Caribbean IMG, a perspective from a successful story after struggle.

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xoggyux

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Hello,
Medical school is over for me and I thought it would be a good idea to share my experience given that I used this forum considerably during my medical/pre-medical school years and found it rather helpful.
In particular, I want to share my story from the moment I applied to medical school to match date. One of the reasons that inspired me to write my story is that for the most part, people only write to complain/criticize, and those that had a good experience/success rarely share their positive experience so when "naive" students read forums like this (and I was one of you not too long ago!) the take-home message is a lot scarier than it probably is.
First, a little bit of my background. I was born in Cuba and immigrated to the US when I was 17-18y old. Finished high school here in the US and joined a community college to pursue a career in engineering. As luck would have it, after ~2 years I serendipitously got exposed to a medically oriented course and in the spot realized that I needed to change my career. So this is where my medical career starts, 2 years into college with absolute no idea about the proper way to approach to applying to this highly competitive field. In fact, not only I was oblivious to the many requirements I needed, I was also fairly ignorant about the way college/university works in the US and on top of that, my English at that point was mediocre at best.

At this point, I transferred applied and got accepted for a transfer into the University of Miami. Perhaps not a super prestigious university, but by no means a bad university either. In fact UM at the time (and still is) was ranked in the top 50 US universities. I mention this not as some sort of bragging, believe me, if you keep reading you will find out I am really in no position to brag, but rather to give you some perspective about my pre-medical school performance, achievements, etc.

I started taking most of my pre-medical requirements at my own discretion. That is, I really did not seek for advisor/counselor advice regarding which classes to take or in what order. At the time I would tell myself (and perhaps I wanted to believe it) that making an appointment with one of those counselors was a waste of my time (or his/hers) and that I could figure this "simple" stuff on my own. The truth is that I was a bit shy about my less-than-great English at the time and also I was too cocky. This resulted in some poor performance in very critical pre-medical requirements. In particular Organic Chemistry and Physics. While most of my undergrad courses were As with just a couple of Bs sprinkled, my Orgo/Physics grades were Cs which certainly did not help me when applying to medical school. The rest of my grades looked rather well, in fact, my gGPA at the end was ~3.46 and sGPA ~3.56. I know, not impressive for a pre-med. Do keep in mind that I was juggling a part-time job (~20hours/week), research (~20h/week), volunteer work (~10h/week), in addition, my English for at least the first 2 years of college was rather poor (most of the B's were in english/literature courses). I was not a bad student by any measure, in fact, my very last semester I was carrying 18 all science courses (including master-level biology/chemistry courses) while doing all the beforementioned extracurriculars. I mention this to stress the importance of seeking advice early on. I am no genius but I am a smart person and I know I could have done a lot better had I seek assistance and had I managed my pre-medical requirements better. I take full responsability for my shortcomings but the rest of my story could have been substantially different if I had taken the time to meet an advisor a few times during my 3rd and 4th year of pre-medical.

At this point in the story, you know my GPA is mediocre as far as pre-medical students are concerned. My MCAT was not better either. I know the MCAT have changed over the years, and to be honest I dont remember the exact numbers I got but suffice it to say that my Science scores (biological and physical sciences) both were exactly average while my reading comprehension was 2 standard deviations below average with the writing sample also beeing rather poor. As a result, my "composite" was a bit below average and my GPA was also below average. At the time of my application to medical school, there was an Excel sheet flying around these forums that the student would enter the grades/MCAT and the sheet would calculate the schools that would "likely" consider me. The top half of the schools in that list was completely out of reach, the 3rd 25th percentile was "long shot" and the bottom 25th percentile is the one I was supposed to be aiming at.
This is another time where I made a colossal mistake. Again, this mistake could have been avoided had I spoke with a few counselors. The mistake in question is that I applied to 6 US medical schools. Yes, you read correctly, just 6. And to make things worse, 2 of those 6 were from the "out of reach" category simply because they had sent me promotional mail to my house and I figured that if they took the time to send me such mail, that I was at least on their radar (poor judgement on my part). So in practice, I only applied to 4 US medical schools. I did not even get interviewed once and only one of those 4 asked me for the secondary/supplemental application, the rest never asked for more documents.
At this point, I had 2 choices. I could either go to a Caribbean Medical School or I could take another year and either continue undergrad to raise my GPA and MCAT or work on a master degree to apply for the next cycle with better credentials. At that time, a family member had just recently graduated from Ross University (one of the "top" Caribbean Schools) and he highly recommended me the school. So I attended their seminar and applied to the university. The interview occurred on July and I assumed that they would take a few weeks or perhaps even months before I would hear back from them. So when I went to the interview, I was under the impression that I was being considered for the January semester (Caribbean school have rolling semesters that begin on Aug/January/April) so when they asked me "If accepted, when are you going to join us" I enthusiastically replied "as soon as possible". This was a colossal mistake as the interviewer followed up with "good, you start on August" (next month). I really did not want to start that soon, for one I had no travel documents at the time (I had an expired Cuban passport, no US passport, no US citizenship), I was still working on my research/part-time and perhaps, more importantly, I had not taken time off to relax/vacation since I moved to the country just 5 years earlier so I was pretty burned out. It was too late (or at least that was what I thought) I had to endure, push forward and join the August semester. I felt that if I said "wait a minute, I really want to take some time off to put my things in orders, I'll come on January" I would be risking my last chance at getting into medical school. That was silly of me, my stats were mediocre by US standards but were far above average for the school, they wanted me as much, if not more, as I wanted them. Asking them for a semester off to put my things in order might have even been considered as a sign of maturity.
So I started my first semester at Ross University. The first semester was a bit rough in the island, my grades were not the best but were acceptable. I had spent 18 years of my life in a country that in terms of amenities/freedom compares very poorly to Dominica, however, after 5 years living in the US I really had a hard time adapting to 3rd world conditions again. Having my friends and family far away did not help either. I endured the first semester. The second semester was a lot easier, my grades improved considerably, I felt the content being taught was easier to remember and I certainly felt more comfortable living in the island.
During my semester break after my 2nd semester I was diagnosed with a benign tumor and although benign, it was a locally invasive tumor in a rather inconvenient place so I had to take that semester off to have surgery. This is where things started to go bad for me. The time off meant that my friends now were in a different (more advanced) semester, that all that "adaptation" I worked for during semester 1 and 2 now was out of the window. When I returned for my 3rd semester I started having academic problems and in fact, I failed the 3rd semester. I returned later that year and repeated the 3rd semester with mediocre grades. My problems did not end here, In fact, I also failed the 4th semester. At this point, the process of dismissal from the institution was started. At this point, all the snobish/elitist people in the forum (if they read this far) are thinking "the only thing worse than attending a Caribbean school, is getting kicked by one". And I deserve the criticism. The truth is I got myself into this awful situation because of not seeking help when I needed it, not recognizing that there was a problem and many other reasons that are too much to enumerate.
Luckily, I applied for an appeal and it was granted to me. So I returned for my 4th semester a 2nd time (remember I had repeated 3rd semester already). At this point, I pass the 4th semester. This also meant that at this point I was a full year behind schedule for graduation (1 semester lost for surgery, 1 semester repeated, I had to sit out 1 semester because I was on probation and then repeat 4th semester).
This is the moment where most students would take Step 1. My school has a very interesting policy. They make us take an exam that the school call COMP which basically consists of a Prometric-administered test with NBME question (very similar to the practice NBME tests). The school has a policy that in order for you to be allowed to sit for Step 1 you must have passed that COMP test with a certain grade which would be equivalent to the minimum passing grade of Step 1. The school allows you to take the comp 3 times with the option to appeal for a 4th. Most students pass this exam in the first or 2nd attempt (makes sense, at this point most students should be ready to pass the step 1). I barely passed it on my 3rd attempt with just a couple points over the minimum. It was finally time to take step 1, and after 1-month studying I took it and 4 weeks laters I got my result: 196 (at the time the passing score was 192, so yes I passed it, but just barely, in fact, I was within the SEM).
If you have read this far, my condolences, but also know that this is when I officially reached rock bottom. This is when the story changes dramatically. I know my step 1 was awful but somehow I felt relieved. At this point, I felt that since I passed, all that had lead to that point was behind me. I could now focus on improving. I enjoyed my 3rd year very much, in fact, it was my favorite. My grades from this point until graduation date were the highest for the reminding of my clinical semesters. At some point, the topic about "specialty" came up during a conversation with one of my 3rd-year preceptors (Internal Medicine) and I shared that I wanted to go into Internal Medicine. My preceptor had no idea about my grades and the only indication of my medical school performance as my performance under her supervision and she dismissively told me "you won't have a problem, you are a great student you will get IM no easy. The reality is that I was well aware that my chances at a residency at this point were grim, and IM was surely out of the question. I this point I should have been aiming for less competitive specialties. So I confronted my preceptor and explained that IM was a long shot for me and shared my grades/step1. At this point she agreed with my first assessment that IM was a long, long, long shot. In fact, her attitude seemed to shift rather rapidly into the "don't even bother applying to IM as that won't happen, put all your eggs in the FM basket" and she offered to help me get residency into FM (she was a FM doctor working as a Hospitalist, that is how she ended up being my IM preceptor). I accepted her offer. However, I was not deterred. I was going to apply to some IM programs regardless. I had already made a mistake of not applying to enough medicals schools when I was in pre-med years. I was not going to repeat the same mistake.
As I was saying. My grades were excellent for my 3rd and 4th years. But part of this dramatic change is a result of changing my study habits. During my third year I read the following books:
Step Up to Medicine
Step Up to Surgery
Pestana Notes
Step Up to Pediatry
Step Up OBGYN
Psychatry First Aid
Mayo Clinic Internal Medicine Board Review
Goldman-Cecil Medicine, 2-Volume Set (this is a reference book, I read a few chapters and used sporadically thorugh 3rd/4th year but did not read/studied the whole book as for the others).
I also read/completed the questions of the following books:
MKSAP 15 for students
Case files Medicine
Case File Surgery
Case Files Pediatry
Case Files Family Medicine
Case Files OBGYN
Case files psychiatry
Completed the following question banks:
Kaplan ~80% (this is, in my opinion, the worse and most boring, out of touch)
USMLE-RX Q bank (100% once, 2nd time ~30% - in my opinion, far superior to Kaplan and 2nd only to uWorld. Also it is very cheap so well worth it)
uWorld (100% once)
Also did all the STEP 2 practice tests (4x NBMEs + uworld self-assessment)

