Are Caribbean medical schools still a sustainable option in 2021 (and beyond)?

[StressfulMD]

In your opinions, do you all believe this to be the case? I personally don't, simply because Step 1 going P/F will change the game somewhat.

The reason why I ask this is because I know someone who recently went to AUC, and at face-value it seems these people are scoring residencies. Or maybe people really just aren't doing their basic research and just go anyway... and it'd be too shocking to me if that were the case.

So, some people make it I suppose? Don't know. Would love to hear your experiences and answers.

---

Members don't see this ad.

 

[voxveritatisetlucis]

I don’t really think they ever were a sustainable option. Anybody who goes is taking a massive gamble of not matching. This was true before step was pass fail and will continue to be true.

 

[FluffyCat1212]

Additionally, one has to consider the pretty unfortunate conflicts of interest that arise from the for-profit nature of these schools. I cannot personally attest to anything, but I have heard horror stories on the internet about the ways that these schools treat their students and the abnormally high rates of attrition. This can translate to fewer resources to help students match. As long as these schools remain for-profit, I don't see this changing in 2021 or beyond.

I have so much respect for people who graduate and match from Carib schools. The hurdles they must have had to jump through in order to even make it to the match are wild!

As a USMD student, this is purely an outsider's POV. Would be very interesting for a Carib student to weigh in!

 

[Doctoscope]

It's probably going to become less and less viable/sustainable, with STEP 1 going P/F, the residency merger, and more and more med schools opening up in the US.

 

[Princeton Medical Student]

Carrib schools will exist as long as sketchy NYC residencies exist.

 

[voxveritatisetlucis]

Carrib schools will exist as long as sketchy NYC residencies exist.

What are said residencies

 

[yuhh]

ofc its possible, just study hard and dont fail out and ull match. its high attrition rate bc half their class not capable/motivated

 

[Proudfather94]

In your opinions, do you all believe this to be the case? I personally don't, simply because Step 1 going P/F will change the game somewhat.

The reason why I ask this is because I know someone who recently went to AUC, and at face-value it seems these people are scoring residencies. Or maybe people really just aren't doing their basic research and just go anyway... and it'd be too shocking to me if that were the case.

So, some people make it I suppose? Don't know. Would love to hear your experiences and answers.

Honestly I don't think so. I think for a few lucky people that it will work out for them but for everyone else they will get screwed over. There is post bacc, smps, and several MCAT resources that can get someone into at least one MD or DO school. With all of that help available if one can't get in it's probably for the best to try something else.

 

[YCAGA]

Sustainable for whom? Even schools without US federal loan approval are able to attract students who pay $50k/year so that is not even a factor in a world where the government takes that away. People will keep going to these schools even if the match rates were like 20% (which tbh with attrition, even the big names probably approach that).

 

[LizzyM]

The word "still" begs the question. Frankly, I don't believe they've ever been a sustainable option.

 

[YCAGA]

The word "still" begs the question. Frankly, I don't believe they've ever been a sustainable option.

If we are talking about sustainable for their students, they might have been less of a gamble in like the 80s? But to be clear I am just saying they were less bad…not good. But in terms of sustainable for the schools, they have definitely made some very wealthy people…

 

[Select All That Apply]

If we are talking about sustainable for their students, they might have been less of a gamble in like the 80s? But to be clear I am just saying they were less bad…not good. But in terms of sustainable for the schools, they have definitely made some very wealthy people…

Certainly not shareholders. ATGE's stock pattern over one year looks like v fib. Actually stock is up 38.34%. That's crazy.

 

[YCAGA]

Certainly not shareholders. ATGE's stock pattern over one year looks like v fib. Actually stock is up 38.34%. That's crazy.

ATGE owns only 2 medical schools of the dozens in the Caribbean and English language schools in Lat Am and those two schools were acquired in the past 20 years. You can bet those 2 schools' founders made a pretty penny when they sold them to ATGE.

