Im going to attempt to put this to rest .
Lets be real about the IMG match statistics. There is an approximately 47% match rate for *ALL* IMGs. This is NOT realistic concerning the Big 4 carib schools (SGU, AUC,Saba,Ross) . The match rate for these schools is approximately 90% or higher for US-citizens graduating from these schools. Keep in mind that IMGs can participate in matching outside of ERAS and the NRMP, so pre-match offers factor in to these statistics. SGU and AUC are generally considered more safe schools to attend because of the level of support given to current students in terms of clinical rotation slots and have mildly more rigorous admissions criteria than Ross, and possibly Saba. Ross is generally known for having trouble with its clinical sites and rotations and like many Caribbean schools known for admitting an overabundance of students and letting attrition level out the classes, while still collecting some of the tuition. The attrition rate is higher at Carib schools than at US schools, and for good reason. The admissions standards in most cases are lower, the schools are located in another country, lifestyle is potentially different and the schools may possibly admit students incapable of completing the curriculum etc.
The important question is, is there a high likelyhood if you go to one of the Big 4 that you can return to the US and land a residency. YES. Is there a possibility of landing ROADE/competitive surg. Spec. from one of these schools. YES. Is it likely that matching a competitive specialty will occur? **NO**.
Lets examine the climate for IMGs currently. There have been several new MD and DO schools which have opened up here in the US, not to mention a planned increase in US mainland school seats over the next 10 years. What this means for IMGs is that the competition for a FIXED number of residency slots is going to get stiffer. There is an argument that there will be students who instead matriculated into the new schools instead of having to go offshore for education and this will essentially offset in the long run, but in my opinion this is just semantics. You have to look at it statistically. DO graduates have the ability to match into both osteopathic and allopathic residencies. Simply by numbers alone, this gives a wider array of residency opportunity for the DO grad than the IMG grad who only has access to ACGME residencies, since AOA (DO) residencies do not admit MDs. Both DO and IMG enter the match as independent applicant status, however it is widely known that an AMG will, in many cases with a large majority of programs, have more potential success than an IMG in matching in general.
Lets distinguish between the bias between carib vs. DO. In terms of residency, it is true that there is a possibility of some allo programs not admitting DOs and also these same programs or other programs not admitting IMGs, however the bias against US DO graduates in matching allo residencies is generally considered to be much less prevalent. MD vs. DO on your coat? Well as much as we all hate this subject, it realistically is valid for someone who is completing or wants to gain admission to a professional program to know that they will receive some degree of prestige and respect from the general public and hospital workers etc. for the amount of work it takes to become a physician. However, in the workplace, the issue of MD or DO is a NON-ISSUE. There literally is NO distinction, separation, or discrimination between allopathic or osteopathic physicians in the hospital/practice etc. For verification of this fact all you need is input from a practicing D.O. which will quell whichever rumors abound SDN.
Since the OP is a Canadian as I once was before becoming a US citizen recently, Im going to have to give you the bad news. You can basically FORGET about returning to Canada for residency if you choose to attend a carib school or any foreign school for that matter. CARMS which is the Canadian version of the NRMP basically has ridiculous clauses and a high discrimination towards IMGs. ( For more info on this plus additional facts PM me). If you are a USDO graduate and attend an ACGME residency in the US, due to the agreement with LCME Canadian schools the ability to be licensed by individual Canadian provinces is more likely, but a DO matching a Canadian residency slot is basically out of the question. If you complete an AOA residency in the US as a DO, Im not currently aware of accreditation status which Canada gives to AOA residency grads. Essentially it is in your favor to attend a US school either DO or MD which takes international students, of this there are several. Or become a US permanent resident prior to going to med school. Either way you are most likely looking at returning to the US for residency instead of Canada. As a carib grad IMG non US citizen you have to have J-1 or Hb-1 visa sponsored by the residency, and there are varying degrees of residencies which are willing to do his, which reduces your chance of residency matching even further.
Lastly, most pre-meds or medical students for that matter can speculate but the majority have no idea what they want to specialize in, and these decisions will probably change during med school. Lets be realistic here. Attending a Carib school can match you pretty effectively into primary care if you are a US citizen, and with a high match rate at that. If you find during med school that you dont want to do primary care and want a ROADE/Ortho/nsurg etc. it will take exceptional step scores, rotation grades, class rank, research etc coming from a carib school. While this can be done, the match rate for people even with these statistics into uber competitive specialties is very dismal. However, USDO graduates have a much much higher statistical probability of matching these specialties even with not so amazing class rank/score etc. Either way, a competitive specialty is hard to match because thats exactly what it is
Competitive. As a US grad you are fighting against other US grads for a spot. As an IMG the fight for a competitive specialty is significantly amplified.
Debtwise lets also examine carib vs. DO. They can both be expensive. WVSOM is similar to SGU in terms of tuition, super expensive. Saba is the cheapest of the 4 but does not have federally subsidized loans. Think about the state of our economy currently. Would you want to bank on it that the other Big 3 carib schools can keep their federal loans? If they lose them then its down to only private loans which can essentially almost make pursuing primary care prohibitive when u consider the interest rates. Whereas USDO will always have federally subsidized loans, and there are USDO schools that have tuition which is almost that of some state MD schools, which can be significantly cheaper.
It seems clear that if the ultimate goal is to become a US practicing physician, attending a US school (MD or DO) will give you less hoops to jump through, more opportunities to match into various specialties, and less hassles with licensing and accreditation. In addition to that the possible financial pitfalls associated with med school, loans and debt, lend a more rosy outlook to mainland schools vs. carib Big 4. If the carib is your ONLY option, then it will still give you a chance to become a physician, just make sure to approach this route with reasonable expectations. 😳