As a result, my step 2 improved significantly. In fact, I got a 247 which was 51 points improvement over my Step 1. More importantly, I felt a lot more confident for the test. I know what you are thinking, it must have been a fluke, someone that repeated 2 semesters, that failed a COMP examination twice and just barely passed it on the 3rd time and barely manage to pass Step 1 by 4 point is not supposed to get a 247. Let me assure you that this score was real, my NBMEs ranged from 236 points (lowest) to 252 highest and the uWorld Self-Assesment was spot on with a 247. This certainly gave me much needed confidence. I was dreading showing up in an interview with another mediocre score. This gave me the last bit of momentum that I needed to go into the interview season. In addition, I passed the step 2 CS in one attempt, hardly an achievement but it could have certainly been a possibility if you only take into account my first few semesters of medical school and an indication of my performance.

During the application seasons, besides the poor performance early on, another thing was hurting my application. My step 2 CS was not released until October. For US graduates that is absolutely no problems but for IMGs it is recommended that we go into the application season with both steps 1/2 CK scores as well as CS for obvious reason. Receiving my CS score in October is not the end of the world, but it is conceivable that I lost a few opportunities to interview because of this (presumably because I might have been filtered). Being an IMG myself, I was advised to apply very broadly and to multiple specialties. My school's official recommendation is to apply to your main specialty and to at least 1 "backup" (they call it "parallel plan" but basically they mean backup) specialty and that for each specialty you apply to no less than 100 programs (although they recommend 200 programs). Again if you are an US graduate you might be surprised because perhaps you only have to apply to 20-30 but this is the reality for IMGs. I ended up applying to ~230 IM programs and to 90ish Family Medicine programs. I want to make clear that I applied to many more IM programs than FM simply because there are far more IM programs than there are FM programs. I put as much work into my FM applications and interviews as I did for the IM ones. Also, I would not have felt any worse matching at an FM program instead of IM as at the moment my goal is to become a hospitalist and I could have done the same either way.
At the end of the application cycle, I had attended 7 interviews in total. Four of those interviews were for IM programs. Two of the programs had university affiliations the rest were a community. I loved all of the programs very much, I would have been very happy in all of them and ranking them was a hard process because I liked them all!
This story is quite long, but it ends with me matching in my #1 IM program. I felt that I needed to tell the whole, long, story because I wanted you to know that if you are in a bad situation (perhaps a bad step score, or a repeat semester, or a failed step1) it is unlikely that your bad situation is as bad as mine was just a couple of years ago. I wanted to make sure that you knew that if Medicine is really what you want you should not give up. If you work hard to improve, you can overcome almost any awful performance in the past. If you just did poorly in your step 1, please don't dwell on it. Study hard and rock on step 2. If you failed something in your first or 2nd year, don't give up, work harder and do better on 3rd and 4th. ASK FOR HELP the moment that you realize you are not performing at your best. It is unlikely that whatever you think is hurting your chances is worse than what was hurting mines.
If I had come to this forum right after my step 1, with a score of 196 and 2 failed semesters in a Caribbean School I am sure I would have received plenty of unanimous advice to drop out and cut my losses. And at that time I was at my lowest, it is not entirely out of the realm of possibilities that I might have followed such advice. So that is the reason I wanted to share this LONG story, I wanted to make sure to share at least 1 positive story to counter the dozens and even hundreds of story that end with the "cut your loses, medicine is not for you". If this is what you love and you don't see yourself doing something else, please don't give up and instead try harder, much harder.

P.S. At one point I might share my experience with Ross University. I just wanted to quickly comment that although I had my issues, in particular during the semesters I was studying on the island, I am very happy I attended this school. I can't say that if I had the opportunity to do it all over again and I could have gone to a US school I would do exactly the same. But what I can say with certainty is that Ross prepared me very well. My shortcomings early on were just that, mine, my fault. The school prepared me well, the school gave me a second and then a third chance. Critics might want to point out that they gave me a chance simply because they get money from me but the reality is they took a risk giving me that chance. In the event that I would have failed (from their point of view, a very likely scenario given the fact that I had performed so awful up to that point) I would have severely impacted the numbers that they need to keep "healthy" to continue to receive Financial Aid Tuition money. In other words, they smart thing for them would have been to let me go and they did not. Instead, they helped me and they have continued to help me at every step of the way (including residency application, etc). I will be very grateful to Ross University and the staff of this school and I owe my success in part to their help.

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Hello,
Medical school is over for me and I thought it would be a good idea to share my experience given that I used this forum considerably during my medical/pre-medical school years and found it rather helpful.
In particular, I want to share my story from the moment I applied to medical school to match date. One of the reasons that inspired me to write my story is that for the most part, people only write to complain/criticize, and those that had a good experience/success rarely share their positive experience so when "naive" students read forums like this (and I was one of you not too long ago!) the take-home message is a lot scarier than it probably is.
First, a little bit of my background. I was born in Cuba and immigrated to the US when I was 17-18y old. Finished high school here in the US and joined a community college to pursue a career in engineering. As luck would have it, after ~2 years I serendipitously got exposed to a medically oriented course and in the spot realized that I needed to change my career. So this is where my medical career starts, 2 years into college with absolute no idea about the proper way to approach to applying to this highly competitive field. In fact, not only I was oblivious to the many requirements I needed, I was also fairly ignorant about the way college/university works in the US and on top of that, my English at that point was mediocre at best.

At this point, I transferred applied and got accepted for a transfer into the University of Miami. Perhaps not a super prestigious university, but by no means a bad university either. In fact UM at the time (and still is) was ranked in the top 50 US universities. I mention this not as some sort of bragging, believe me, if you keep reading you will find out I am really in no position to brag, but rather to give you some perspective about my pre-medical school performance, achievements, etc.