 

[voxveritatisetlucis]

Certainly not shareholders. ATGE's stock pattern over one year looks like v fib. Actually stock is up 38.34%. That's crazy.

Will buy some of this when earnings ratio dips below 18. I think that long term headwinds actually favor these schools. I mean just look at the drastic increase in med school apps. How many of the people who don’t get in, try one or two more cycles and then give up, only to realize manufacturing jobs, finance jobs etc. are gone and never coming back. They might go to Caribbean at that point, especially if senators and congressional reps keep giving false hope of debt cancellation.

Thanks for putting it on my radar

 

[YCAGA]

Will buy some of this when earnings ratio dips below 18. I think that long term headwinds actually favor these schools. I mean just look at the drastic increase in med school apps. How many of the people who don’t get in, try one or two more cycles and then give up, only to realize manufacturing jobs, finance jobs etc. are gone and never coming back. They might go to Caribbean at that point, especially if senators and congressional reps keep giving false hope of debt cancellation.

Thanks for putting it on my radar

DO in my school state has almost doubled their class size in less than 4 years and will soon be training more physicians than all the MD schools in the state combined. Add to that the slow trickle every year of 1-3 new MD schools, almost exclusively funded by big healthcare companies like Kaiser, HCA, etc. Caribbean schools are definitely going to get pushed out of the market. "Low tier" DO schools already have a very difficult time getting their students passable clinical experience, and passable as in they keep their DO accreditation--LCME would nuke many DO schools based on their lack of quality clinical experiences.

 

[Matthew9Thirtyfive]

They have a less than 50/50 chance of matching from even the “top” Carib schools, and that’s if you include crappy prelim programs that go nowhere. Now that step 1 is about to be p/f, that is going to just get even worse.

 

[MyOdyssey]

Will buy some of this when earnings ratio dips below 18. I think that long term headwinds actually favor these schools. I mean just look at the drastic increase in med school apps. How many of the people who don’t get in, try one or two more cycles and then give up, only to realize manufacturing jobs, finance jobs etc. are gone and never coming back. They might go to Caribbean at that point, especially if senators and congressional reps keep giving false hope of debt cancellation.

Thanks for putting it on my radar

Andrew Yang approves your message.

 

[MyOdyssey]

They have a less than 50/50 chance of matching from even the “top” Carib schools, and that’s if you include crappy prelim programs that go nowhere. Now that step 1 is about to be p/f, that is going to just get even worse.

Why did the powers that be make step 1 P/F? I still don’t understand.

 

[voxveritatisetlucis]

Why did the powers that be make step 1 P/F? I still don’t understand.

Consolidated effort to eliminate all standardized testing. For example, every Ivy League school is test optional this application cycle. NYC public schools just eliminated G&T program.

I’m glad I applied when the SAT and SAT II were required. My family didn’t have any money for fancy extracurriculars and what not while I was in high school. Would’ve never been able to get into my alma mater.

 

[MyOdyssey]

Consolidated effort to eliminate all standardized testing. For example, all Ivy League schools are test optional this application cycle. NYC public schools just eliminated G&T program.

I’m glad I applied when the SAT and SAT II were required. My family didn’t have any money for fancy extracurriculars and what not while I was in high school

The MCAT's next to go?

 

[voxveritatisetlucis]

The MCAT's next to go?

I would imagine.

 

[Proudfather94]

I would imagine.

I thought that was in place to act as an equalizer between colleges as well as to predict ones ability to get through medical school. If they get rid of that all the colleges that do grade inflation will have more people applying than they know what to do with lol.

 

[MyOdyssey]

I thought that was in place to act as an equalizer between colleges as well as to predict ones ability to get through medical school. If they get rid of that all the colleges that do grade inflation will have more people applying than they know what to do with lol.

Same with high schools and the SAT

 

[voxveritatisetlucis]

Same with high schools and the SAT

Same with residencies and step 1

 

[Matthew9Thirtyfive]

The mcat is not going anywhere lol. Step 1 was never designed to be used as an applicant stratification tool. It has been used that way, and that use has been changing medical education for the worse. That’s why it is going pass/fail.

