually interviewed a student from St. Georges with a 25 on the MCAT; decent grades on the island and decent Step 1. This person had to repeat most of the third year, but did well. This is one case, but there are others.

In the end, honestly, nobody cares where you went to medical school. Yes, it's an added hurdle for people that want insanely competitive residencies, but that's not insurmountable either.

Thanks for your input. Money and future debt load is also part of my motivation. If I do go for the 2nd bachelor's and get accepted in my province in Canada, my tuition would be around $3000/term whereas right now it's $30,000/term. I'm figuring that much money might be worth gambling 2 years of my life for.. but I might be wrong I don't know.

In regards to transfers, I've done some research and it seems to be extremely rare and unlikely. There are only a handful of schools that accept transfers at all (in MS3) and I'm under the impression that the candidates have to be truly exceptional and accomplished (including premed MCAT & GPA). I'm actually curious to know which school you interviewed this candidate at.

 

[EdLongshanks]

I'm currently a term 1 medstudent at Saint George's University in Grenada. I'm doing well and loving every second of it. But unfortunately the residency situation for Caribbean grads seems to be deteriorating and by the time I graduate I might be faced with quite a few difficulties when it comes time to selecting a field and training. I guess I also in some sense feel that I "deserve better" and know that I didn't give it my best when I applied to medschool back home. I never applied to Canadian schools because I knew I wasn't competitive, I did apply to my state school through AMCAS before coming down here. I'm a big fan of research and would like to have as many opportunities available to me as possible, this just isn't possible with a Caribbean education and while I don't know exactly what field I want to end up in, I don't think family medicine is for me.

If you put a pros/cons sheet on this, I think that you will see that finishing your degree in the caribbean is a better deal for you (except for the possibility that Scottish Chap mentioned).

Look at the worst case for sticking it out. You get a single internal medicine intern year after you graduate in 2014 and are not able to match into a full-length residency. You might take 2 or 3 years before you find the post-intern residency that you want in 2017 or 2018. During this time you can work as a non-board certified contract doctor (for good money). In this case you are still in better shape than you would be if you transferred back and started the application process all over again, entered medical school in 2013 and graduated in 2017 and were just then applying for your first-year residency.

The extra debt that you worry about is over-ridden by starting your career 3 years sooner.

 

[Gavanshir]

If you put a pros/cons sheet on this, I think that you will see that finishing your degree in the caribbean is a better deal for you (except for the possibility that Scottish Chap mentioned).

Look at the worst case for sticking it out. You get a single internal medicine intern year after you graduate in 2014 and are not able to match into a full-length residency. You might take 2 or 3 years before you find the post-intern residency that you want in 2017 or 2018. During this time you can work as a non-board certified contract doctor (for good money). In this case you are still in better shape than you would be if you transferred back and started the application process all over again, entered medical school in 2013 and graduated in 2017 and were just then applying for your first-year residency.

The extra debt that you worry about is over-ridden by starting your career 3 years sooner.

Thank you for that breakdown, you have a point. But by "non-board certified contract doctor", do you mean moonlighting?

Considering that I'll have 300K in debt accruing interest at that point, it really does need to be reasonably good enough money.

Otherwise it's either take 2 years now (pre-debt) to give this a try or possibly have to take 1, 2 or 3 years come residency time when my 300K in debt will be accruing interest. It seems to me that both have relatively equal pros and cons but the answer still isn't obvious to me. I'll give it a few more days to see if anything else becomes evident about the decision.

Here are the 2 WORST case scenarios:

Scenario A:

I stick it out. Pass my boards with average scores and the only thing I can match into is family practice in terrible locations (2015). I do a few years of research or whatnot and continue trying to get the residency I want.

Scenario B:

I leave medschool now, spend two years trying to get into medschool in North America while doing research on the side, and I dont get in. I come back to the Caribbean in 2 years, in 2013. Still term 1 and have lost 2 years.