I started taking most of my pre-medical requirements at my own discretion. That is, I really did not seek for advisor/counselor advice regarding which classes to take or in what order. At the time I would tell myself (and perhaps I wanted to believe it) that making an appointment with one of those counselors was a waste of my time (or his/hers) and that I could figure this "simple" stuff on my own. The truth is that I was a bit shy about my less-than-great English at the time and also I was too cocky. This resulted in some poor performance in very critical pre-medical requirements. In particular Organic Chemistry and Physics. While most of my undergrad courses were As with just a couple of Bs sprinkled, my Orgo/Physics grades were Cs which certainly did not help me when applying to medical school. The rest of my grades looked rather well, in fact, my gGPA at the end was ~3.46 and sGPA ~3.56. I know, not impressive for a pre-med. Do keep in mind that I was juggling a part-time job (~20hours/week), research (~20h/week), volunteer work (~10h/week), in addition, my English for at least the first 2 years of college was rather poor (most of the B's were in english/literature courses). I was not a bad student by any measure, in fact, my very last semester I was carrying 18 all science courses (including master-level biology/chemistry courses) while doing all the beforementioned extracurriculars. I mention this to stress the importance of seeking advice early on. I am no genius but I am a smart person and I know I could have done a lot better had I seek assistance and had I managed my pre-medical requirements better. I take full responsability for my shortcomings but the rest of my story could have been substantially different if I had taken the time to meet an advisor a few times during my 3rd and 4th year of pre-medical.

At this point in the story, you know my GPA is mediocre as far as pre-medical students are concerned. My MCAT was not better either. I know the MCAT have changed over the years, and to be honest I dont remember the exact numbers I got but suffice it to say that my Science scores (biological and physical sciences) both were exactly average while my reading comprehension was 2 standard deviations below average with the writing sample also beeing rather poor. As a result, my "composite" was a bit below average and my GPA was also below average. At the time of my application to medical school, there was an Excel sheet flying around these forums that the student would enter the grades/MCAT and the sheet would calculate the schools that would "likely" consider me. The top half of the schools in that list was completely out of reach, the 3rd 25th percentile was "long shot" and the bottom 25th percentile is the one I was supposed to be aiming at.
This is another time where I made a colossal mistake. Again, this mistake could have been avoided had I spoke with a few counselors. The mistake in question is that I applied to 6 US medical schools. Yes, you read correctly, just 6. And to make things worse, 2 of those 6 were from the "out of reach" category simply because they had sent me promotional mail to my house and I figured that if they took the time to send me such mail, that I was at least on their radar (poor judgement on my part). So in practice, I only applied to 4 US medical schools. I did not even get interviewed once and only one of those 4 asked me for the secondary/supplemental application, the rest never asked for more documents.
At this point, I had 2 choices. I could either go to a Caribbean Medical School or I could take another year and either continue undergrad to raise my GPA and MCAT or work on a master degree to apply for the next cycle with better credentials. At that time, a family member had just recently graduated from Ross University (one of the "top" Caribbean Schools) and he highly recommended me the school. So I attended their seminar and applied to the university. The interview occurred on July and I assumed that they would take a few weeks or perhaps even months before I would hear back from them. So when I went to the interview, I was under the impression that I was being considered for the January semester (Caribbean school have rolling semesters that begin on Aug/January/April) so when they asked me "If accepted, when are you going to join us" I enthusiastically replied "as soon as possible". This was a colossal mistake as the interviewer followed up with "good, you start on August" (next month). I really did not want to start that soon, for one I had no travel documents at the time (I had an expired Cuban passport, no US passport, no US citizenship), I was still working on my research/part-time and perhaps, more importantly, I had not taken time off to relax/vacation since I moved to the country just 5 years earlier so I was pretty burned out. It was too late (or at least that was what I thought) I had to endure, push forward and join the August semester. I felt that if I said "wait a minute, I really want to take some time off to put my things in orders, I'll come on January" I would be risking my last chance at getting into medical school. That was silly of me, my stats were mediocre by US standards but were far above average for the school, they wanted me as much, if not more, as I wanted them. Asking them for a semester off to put my things in order might have even been considered as a sign of maturity.
So I started my first semester at Ross University. The first semester was a bit rough in the island, my grades were not the best but were acceptable. I had spent 18 years of my life in a country that in terms of amenities/freedom compares very poorly to Dominica, however, after 5 years living in the US I really had a hard time adapting to 3rd world conditions again. Having my friends and family far away did not help either. I endured the first semester. The second semester was a lot easier, my grades improved considerably, I felt the content being taught was easier to remember and I certainly felt more comfortable living in the island.
During my semester break after my 2nd semester I was diagnosed with a benign tumor and although benign, it was a locally invasive tumor in a rather inconvenient place so I had to take that semester off to have surgery. This is where things started to go bad for me. The time off meant that my friends now were in a different (more advanced) semester, that all that "adaptation" I worked for during semester 1 and 2 now was out of the window. When I returned for my 3rd semester I started having academic problems and in fact, I failed the 3rd semester. I returned later that year and repeated the 3rd semester with mediocre grades. My problems did not end here, In fact, I also failed the 4th semester. At this point, the process of dismissal from the institution was started. At this point, all the snobish/elitist people in the forum (if they read this far) are thinking "the only thing worse than attending a Caribbean school, is getting kicked by one". And I deserve the criticism. The truth is I got myself into this awful situation because of not seeking help when I needed it, not recognizing that there was a problem and many other reasons that are too much to enumerate.
Luckily, I applied for an appeal and it was granted to me. So I returned for my 4th semester a 2nd time (remember I had repeated 3rd semester already). At this point, I pass the 4th semester. This also meant that at this point I was a full year behind schedule for graduation (1 semester lost for surgery, 1 semester repeated, I had to sit out 1 semester because I was on probation and then repeat 4th semester).
This is the moment where most students would take Step 1. My school has a very interesting policy. They make us take an exam that the school call COMP which basically consists of a Prometric-administered test with NBME question (very similar to the practice NBME tests). The school has a policy that in order for you to be allowed to sit for Step 1 you must have passed that COMP test with a certain grade which would be equivalent to the minimum passing grade of Step 1. The school allows you to take the comp 3 times with the option to appeal for a 4th. Most students pass this exam in the first or 2nd attempt (makes sense, at this point most students should be ready to pass the step 1). I barely passed it on my 3rd attempt with just a couple points over the minimum. It was finally time to take step 1, and after 1-month studying I took it and 4 weeks laters I got my result: 196 (at the time the passing score was 192, so yes I passed it, but just barely, in fact, I was within the SEM).
If you have read this far, my condolences, but also know that this is when I officially reached rock bottom. This is when the story changes dramatically. I know my step 1 was awful but somehow I felt relieved. At this point, I felt that since I passed, all that had lead to that point was behind me. I could now focus on improving. I enjoyed my 3rd year very much, in fact, it was my favorite. My grades from this point until graduation date were the highest for the reminding of my clinical semesters. At some point, the topic about "specialty" came up during a conversation with one of my 3rd-year preceptors (Internal Medicine) and I shared that I wanted to go into Internal Medicine. My preceptor had no idea about my grades and the only indication of my medical school performance as my performance under her supervision and she dismissively told me "you won't have a problem, you are a great student you will get IM no easy. The reality is that I was well aware that my chances at a residency at this point were grim, and IM was surely out of the question. I this point I should have been aiming for less competitive specialties. So I confronted my preceptor and explained that IM was a long shot for me and shared my grades/step1. At this point she agreed with my first assessment that IM was a long, long, long shot. In fact, her attitude seemed to shift rather rapidly into the "don't even bother applying to IM as that won't happen, put all your eggs in the FM basket" and she offered to help me get residency into FM (she was a FM doctor working as a Hospitalist, that is how she ended up being my IM preceptor). I accepted her offer. However, I was not deterred. I was going to apply to some IM programs regardless. I had already made a mistake of not applying to enough medicals schools when I was in pre-med years. I was not going to repeat the same mistake.
As I was saying. My grades were excellent for my 3rd and 4th years. But part of this dramatic change is a result of changing my study habits. During my third year I read the following books:
Step Up to Medicine
Step Up to Surgery
Pestana Notes
Step Up to Pediatry
Step Up OBGYN
Psychatry First Aid
Mayo Clinic Internal Medicine Board Review
Goldman-Cecil Medicine, 2-Volume Set (this is a reference book, I read a few chapters and used sporadically thorugh 3rd/4th year but did not read/studied the whole book as for the others).
I also read/completed the questions of the following books:
MKSAP 15 for students
Case files Medicine
Case File Surgery
Case Files Pediatry
Case Files Family Medicine
Case Files OBGYN
Case files psychiatry
Completed the following question banks:
Kaplan ~80% (this is, in my opinion, the worse and most boring, out of touch)
USMLE-RX Q bank (100% once, 2nd time ~30% - in my opinion, far superior to Kaplan and 2nd only to uWorld. Also it is very cheap so well worth it)
uWorld (100% once)
Also did all the STEP 2 practice tests (4x NBMEs + uworld self-assessment)