 

[Doctoscope]

The MCAT's next to go?

The MCAT going away would be far worse than keeping it, since it's the only equalizer between applicants. GPA is far too subjective.

 

[voxveritatisetlucis]

The mcat is not going anywhere lol. Step 1 was never designed to be used as an applicant stratification tool. It has been used that way, and that use has been changing medical education for the worse. That’s why it is going pass/fail.

I don’t know, people said the same about SAT/ACT once upon time. I never could have imagined that every Ivy League undergrad would become test optional. Although I guess there is somewhat of a difference because it’s not like once can choose to take Step 1 for an actual score to submit. At least with test optional undergrads, applicants can still submit standardized tests

 

[Matthew9Thirtyfive]

I don’t know, people said the same about SAT/ACT once upon time. I never could have imagined that every Ivy League undergrad would become test optional. Although I guess there is somewhat of a difference because it’s not like once can choose to take Step 1 for an actual score to submit. At least with test optional undergrads, applicants can still submit standardized tests

Exactly. The SAT is also drastically different than the step exams.

 

[YCAGA]

They have a less than 50/50 chance of matching from even the “top” Carib schools, and that’s if you include crappy prelim programs that go nowhere. Now that step 1 is about to be p/f, that is going to just get even worse.

Why does Step 1 going P/F change things? Everyone keeps saying that like it is a given. Yet it makes no logical sense if we are talking about overall match rate for Caribbean students, which is what we are talking about with the "50/50" chance.

There are 10,000+ more residency spots than there are US MD and DO graduates. Caribbean grads aren't really competing with US students for residency spots, they are competing with other IMG's. And other IMG's (i.e. non-US citizens) are almost certainly hurt more by P/F than Caribbean grads. Other IMG's do not have all of their clinical rotations in the US like Caribbean students. Add to IMG's being a question mark in terms of English language skills, cultural difference, and visa issues, and Caribbean medical students are probably helped by Step 1 pass/fail. With Step 1 and Step 2 scored it was easier to justify a non-US citizen IMG with good scores over a Caribbean grad with bad scores. And I say IMG with good scores because the IMG median matched Step 1 in 2020 for internal medicine was 237, which is good, but only a few percentile points above 50th. It is a common myth that non-citizen IMG's need like a 260 to match FM (median for FM in 2020 for that cohort was 219).

Now if we redefine "get worse" as Caribbean students matching into their desired speciality that isn't FM/IM/peds/neuro and maybe a few others, then yes things will get worse. But if we just measure Caribbean schools by match rates, the short term outlook has actually improved. (Long term, MD and DO expansion will hurt them).

 

[YCAGA]

Caribb schools SHOULD only be an option if you've literally applied 3x to US MD AND DO schools without any luck. AND you should have a 510+ to minimize the chances of remediating a year of flunking out before M2 in the Caribb. You want to maximize the chance of passing.

Now, SGU average is ~497 and the others are much lower. I bet if you took only the people who graduated PLUS matched from SGU the MCAT average would be closer to 503-ish. I know people who scored much lower and still got through all 4 years and matched, but the odds DRASTICALLY worsen with a low MCAT (means you're a slow learner and poor test taker). Too high of a risk. Better off doing a DO-SMP with guaranteed acceptance (most have ridiculously low requirements like 3.3/497 for guaranteed matriculation)

There is no reason to go to the Caribbean when you can study in English at a real legitimate Italian university for 0-2k/year and get a degree that is automatically recognized in over 2 dozen countries (all of the EU). A few of those countries are realistic options for residency if you do not match in the US and your desire to be a doctor is stronger than any distaste you have for learning a new language. Now, I recommend against Caribbean, Australian, Israeli, and EU schools, but the Caribbean is definitely the fourth out of those four options, and the EU is far and away the number one. Some people are stubborn and/or naive enough to not give up after getting rejected from US schools, so I encourage people to look into the EU options before they blow $400k on an island somewhere.