 

[lsu hopeful]

I mean this sincerely 100%:

I love being involved with people who believe the worst case scenario is having average test scores.

 

[Scottish Chap]

Thank you for that breakdown, you have a point. But by "non-board certified contract doctor", do you mean moonlighting?

Considering that I'll have 300K in debt accruing interest at that point, it really does need to be reasonably good enough money.

Otherwise it's either take 2 years now (pre-debt) to give this a try or possibly have to take 1, 2 or 3 years come residency time when my 300K in debt will be accruing interest. It seems to me that both have relatively equal pros and cons but the answer still isn't obvious to me. I'll give it a few more days to see if anything else becomes evident about the decision.

Here are the 2 WORST case scenarios:

Scenario A:

I stick it out. Pass my boards with average scores and the only thing I can match into is family practice in terrible locations (2015). I do a few years of research or whatnot and continue trying to get the residency I want.

Scenario B:

I leave medschool now, spend two years trying to get into medschool in North America while doing research on the side, and I dont get in. I come back to the Caribbean in 2 years, in 2013. Still term 1 and have lost 2 years.

Sorry about the "U.S. med school" thing. You even told me you were from North of the border. This makes it even more prudent to consider before you leave Grenada since medical schools in your neck of the woods are even less forgiving with respect to MCAT and GPA requirements. What you suggest is a massive, massive gamble, and far more risky than finishing out your degree. In the U.S., at least there are D.O. schools and the option of grade replacement, but it's going to look very off that you left medical school--even if it was overseas.

Perhaps what EdLongshanks was referring to above was working as a non-board certified physician after you have completed one or more years of residency training (the old general practitioner path which is fast becoming extinct as many of those docs can no longer get reimbursement). I can do this right now, but it's not straight-forward. Basically, if you pass Step 3 of the USMLE and register with a state medical board (pay them their fee, that is) you legally can work without supervision. Most people do this by moonlighting in the institution where they are residents (the money is good and the malpractice insurance does not need to be modified). Other residents can work on Native American Reservations (the money is also good). Still others (usually fellows) can work at community hospitals/urgent care centers on the weekends etc., but many facilities will not let you do this unless you are board eligible or board-certified (and after a year of internship, you will be neither). A friend of mine tried this after completing a year of internship and leaving his program. Local emergency rooms and community hospitals would not take him with only one year of internship-level training, even though he passed Step 3 and could legally work without supervision. This is anecdotal, I appreciate.

From what you posted above, I get the impression that you think only board scores are important in securing a residency position and that average medical school performance relegates you to the despair of a PCP in a rural area. Hang your head high, man, you are in medical school! You are also attending (arguably) the most respected Caribbean medical school. Do not under-estimate how much your clinical performance and connections that you make will play into you securing a competitive residency position.

Here are some examples of people I personally have encountered who did fairly well in Caribbean medical schools, and wrote their own ticket: Ross graduate in an academic neurosurgery residency in Upstate NY, St. George's graduate in a medicine residency at Yale, St. George's graduate in a general surgery residency at Johns Hopkins, St. George's graduate in a radiation oncology residency at Johns Hopkins. Reciprocate some of the faith your medical school has thrown your way. Again, what you are suggesting is a huge gamble IMHO, but good luck.

 

[Gavanshir]

Thanks very much Scottish. I needed to hear that, besides getting any studying done is nearly impossible with all these thoughts. Unfortunately, I made the mistake of opening the post-bac and SMP thread on SDN which added a whole new factor to this formula

I'm going to put all this aside for now until my head clears up. Thanks again!

 

[kcin]

I'm just curious, how were you planning to get financial aid from the US govt when you're a Canadian? I thought only PRs and citizens were elligible.

 

[Gavanshir]

I'm just curious, how were you planning to get financial aid from the US govt when you're a Canadian? I thought only PRs and citizens were elligible.

I'm a PR as well.