As a result, my step 2 improved significantly. In fact, I got a 247 which was 51 points improvement over my Step 1. More importantly, I felt a lot more confident for the test. I know what you are thinking, it must have been a fluke, someone that repeated 2 semesters, that failed a COMP examination twice and just barely passed it on the 3rd time and barely manage to pass Step 1 by 4 point is not supposed to get a 247. Let me assure you that this score was real, my NBMEs ranged from 236 points (lowest) to 252 highest and the uWorld Self-Assesment was spot on with a 247. This certainly gave me much needed confidence. I was dreading showing up in an interview with another mediocre score. This gave me the last bit of momentum that I needed to go into the interview season. In addition, I passed the step 2 CS in one attempt, hardly an achievement but it could have certainly been a possibility if you only take into account my first few semesters of medical school and an indication of my performance.

During the application seasons, besides the poor performance early on, another thing was hurting my application. My step 2 CS was not released until October. For US graduates that is absolutely no problems but for IMGs it is recommended that we go into the application season with both steps 1/2 CK scores as well as CS for obvious reason. Receiving my CS score in October is not the end of the world, but it is conceivable that I lost a few opportunities to interview because of this (presumably because I might have been filtered). Being an IMG myself, I was advised to apply very broadly and to multiple specialties. My school's official recommendation is to apply to your main specialty and to at least 1 "backup" (they call it "parallel plan" but basically they mean backup) specialty and that for each specialty you apply to no less than 100 programs (although they recommend 200 programs). Again if you are an US graduate you might be surprised because perhaps you only have to apply to 20-30 but this is the reality for IMGs. I ended up applying to ~230 IM programs and to 90ish Family Medicine programs. I want to make clear that I applied to many more IM programs than FM simply because there are far more IM programs than there are FM programs. I put as much work into my FM applications and interviews as I did for the IM ones. Also, I would not have felt any worse matching at an FM program instead of IM as at the moment my goal is to become a hospitalist and I could have done the same either way.
At the end of the application cycle, I had attended 7 interviews in total. Four of those interviews were for IM programs. Two of the programs had university affiliations the rest were a community. I loved all of the programs very much, I would have been very happy in all of them and ranking them was a hard process because I liked them all!
This story is quite long, but it ends with me matching in my #1 IM program. I felt that I needed to tell the whole, long, story because I wanted you to know that if you are in a bad situation (perhaps a bad step score, or a repeat semester, or a failed step1) it is unlikely that your bad situation is as bad as mine was just a couple of years ago. I wanted to make sure that you knew that if Medicine is really what you want you should not give up. If you work hard to improve, you can overcome almost any awful performance in the past. If you just did poorly in your step 1, please don't dwell on it. Study hard and rock on step 2. If you failed something in your first or 2nd year, don't give up, work harder and do better on 3rd and 4th. ASK FOR HELP the moment that you realize you are not performing at your best. It is unlikely that whatever you think is hurting your chances is worse than what was hurting mines.
If I had come to this forum right after my step 1, with a score of 196 and 2 failed semesters in a Caribbean School I am sure I would have received plenty of unanimous advice to drop out and cut my losses. And at that time I was at my lowest, it is not entirely out of the realm of possibilities that I might have followed such advice. So that is the reason I wanted to share this LONG story, I wanted to make sure to share at least 1 positive story to counter the dozens and even hundreds of story that end with the "cut your loses, medicine is not for you". If this is what you love and you don't see yourself doing something else, please don't give up and instead try harder, much harder.

P.S. At one point I might share my experience with Ross University. I just wanted to quickly comment that although I had my issues, in particular during the semesters I was studying on the island, I am very happy I attended this school. I can't say that if I had the opportunity to do it all over again and I could have gone to a US school I would do exactly the same. But what I can say with certainty is that Ross prepared me very well. My shortcomings early on were just that, mine, my fault. The school prepared me well, the school gave me a second and then a third chance. Critics might want to point out that they gave me a chance simply because they get money from me but the reality is they took a risk giving me that chance. In the event that I would have failed (from their point of view, a very likely scenario given the fact that I had performed so awful up to that point) I would have severely impacted the numbers that they need to keep "healthy" to continue to receive Financial Aid Tuition money. In other words, they smart thing for them would have been to let me go and they did not. Instead, they helped me and they have continued to help me at every step of the way (including residency application, etc). I will be very grateful to Ross University and the staff of this school and I owe my success in part to their help.
Congrats dude, I'm sincerely happy for you, you've overcome what would've crushed so many others and I hope you all the best for your future which I'm sure will be glorious! :)
 
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Long read. But congrats.
 
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This is awesome.. Great work! :thumbup: Shows that being highly motivated and hard working can get you places
 
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Good job persevering through the bad times. Thank you for sharing your story.
 
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Effin awesome. Congrats to ya!
 
Thank you for sharing, very insightful. Congrats :)
 
Thanks for sharing your story. I too went to Ross and have a similar Step1 story. I got burnt out. I am now repeating Step1, Step2ck. And hope to be another Ross miracle:)


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I wanted to know if it is possible to work in europe or in the middle east with a md degree from the caribbean schools, or is there any difference regarding the med schools regarding their tiers placement

It must be do able. Because I know people in Denmark that are practicing medicine but have never passed Step1 exams in the USA.


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It must be do able. Because I know people in Denmark that are practicing medicine but have never passed Step1 exams in the USA.


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Awesome, are they from the Danemark? my main issue is for the residency, being a non US citizien my chances are lower for matching, is there any probability that I could do my residency in europe or anywhere else but the states with an md degree from the caribbean?
 
Hello,
Medical school is over for me and I thought it would be a good idea to share my experience given that I used this forum considerably during my medical/pre-medical school years and found it rather helpful.
In particular, I want to share my story from the moment I applied to medical school to match date. One of the reasons that inspired me to write my story is that for the most part, people only write to complain/criticize, and those that had a good experience/success rarely share their positive experience so when "naive" students read forums like this (and I was one of you not too long ago!) the take-home message is a lot scarier than it probably is.
First, a little bit of my background. I was born in Cuba and immigrated to the US when I was 17-18y old. Finished high school here in the US and joined a community college to pursue a career in engineering. As luck would have it, after ~2 years I serendipitously got exposed to a medically oriented course and in the spot realized that I needed to change my career. So this is where my medical career starts, 2 years into college with absolute no idea about the proper way to approach to applying to this highly competitive field. In fact, not only I was oblivious to the many requirements I needed, I was also fairly ignorant about the way college/university works in the US and on top of that, my English at that point was mediocre at best.

At this point, I transferred applied and got accepted for a transfer into the University of Miami. Perhaps not a super prestigious university, but by no means a bad university either. In fact UM at the time (and still is) was ranked in the top 50 US universities. I mention this not as some sort of bragging, believe me, if you keep reading you will find out I am really in no position to brag, but rather to give you some perspective about my pre-medical school performance, achievements, etc.

I started taking most of my pre-medical requirements at my own discretion. That is, I really did not seek for advisor/counselor advice regarding which classes to take or in what order. At the time I would tell myself (and perhaps I wanted to believe it) that making an appointment with one of those counselors was a waste of my time (or his/hers) and that I could figure this "simple" stuff on my own. The truth is that I was a bit shy about my less-than-great English at the time and also I was too cocky. This resulted in some poor performance in very critical pre-medical requirements. In particular Organic Chemistry and Physics. While most of my undergrad courses were As with just a couple of Bs sprinkled, my Orgo/Physics grades were Cs which certainly did not help me when applying to medical school. The rest of my grades looked rather well, in fact, my gGPA at the end was ~3.46 and sGPA ~3.56. I know, not impressive for a pre-med. Do keep in mind that I was juggling a part-time job (~20hours/week), research (~20h/week), volunteer work (~10h/week), in addition, my English for at least the first 2 years of college was rather poor (most of the B's were in english/literature courses). I was not a bad student by any measure, in fact, my very last semester I was carrying 18 all science courses (including master-level biology/chemistry courses) while doing all the beforementioned extracurriculars. I mention this to stress the importance of seeking advice early on. I am no genius but I am a smart person and I know I could have done a lot better had I seek assistance and had I managed my pre-medical requirements better. I take full responsability for my shortcomings but the rest of my story could have been substantially different if I had taken the time to meet an advisor a few times during my 3rd and 4th year of pre-medical.