 

[voxveritatisetlucis]

There is no reason to go to the Caribbean when you can study in English at a real legitimate Italian university for 0-2k/year and get a degree that is automatically recognized in over 2 dozen countries (all of the EU). A few of those countries are realistic options for residency if you do not match in the US and your desire to be a doctor is stronger than any distaste you have for learning a new language. Now, I recommend against Caribbean, Australian, Israeli, and EU schools, but the Caribbean is definitely the fourth out of those four options, and the EU is far and away the number one. Some people are stubborn and/or naive enough to not give up after getting rejected from US schools, so I encourage people to look into the EU options before they blow $400k on an island somewhere.

I thought most eu universities required dual citizenship?

 

[YCAGA]

I thought most eu universities required dual citizenship?

Zero EU universities taught in English require dual citizenship. It is still big business over there and that would be horrible for business. The Eastern Bloc countries charge 6k-10k euro per year. It is just these degrees are taught at actual universities, have fall back options, and are literally an order of magnitude cheaper per year than the Carib.

 

[Gambino.]

The big 3 (I guess big 2 pending SGU's accreditation) likely won't see a massive change when it comes to primary care placements as the data we have been given shows that our average matched step 1 scores for those specialties are right around the US average anyways. It will likely place a bigger emphasis on step 2 as a weak step 2 score could be seen as a risk for when step 3 comes around. Where it will hurt is the more competitive specialties for IMGs such as gas, DR, etc. I would definitely expect worse match rates overall for the smaller and less known schools where above average step 1 scores were required even for primary care.

 

[Proudfather94]

The MCAT going away would be far worse than keeping it, since it's the only equalizer between applicants. GPA is far too subjective.

Yeah my state university prided itself on grade deflation and purposely tanked averages in classes pre meds took and curved everything but an A. You had to get like 30-35% above class average to even get an A in these classes. I'd be so mad if they got rid of the MCAT lol.

 

[YCAGA]

I don't disagree with you but I think the reason most people choose caribbean over EU (israel and australia have higher admission standards and Sackler/UQ-Ochsner are better than most DO schools tbh) is because the Caribbean curriculum *usually* teaches right to the test/is more standarized whereas it can vary in EU schools and you might spend 1-2 additional years figuring out how to take step 1/2. That 1-2 years can be $500k+ in salary and some people just want to learn for Step 1 (EU schools might be closer in education to US schools in things such as *gasp* bedside manner and other skills). Not saying Caribb is better but I think that's the reasoning most people have for choosing caribb over EU. Also, I know tons of people in the Caribb who just want an "easy" $250k 9-5 job and have rich/MD parents who can foot the bill.

Missed salary is a non-factor when match rates are at best 50/50. Another thing with European schools is that you get 5 real summer breaks of 2-3 months. Sometimes you need to do 2-4 weeks of clerkships, otherwise that is built in dedicated.

 

[NotAProgDirector]

@YCAGA basically said what I was going to say in their top post. There are many more residency spots than US grads. I agree that doing post-bacc grade repair or whatever and maximizing chances of gettng into a US school is almost always the best option and will yield the most opportunities in residency and specialty. But there are many spots in the match for IMGs -- might be at less prestigious places, and might be just 1 year internships. But many are categorical spots. Once all of S1 is P/F, it will be that way for all IMG's so it won't matter all that much. I agree that carib students may have a boost -- since they have US clinical experience. But programs are likely to just shift to S2 and the game will be the same.

A Carib education remains a gamble. 20-40% of students end up failing out. Some do poorly enough such that they don't fail out, yet can't find a residency. Whether you consider this "giving people a chance to succeed" or "setting people up to fail and exploiting their unrealistic desires" depends on how you see the situation.

 

[BowlingDoctor]

*Carib Med Student here* - As long as you're ok with matching into FM I think they are a viable option. Most people in my class want either FM or IM.