At this point in the story, you know my GPA is mediocre as far as pre-medical students are concerned. My MCAT was not better either. I know the MCAT have changed over the years, and to be honest I dont remember the exact numbers I got but suffice it to say that my Science scores (biological and physical sciences) both were exactly average while my reading comprehension was 2 standard deviations below average with the writing sample also beeing rather poor. As a result, my "composite" was a bit below average and my GPA was also below average. At the time of my application to medical school, there was an Excel sheet flying around these forums that the student would enter the grades/MCAT and the sheet would calculate the schools that would "likely" consider me. The top half of the schools in that list was completely out of reach, the 3rd 25th percentile was "long shot" and the bottom 25th percentile is the one I was supposed to be aiming at.
This is another time where I made a colossal mistake. Again, this mistake could have been avoided had I spoke with a few counselors. The mistake in question is that I applied to 6 US medical schools. Yes, you read correctly, just 6. And to make things worse, 2 of those 6 were from the "out of reach" category simply because they had sent me promotional mail to my house and I figured that if they took the time to send me such mail, that I was at least on their radar (poor judgement on my part). So in practice, I only applied to 4 US medical schools. I did not even get interviewed once and only one of those 4 asked me for the secondary/supplemental application, the rest never asked for more documents.
At this point, I had 2 choices. I could either go to a Caribbean Medical School or I could take another year and either continue undergrad to raise my GPA and MCAT or work on a master degree to apply for the next cycle with better credentials. At that time, a family member had just recently graduated from Ross University (one of the "top" Caribbean Schools) and he highly recommended me the school. So I attended their seminar and applied to the university. The interview occurred on July and I assumed that they would take a few weeks or perhaps even months before I would hear back from them. So when I went to the interview, I was under the impression that I was being considered for the January semester (Caribbean school have rolling semesters that begin on Aug/January/April) so when they asked me "If accepted, when are you going to join us" I enthusiastically replied "as soon as possible". This was a colossal mistake as the interviewer followed up with "good, you start on August" (next month). I really did not want to start that soon, for one I had no travel documents at the time (I had an expired Cuban passport, no US passport, no US citizenship), I was still working on my research/part-time and perhaps, more importantly, I had not taken time off to relax/vacation since I moved to the country just 5 years earlier so I was pretty burned out. It was too late (or at least that was what I thought) I had to endure, push forward and join the August semester. I felt that if I said "wait a minute, I really want to take some time off to put my things in orders, I'll come on January" I would be risking my last chance at getting into medical school. That was silly of me, my stats were mediocre by US standards but were far above average for the school, they wanted me as much, if not more, as I wanted them. Asking them for a semester off to put my things in order might have even been considered as a sign of maturity.
So I started my first semester at Ross University. The first semester was a bit rough in the island, my grades were not the best but were acceptable. I had spent 18 years of my life in a country that in terms of amenities/freedom compares very poorly to Dominica, however, after 5 years living in the US I really had a hard time adapting to 3rd world conditions again. Having my friends and family far away did not help either. I endured the first semester. The second semester was a lot easier, my grades improved considerably, I felt the content being taught was easier to remember and I certainly felt more comfortable living in the island.
During my semester break after my 2nd semester I was diagnosed with a benign tumor and although benign, it was a locally invasive tumor in a rather inconvenient place so I had to take that semester off to have surgery. This is where things started to go bad for me. The time off meant that my friends now were in a different (more advanced) semester, that all that "adaptation" I worked for during semester 1 and 2 now was out of the window. When I returned for my 3rd semester I started having academic problems and in fact, I failed the 3rd semester. I returned later that year and repeated the 3rd semester with mediocre grades. My problems did not end here, In fact, I also failed the 4th semester. At this point, the process of dismissal from the institution was started. At this point, all the snobish/elitist people in the forum (if they read this far) are thinking "the only thing worse than attending a Caribbean school, is getting kicked by one". And I deserve the criticism. The truth is I got myself into this awful situation because of not seeking help when I needed it, not recognizing that there was a problem and many other reasons that are too much to enumerate.
Luckily, I applied for an appeal and it was granted to me. So I returned for my 4th semester a 2nd time (remember I had repeated 3rd semester already). At this point, I pass the 4th semester. This also meant that at this point I was a full year behind schedule for graduation (1 semester lost for surgery, 1 semester repeated, I had to sit out 1 semester because I was on probation and then repeat 4th semester).
This is the moment where most students would take Step 1. My school has a very interesting policy. They make us take an exam that the school call COMP which basically consists of a Prometric-administered test with NBME question (very similar to the practice NBME tests). The school has a policy that in order for you to be allowed to sit for Step 1 you must have passed that COMP test with a certain grade which would be equivalent to the minimum passing grade of Step 1. The school allows you to take the comp 3 times with the option to appeal for a 4th. Most students pass this exam in the first or 2nd attempt (makes sense, at this point most students should be ready to pass the step 1). I barely passed it on my 3rd attempt with just a couple points over the minimum. It was finally time to take step 1, and after 1-month studying I took it and 4 weeks laters I got my result: 196 (at the time the passing score was 192, so yes I passed it, but just barely, in fact, I was within the SEM).
If you have read this far, my condolences, but also know that this is when I officially reached rock bottom. This is when the story changes dramatically. I know my step 1 was awful but somehow I felt relieved. At this point, I felt that since I passed, all that had lead to that point was behind me. I could now focus on improving. I enjoyed my 3rd year very much, in fact, it was my favorite. My grades from this point until graduation date were the highest for the reminding of my clinical semesters. At some point, the topic about "specialty" came up during a conversation with one of my 3rd-year preceptors (Internal Medicine) and I shared that I wanted to go into Internal Medicine. My preceptor had no idea about my grades and the only indication of my medical school performance as my performance under her supervision and she dismissively told me "you won't have a problem, you are a great student you will get IM no easy. The reality is that I was well aware that my chances at a residency at this point were grim, and IM was surely out of the question. I this point I should have been aiming for less competitive specialties. So I confronted my preceptor and explained that IM was a long shot for me and shared my grades/step1. At this point she agreed with my first assessment that IM was a long, long, long shot. In fact, her attitude seemed to shift rather rapidly into the "don't even bother applying to IM as that won't happen, put all your eggs in the FM basket" and she offered to help me get residency into FM (she was a FM doctor working as a Hospitalist, that is how she ended up being my IM preceptor). I accepted her offer. However, I was not deterred. I was going to apply to some IM programs regardless. I had already made a mistake of not applying to enough medicals schools when I was in pre-med years. I was not going to repeat the same mistake.
As I was saying. My grades were excellent for my 3rd and 4th years. But part of this dramatic change is a result of changing my study habits. During my third year I read the following books:
Step Up to Medicine
Step Up to Surgery
Pestana Notes
Step Up to Pediatry
Step Up OBGYN
Psychatry First Aid
Mayo Clinic Internal Medicine Board Review
Goldman-Cecil Medicine, 2-Volume Set (this is a reference book, I read a few chapters and used sporadically thorugh 3rd/4th year but did not read/studied the whole book as for the others).
I also read/completed the questions of the following books:
MKSAP 15 for students
Case files Medicine
Case File Surgery
Case Files Pediatry
Case Files Family Medicine
Case Files OBGYN
Case files psychiatry
Completed the following question banks:
Kaplan ~80% (this is, in my opinion, the worse and most boring, out of touch)
USMLE-RX Q bank (100% once, 2nd time ~30% - in my opinion, far superior to Kaplan and 2nd only to uWorld. Also it is very cheap so well worth it)
uWorld (100% once)
Also did all the STEP 2 practice tests (4x NBMEs + uworld self-assessment)

As a result, my step 2 improved significantly. In fact, I got a 247 which was 51 points improvement over my Step 1. More importantly, I felt a lot more confident for the test. I know what you are thinking, it must have been a fluke, someone that repeated 2 semesters, that failed a COMP examination twice and just barely passed it on the 3rd time and barely manage to pass Step 1 by 4 point is not supposed to get a 247. Let me assure you that this score was real, my NBMEs ranged from 236 points (lowest) to 252 highest and the uWorld Self-Assesment was spot on with a 247. This certainly gave me much needed confidence. I was dreading showing up in an interview with another mediocre score. This gave me the last bit of momentum that I needed to go into the interview season. In addition, I passed the step 2 CS in one attempt, hardly an achievement but it could have certainly been a possibility if you only take into account my first few semesters of medical school and an indication of my performance.