 

[doctorsmom5594]

Fifty percent of doctors in us came from Caribbean medical schools.
Do not expect to get a top tier residency since they usually screen out anything but us med schools.
My daughter did get interviews at two.
She had one friend who didn't matc

h the first year but she wanted a very competitive program and didn't have the scores for it.

 

[doctorsmom5594]

It all worked out for my daughter, she ended up getting what she wanted. She did not go into family practice.
She wouldn't have been accepted into a us program.
She had a horrible GPA.
If she had to do it again she would get another degree and raise her gpa.
You certainly have to learn it all on your own.
She interviewed with others from the other Caribbean schools and DO schools.

 

[Spine MD]

As we continue to increase the number of US trainees with larger med school classes and expansion of both MD and DO programs, it will only become harder for US Caribbean grads. Everyone in GME is aware of the circumstances around these programs.

 

[dorordian]

I think, for the ones that make it work, there are a lot of factors we don't see that enable them to do so. For example, I know a person that matched from a Caribbean school but this person has two parent physicians, as well as grandparent physicians, which could really help someone depending on where they apply. I think factors like these, that are less seen/hard to calculate, play a large role in the number of Caribbean students that match.

In my opinion it is much safer to go US MD/DO over Caribbean. For any Caribbean students reading this, I nonetheless wish you the best and hope you become a great physician.

 

[voxveritatisetlucis]

You also are probably limited in private practice or maybe even in faculty practice (assuming part of compensation is based on billable hours). Even though they don’t care about rankings, patients many probably don’t want to see a doctor who lists education as a Caribbean school

 

[Psych2014]

In your opinions, do you all believe this to be the case? I personally don't, simply because Step 1 going P/F will change the game somewhat.

The reason why I ask this is because I know someone who recently went to AUC, and at face-value it seems these people are scoring residencies. Or maybe people really just aren't doing their basic research and just go anyway... and it'd be too shocking to me if that were the case.

So, some people make it I suppose? Don't know. Would love to hear your experiences and answers.

Hi-I attended a Caribbean medical school that used to be a tier lower than AUC. That is Medical University of the Americas in Nevis. In about 2018 or so MUA achieved full acceptance for graduates to practice in California, which is huge. I am currently a board certified psychiatrist. I had no problem passing all steps of the USMLE and achieving a residency spot. For the match, I applied to about 10 Caribbean friendly Psychiatry programs and got five interviews. I did apply exclusively to Caribbean friendly residencies. I would say the main thing that drags down the statistics of some of the Caribbean medical schools is that they have far lower acceptance standards than U.S. medical schools. So you have a lot of students getting in who probably didn't have the wherewithal to make it all the way through. I am no genius, just a hard worker, and a bit older, with a lot of motivation. But I would say AUC, Saba, MUA and of course St George's are all good choices, as long as you're sure that medical school is right for you, and get educated on the peculiarities and different pathways that you need to know about for Caribbean schools (as mentioned by other posts here). You're going to get a lot of differing opinions here about Caribbean schools, but they are definitely an option if you're motivated. And, living on a Caribbean island is not always easy for 1.5 to 2 years.

 

[doctor_crane]

The real danger of Caribbean schools is not matching, it is actually graduating, passing board exams.
Doing medical school there is like doing medical school on hard mode.
Less resources to help you and a school that doesn’t care if you pass or not. (At least relative to US schools)
I’d have a huge amount of respect for someone that passes boards and went to a Caribbean school.

 

[thruaway]

I'm currently an MS4 at of the "Big 3" Caribbean Medical Schools so maybe I can maybe also shed some light on this discussion.

Going to any of the Big 3 vs any of the other Caribbean medical schools is already a bit of a disparity. The big 3 have been established and have had a track record for quite some time so they're a little more organized and hospitals and programs know about them, thus making it easier to match.

These schools will always be sustainable because USMD or DO grads don't apply to the same specialties or programs within specialties. The reality is, most grads don't want to be an FM doctor. "Commitment to the specialty" is one of the highest-rated items from the NRMP PD survey, and after discussing with my USMD and DO friends, the only ones who were applying for FM were pretty much only doing it as a backup. PDs want residents that are passionate about their specialty. Best example I can give is how I have proportionally more interviews than my DO friend, mainly because his personal statement and extracurriculars are more about his #1 specialty(which his scores are not competitive for so he, unfortunately, has not gotten many interviews for) so its quite obvious he does not want to be an FM doctor on paper. I've been set on FM since basic sciences, so on paper, you can feel my passion for FM.

Even within specialties, if you look at the match lists, by and large, we match at the same hospitals and similar ones each year. Our match-list for Rads and Psych were better these past few years, but personally, I believe it's because more Rads and Psych residencies have opened up at similar programs we match at. Most people don't want to be in the deep rural, or at malignant programs in desirable areas, but most of us are willing to go there.

I think a previous poster also hit the nail on the head. Some of my class, to be honest, are just not good students. A majority definitely are, but a certain portion, just don't study enough. 1st semester, there were students I knew who would wait until the week of exams to start studying. Comparing my experiences with my USMD and DO counterparts for basic sciences(because after that for clinical we're back in the US, where I personally noticed no difference) I noticed that it was a little bit harder than they had, but there was not as huge a disparity as I thought there was going to be.

Anyway, that's just my $.02 in the situation

 

[ChiDr]

You have to look at the data. Residency spots - MD US - DO US - MD IMG US - MD non IMG = a huge negative number.

This is scary and extremely worrisome when accumulating >300k of debt.

Now, can US IMG, nonUS IMG, and specifically Carribean IMGs get residency spots. Of course. The stats show it.

Is it becoming harder, yes, the stats show it.

Look at the published data from
matches over the years.

Take into consideration the new number of medical schools in the US, a dramatic increase in graduating students plus the lack of residency spots in many specialty fields leads to a grim future. However, all of this is speculation. Nevertheless, the stats point to decreasing outlooks. IMO.

 

[mcat_taker]

There is no reason to go to the Caribbean when you can study in English at a real legitimate Italian university for 0-2k/year and get a degree that is automatically recognized in over 2 dozen countries (all of the EU). A few of those countries are realistic options for residency if you do not match in the US and your desire to be a doctor is stronger than any distaste you have for learning a new language. Now, I recommend against Caribbean, Australian, Israeli, and EU schools, but the Caribbean is definitely the fourth out of those four options, and the EU is far and away the number one. Some people are stubborn and/or naive enough to not give up after getting rejected from US schools, so I encourage people to look into the EU options before they blow $400k on an island somewhere.

I would disagree with this. Yes EU is cheaper but it is easier to stay and work after graduating from an Australian medical school than from an EU school without EU citizenship and no language headaches. Take it from me- I've worked as a physician and US citizen in both Australia and the U.S and matched coming from an Australian school.

 

[Metamorphosis.DO]

Carrib schools will exist as long as sketchy NYC residencies exist.

Wait what’s this about? Where can I learn more?

 

[ChiDr]

I would disagree with this. Yes EU is cheaper but it is easier to stay and work after graduating from an Australian medical school than from an EU school without EU citizenship and no language headaches. Take it from me- I've worked as a physician and US citizen in both Australia and the U.S and matched coming from an Australian school.

I would say, wait the extra year or two, work on getting grades up, beefing up a resume, studying and retaking entrance tests. Then apply to US programs, MD and DO. But that’s just my bias.

I know great docs that attended schools in the Caribbean that are now in Rad, Anesthesia, and GS. You can do it but your risk is greater. It’s a risk, a big risk when you look at match placement.

 

[YCAGA]

I would disagree with this. Yes EU is cheaper but it is easier to stay and work after graduating from an Australian medical school than from an EU school without EU citizenship and no language headaches. Take it from me- I've worked as a physician and US citizen in both Australia and the U.S and matched coming from an Australian school.

That is patently false about both the EU and Australia, unless you are talking about Australia more than a decade ago. For the EU, you would need to go 15+ years back to sorta be correct.