During the application seasons, besides the poor performance early on, another thing was hurting my application. My step 2 CS was not released until October. For US graduates that is absolutely no problems but for IMGs it is recommended that we go into the application season with both steps 1/2 CK scores as well as CS for obvious reason. Receiving my CS score in October is not the end of the world, but it is conceivable that I lost a few opportunities to interview because of this (presumably because I might have been filtered). Being an IMG myself, I was advised to apply very broadly and to multiple specialties. My school's official recommendation is to apply to your main specialty and to at least 1 "backup" (they call it "parallel plan" but basically they mean backup) specialty and that for each specialty you apply to no less than 100 programs (although they recommend 200 programs). Again if you are an US graduate you might be surprised because perhaps you only have to apply to 20-30 but this is the reality for IMGs. I ended up applying to ~230 IM programs and to 90ish Family Medicine programs. I want to make clear that I applied to many more IM programs than FM simply because there are far more IM programs than there are FM programs. I put as much work into my FM applications and interviews as I did for the IM ones. Also, I would not have felt any worse matching at an FM program instead of IM as at the moment my goal is to become a hospitalist and I could have done the same either way.
At the end of the application cycle, I had attended 7 interviews in total. Four of those interviews were for IM programs. Two of the programs had university affiliations the rest were a community. I loved all of the programs very much, I would have been very happy in all of them and ranking them was a hard process because I liked them all!
This story is quite long, but it ends with me matching in my #1 IM program. I felt that I needed to tell the whole, long, story because I wanted you to know that if you are in a bad situation (perhaps a bad step score, or a repeat semester, or a failed step1) it is unlikely that your bad situation is as bad as mine was just a couple of years ago. I wanted to make sure that you knew that if Medicine is really what you want you should not give up. If you work hard to improve, you can overcome almost any awful performance in the past. If you just did poorly in your step 1, please don't dwell on it. Study hard and rock on step 2. If you failed something in your first or 2nd year, don't give up, work harder and do better on 3rd and 4th. ASK FOR HELP the moment that you realize you are not performing at your best. It is unlikely that whatever you think is hurting your chances is worse than what was hurting mines.
If I had come to this forum right after my step 1, with a score of 196 and 2 failed semesters in a Caribbean School I am sure I would have received plenty of unanimous advice to drop out and cut my losses. And at that time I was at my lowest, it is not entirely out of the realm of possibilities that I might have followed such advice. So that is the reason I wanted to share this LONG story, I wanted to make sure to share at least 1 positive story to counter the dozens and even hundreds of story that end with the "cut your loses, medicine is not for you". If this is what you love and you don't see yourself doing something else, please don't give up and instead try harder, much harder.

P.S. At one point I might share my experience with Ross University. I just wanted to quickly comment that although I had my issues, in particular during the semesters I was studying on the island, I am very happy I attended this school. I can't say that if I had the opportunity to do it all over again and I could have gone to a US school I would do exactly the same. But what I can say with certainty is that Ross prepared me very well. My shortcomings early on were just that, mine, my fault. The school prepared me well, the school gave me a second and then a third chance. Critics might want to point out that they gave me a chance simply because they get money from me but the reality is they took a risk giving me that chance. In the event that I would have failed (from their point of view, a very likely scenario given the fact that I had performed so awful up to that point) I would have severely impacted the numbers that they need to keep "healthy" to continue to receive Financial Aid Tuition money. In other words, they smart thing for them would have been to let me go and they did not. Instead, they helped me and they have continued to help me at every step of the way (including residency application, etc). I will be very grateful to Ross University and the staff of this school and I owe my success in part to their help.
Congrats to the brave souls who read this whole thing.
 
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Congrats to the brave souls who read this whole thing.
Hey! You didn't have to read it if you did not want to. Just wanted to point out that if reading a couple of pages worth of text is daunting for you, medicine will probably not agree with you.
 
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Hey! You didn't have to read it if you did not want to. Just wanted to point out that if reading a couple of pages worth of text is daunting for you, medicine will probably not agree with you.
Lol
 
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This is the best post about the caribbean I have seen yet. I have been lurking reading the caribbean postings and just been feeling awful about my decision to go. I have never even bothered to apply to US schools. I have three kids and non trad and still excited despite the horrible, snide, you're not good enough- don't bother mentality I have been reading. I almost lost interest in reading any posts. Very disheartening. I APPLAUD you from your bravery in sharing and persevering I wish you luck!!
 
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This is the best post about the caribbean I have seen yet. I have been lurking reading the caribbean postings and just been feeling awful about my decision to go. I have never even bothered to apply to US schools. I have three kids and non trad and still excited despite the horrible, snide, you're not good enough- don't bother mentality I have been reading. I almost lost interest in reading any posts. Very disheartening. I APPLAUD you from your bravery in sharing and persevering I wish you luck!!
Have you already started at your Caribbean med school? If not, then I strongly recommend at least trying to apply to US med schools first! I don't have kids but I would think having three kids is not going to be easy to make it through med school without family and other social support. So I would do everything in your power to get into a US med school, preferably to a school near family or others who can help you and your kids. Please consider this advice!
 
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Have you already started at your Caribbean med school? If not, then I strongly recommend at least trying to apply to US med schools first! I don't have kids but I would think having three kids is not going to be easy to make it through med school without family and other social support. So I would do everything in your power to get into a US med school, preferably to a school near family or others who can help you and your kids. Please consider this advice!

I have family and support where Im going in the Caribbean. I appreciate your concern but I am happy with my decision.
 
This is the best post about the caribbean I have seen yet. I have been lurking reading the caribbean postings and just been feeling awful about my decision to go. I have never even bothered to apply to US schools. I have three kids and non trad and still excited despite the horrible, snide, you're not good enough- don't bother mentality I have been reading. I almost lost interest in reading any posts. Very disheartening. I APPLAUD you from your bravery in sharing and persevering I wish you luck!!

Kudos to you for following your dreams.

Go to the Caribbean, graduate and go forward. Any good physician will tell you that their training was largely auto-didactic. A very large percentage of medical students at LCME / USA schools don't even attend lectures, ignore the "required" textbooks, use online resources from the comfort of their apartments and comment (on SDN no less) that their clinical rotations are abusive, hostile and demeaning. You get out of it what you put into it. so go to the Caribbean and put much effort in it.

There is a physician who attends our church who runs the occupational health department at an HCA facility. She is making a ton of money, has 3 adult children, divorced and is playing the field as to dating. She looks fabulous, has great energy and doesn't bat an eye when asked which she school she attended: Ross U. When I asked her about her Step 1 / 2 Scores, she laughed. But there she is, doing good work and seems quite happy.

Stock up on SPF 30! :)
 
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I have family and support where Im going in the Caribbean. I appreciate your concern but I am happy with my decision.
Glad you're happy. I was mostly just concerned about the fact that you hadn't tried to apply to any US school first. But who am I to judge? You do you. Be well.
 
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Kudos to you for following your dreams.

Go to the Caribbean, graduate and go forward. Any good physician will tell you that their training was largely auto-didactic. A very large percentage of medical students at LCME / USA schools don't even attend lectures, ignore the "required" textbooks, use online resources from the comfort of their apartments and comment (on SDN no less) that their clinical rotations are abusive, hostile and demeaning. You get out of it what you put into it. so go to the Caribbean and put much effort in it.

There is a physician who attends our church who runs the occupational health department at an HCA facility. She is making a ton of money, has 3 adult children, divorced and is playing the field as to dating. She looks fabulous, has great energy and doesn't bat an eye when asked which she school she attended: Ross U. When I asked her about her Step 1 / 2 Scores, she laughed. But there she is, doing good work and seems quite happy.

Stock up on SPF 30! :)

Sure this could be argued for year 1 and 2, but the quality of your clinical rotations plays a large part in the quality in your 3rd and 4th education. Caribbean schools are very poor in that department historically, so you may be playing some catch up come residency time(if you match that it)
 
Hello,
Medical school is over for me and I thought it would be a good idea to share my experience given that I used this forum considerably during my medical/pre-medical school years and found it rather helpful.
In particular, I want to share my story from the moment I applied to medical school to match date. One of the reasons that inspired me to write my story is that for the most part, people only write to complain/criticize, and those that had a good experience/success rarely share their positive experience so when "naive" students read forums like this (and I was one of you not too long ago!) the take-home message is a lot scarier than it probably is.
First, a little bit of my background. I was born in Cuba and immigrated to the US when I was 17-18y old. Finished high school here in the US and joined a community college to pursue a career in engineering. As luck would have it, after ~2 years I serendipitously got exposed to a medically oriented course and in the spot realized that I needed to change my career. So this is where my medical career starts, 2 years into college with absolute no idea about the proper way to approach to applying to this highly competitive field. In fact, not only I was oblivious to the many requirements I needed, I was also fairly ignorant about the way college/university works in the US and on top of that, my English at that point was mediocre at best.

At this point, I transferred applied and got accepted for a transfer into the University of Miami. Perhaps not a super prestigious university, but by no means a bad university either. In fact UM at the time (and still is) was ranked in the top 50 US universities. I mention this not as some sort of bragging, believe me, if you keep reading you will find out I am really in no position to brag, but rather to give you some perspective about my pre-medical school performance, achievements, etc.

I started taking most of my pre-medical requirements at my own discretion. That is, I really did not seek for advisor/counselor advice regarding which classes to take or in what order. At the time I would tell myself (and perhaps I wanted to believe it) that making an appointment with one of those counselors was a waste of my time (or his/hers) and that I could figure this "simple" stuff on my own. The truth is that I was a bit shy about my less-than-great English at the time and also I was too cocky. This resulted in some poor performance in very critical pre-medical requirements. In particular Organic Chemistry and Physics. While most of my undergrad courses were As with just a couple of Bs sprinkled, my Orgo/Physics grades were Cs which certainly did not help me when applying to medical school. The rest of my grades looked rather well, in fact, my gGPA at the end was ~3.46 and sGPA ~3.56. I know, not impressive for a pre-med. Do keep in mind that I was juggling a part-time job (~20hours/week), research (~20h/week), volunteer work (~10h/week), in addition, my English for at least the first 2 years of college was rather poor (most of the B's were in english/literature courses). I was not a bad student by any measure, in fact, my very last semester I was carrying 18 all science courses (including master-level biology/chemistry courses) while doing all the beforementioned extracurriculars. I mention this to stress the importance of seeking advice early on. I am no genius but I am a smart person and I know I could have done a lot better had I seek assistance and had I managed my pre-medical requirements better. I take full responsability for my shortcomings but the rest of my story could have been substantially different if I had taken the time to meet an advisor a few times during my 3rd and 4th year of pre-medical.

At this point in the story, you know my GPA is mediocre as far as pre-medical students are concerned. My MCAT was not better either. I know the MCAT have changed over the years, and to be honest I dont remember the exact numbers I got but suffice it to say that my Science scores (biological and physical sciences) both were exactly average while my reading comprehension was 2 standard deviations below average with the writing sample also beeing rather poor. As a result, my "composite" was a bit below average and my GPA was also below average. At the time of my application to medical school, there was an Excel sheet flying around these forums that the student would enter the grades/MCAT and the sheet would calculate the schools that would "likely" consider me. The top half of the schools in that list was completely out of reach, the 3rd 25th percentile was "long shot" and the bottom 25th percentile is the one I was supposed to be aiming at.
This is another time where I made a colossal mistake. Again, this mistake could have been avoided had I spoke with a few counselors. The mistake in question is that I applied to 6 US medical schools. Yes, you read correctly, just 6. And to make things worse, 2 of those 6 were from the "out of reach" category simply because they had sent me promotional mail to my house and I figured that if they took the time to send me such mail, that I was at least on their radar (poor judgement on my part). So in practice, I only applied to 4 US medical schools. I did not even get interviewed once and only one of those 4 asked me for the secondary/supplemental application, the rest never asked for more documents.
At this point, I had 2 choices. I could either go to a Caribbean Medical School or I could take another year and either continue undergrad to raise my GPA and MCAT or work on a master degree to apply for the next cycle with better credentials. At that time, a family member had just recently graduated from Ross University (one of the "top" Caribbean Schools) and he highly recommended me the school. So I attended their seminar and applied to the university. The interview occurred on July and I assumed that they would take a few weeks or perhaps even months before I would hear back from them. So when I went to the interview, I was under the impression that I was being considered for the January semester (Caribbean school have rolling semesters that begin on Aug/January/April) so when they asked me "If accepted, when are you going to join us" I enthusiastically replied "as soon as possible". This was a colossal mistake as the interviewer followed up with "good, you start on August" (next month). I really did not want to start that soon, for one I had no travel documents at the time (I had an expired Cuban passport, no US passport, no US citizenship), I was still working on my research/part-time and perhaps, more importantly, I had not taken time off to relax/vacation since I moved to the country just 5 years earlier so I was pretty burned out. It was too late (or at least that was what I thought) I had to endure, push forward and join the August semester. I felt that if I said "wait a minute, I really want to take some time off to put my things in orders, I'll come on January" I would be risking my last chance at getting into medical school. That was silly of me, my stats were mediocre by US standards but were far above average for the school, they wanted me as much, if not more, as I wanted them. Asking them for a semester off to put my things in order might have even been considered as a sign of maturity.
So I started my first semester at Ross University. The first semester was a bit rough in the island, my grades were not the best but were acceptable. I had spent 18 years of my life in a country that in terms of amenities/freedom compares very poorly to Dominica, however, after 5 years living in the US I really had a hard time adapting to 3rd world conditions again. Having my friends and family far away did not help either. I endured the first semester. The second semester was a lot easier, my grades improved considerably, I felt the content being taught was easier to remember and I certainly felt more comfortable living in the island.
During my semester break after my 2nd semester I was diagnosed with a benign tumor and although benign, it was a locally invasive tumor in a rather inconvenient place so I had to take that semester off to have surgery. This is where things started to go bad for me. The time off meant that my friends now were in a different (more advanced) semester, that all that "adaptation" I worked for during semester 1 and 2 now was out of the window. When I returned for my 3rd semester I started having academic problems and in fact, I failed the 3rd semester. I returned later that year and repeated the 3rd semester with mediocre grades. My problems did not end here, In fact, I also failed the 4th semester. At this point, the process of dismissal from the institution was started. At this point, all the snobish/elitist people in the forum (if they read this far) are thinking "the only thing worse than attending a Caribbean school, is getting kicked by one". And I deserve the criticism. The truth is I got myself into this awful situation because of not seeking help when I needed it, not recognizing that there was a problem and many other reasons that are too much to enumerate.
Luckily, I applied for an appeal and it was granted to me. So I returned for my 4th semester a 2nd time (remember I had repeated 3rd semester already). At this point, I pass the 4th semester. This also meant that at this point I was a full year behind schedule for graduation (1 semester lost for surgery, 1 semester repeated, I had to sit out 1 semester because I was on probation and then repeat 4th semester).
This is the moment where most students would take Step 1. My school has a very interesting policy. They make us take an exam that the school call COMP which basically consists of a Prometric-administered test with NBME question (very similar to the practice NBME tests). The school has a policy that in order for you to be allowed to sit for Step 1 you must have passed that COMP test with a certain grade which would be equivalent to the minimum passing grade of Step 1. The school allows you to take the comp 3 times with the option to appeal for a 4th. Most students pass this exam in the first or 2nd attempt (makes sense, at this point most students should be ready to pass the step 1). I barely passed it on my 3rd attempt with just a couple points over the minimum. It was finally time to take step 1, and after 1-month studying I took it and 4 weeks laters I got my result: 196 (at the time the passing score was 192, so yes I passed it, but just barely, in fact, I was within the SEM).
If you have read this far, my condolences, but also know that this is when I officially reached rock bottom. This is when the story changes dramatically. I know my step 1 was awful but somehow I felt relieved. At this point, I felt that since I passed, all that had lead to that point was behind me. I could now focus on improving. I enjoyed my 3rd year very much, in fact, it was my favorite. My grades from this point until graduation date were the highest for the reminding of my clinical semesters. At some point, the topic about "specialty" came up during a conversation with one of my 3rd-year preceptors (Internal Medicine) and I shared that I wanted to go into Internal Medicine. My preceptor had no idea about my grades and the only indication of my medical school performance as my performance under her supervision and she dismissively told me "you won't have a problem, you are a great student you will get IM no easy. The reality is that I was well aware that my chances at a residency at this point were grim, and IM was surely out of the question. I this point I should have been aiming for less competitive specialties. So I confronted my preceptor and explained that IM was a long shot for me and shared my grades/step1. At this point she agreed with my first assessment that IM was a long, long, long shot. In fact, her attitude seemed to shift rather rapidly into the "don't even bother applying to IM as that won't happen, put all your eggs in the FM basket" and she offered to help me get residency into FM (she was a FM doctor working as a Hospitalist, that is how she ended up being my IM preceptor). I accepted her offer. However, I was not deterred. I was going to apply to some IM programs regardless. I had already made a mistake of not applying to enough medicals schools when I was in pre-med years. I was not going to repeat the same mistake.
As I was saying. My grades were excellent for my 3rd and 4th years. But part of this dramatic change is a result of changing my study habits. During my third year I read the following books:
Step Up to Medicine
Step Up to Surgery
Pestana Notes
Step Up to Pediatry
Step Up OBGYN
Psychatry First Aid
Mayo Clinic Internal Medicine Board Review
Goldman-Cecil Medicine, 2-Volume Set (this is a reference book, I read a few chapters and used sporadically thorugh 3rd/4th year but did not read/studied the whole book as for the others).
I also read/completed the questions of the following books:
MKSAP 15 for students
Case files Medicine
Case File Surgery
Case Files Pediatry
Case Files Family Medicine
Case Files OBGYN
Case files psychiatry
Completed the following question banks:
Kaplan ~80% (this is, in my opinion, the worse and most boring, out of touch)
USMLE-RX Q bank (100% once, 2nd time ~30% - in my opinion, far superior to Kaplan and 2nd only to uWorld. Also it is very cheap so well worth it)
uWorld (100% once)
Also did all the STEP 2 practice tests (4x NBMEs + uworld self-assessment)

As a result, my step 2 improved significantly. In fact, I got a 247 which was 51 points improvement over my Step 1. More importantly, I felt a lot more confident for the test. I know what you are thinking, it must have been a fluke, someone that repeated 2 semesters, that failed a COMP examination twice and just barely passed it on the 3rd time and barely manage to pass Step 1 by 4 point is not supposed to get a 247. Let me assure you that this score was real, my NBMEs ranged from 236 points (lowest) to 252 highest and the uWorld Self-Assesment was spot on with a 247. This certainly gave me much needed confidence. I was dreading showing up in an interview with another mediocre score. This gave me the last bit of momentum that I needed to go into the interview season. In addition, I passed the step 2 CS in one attempt, hardly an achievement but it could have certainly been a possibility if you only take into account my first few semesters of medical school and an indication of my performance.

During the application seasons, besides the poor performance early on, another thing was hurting my application. My step 2 CS was not released until October. For US graduates that is absolutely no problems but for IMGs it is recommended that we go into the application season with both steps 1/2 CK scores as well as CS for obvious reason. Receiving my CS score in October is not the end of the world, but it is conceivable that I lost a few opportunities to interview because of this (presumably because I might have been filtered). Being an IMG myself, I was advised to apply very broadly and to multiple specialties. My school's official recommendation is to apply to your main specialty and to at least 1 "backup" (they call it "parallel plan" but basically they mean backup) specialty and that for each specialty you apply to no less than 100 programs (although they recommend 200 programs). Again if you are an US graduate you might be surprised because perhaps you only have to apply to 20-30 but this is the reality for IMGs. I ended up applying to ~230 IM programs and to 90ish Family Medicine programs. I want to make clear that I applied to many more IM programs than FM simply because there are far more IM programs than there are FM programs. I put as much work into my FM applications and interviews as I did for the IM ones. Also, I would not have felt any worse matching at an FM program instead of IM as at the moment my goal is to become a hospitalist and I could have done the same either way.
At the end of the application cycle, I had attended 7 interviews in total. Four of those interviews were for IM programs. Two of the programs had university affiliations the rest were a community. I loved all of the programs very much, I would have been very happy in all of them and ranking them was a hard process because I liked them all!
This story is quite long, but it ends with me matching in my #1 IM program. I felt that I needed to tell the whole, long, story because I wanted you to know that if you are in a bad situation (perhaps a bad step score, or a repeat semester, or a failed step1) it is unlikely that your bad situation is as bad as mine was just a couple of years ago. I wanted to make sure that you knew that if Medicine is really what you want you should not give up. If you work hard to improve, you can overcome almost any awful performance in the past. If you just did poorly in your step 1, please don't dwell on it. Study hard and rock on step 2. If you failed something in your first or 2nd year, don't give up, work harder and do better on 3rd and 4th. ASK FOR HELP the moment that you realize you are not performing at your best. It is unlikely that whatever you think is hurting your chances is worse than what was hurting mines.
If I had come to this forum right after my step 1, with a score of 196 and 2 failed semesters in a Caribbean School I am sure I would have received plenty of unanimous advice to drop out and cut my losses. And at that time I was at my lowest, it is not entirely out of the realm of possibilities that I might have followed such advice. So that is the reason I wanted to share this LONG story, I wanted to make sure to share at least 1 positive story to counter the dozens and even hundreds of story that end with the "cut your loses, medicine is not for you". If this is what you love and you don't see yourself doing something else, please don't give up and instead try harder, much harder.

P.S. At one point I might share my experience with Ross University. I just wanted to quickly comment that although I had my issues, in particular during the semesters I was studying on the island, I am very happy I attended this school. I can't say that if I had the opportunity to do it all over again and I could have gone to a US school I would do exactly the same. But what I can say with certainty is that Ross prepared me very well. My shortcomings early on were just that, mine, my fault. The school prepared me well, the school gave me a second and then a third chance. Critics might want to point out that they gave me a chance simply because they get money from me but the reality is they took a risk giving me that chance. In the event that I would have failed (from their point of view, a very likely scenario given the fact that I had performed so awful up to that point) I would have severely impacted the numbers that they need to keep "healthy" to continue to receive Financial Aid Tuition money. In other words, they smart thing for them would have been to let me go and they did not. Instead, they helped me and they have continued to help me at every step of the way (including residency application, etc). I will be very grateful to Ross University and the staff of this school and I owe my success in part to their help.

CONGRATSSSS!! SUPER CONGRATULATIONNNSS!!! AND FOR THE MOST PART......
THANK YOU!!
THANK YOU FOR TAKING THE TIME TO WRITE THIS POST, for students like me that will soon apply and have people around that keep giving me the "but and what if"
THANK YOU FOR SHOWING THAT IT HAS BEEN DONE AND IT CAN BE DONE AGAIN because as a med student that never wanted to give up, I tend to be afraid when all other med students picture things as impossible
THANK YOU FOR NO GIVING UP, and pushing yourself to the limit to prove that we can get there
THANK YOU, THANK YOU, THANK YOU, THANK YOU!!!
CONGRATULATIONSS!! AND WISH YOU THE BEST IN RESIDENCY!!
 
CONGRATSSSS!! SUPER CONGRATULATIONNNSS!!! AND FOR THE MOST PART......
THANK YOU!!
THANK YOU FOR TAKING THE TIME TO WRITE THIS POST, for students like me that will soon apply and have people around that keep giving me the "but and what if"
THANK YOU FOR SHOWING THAT IT HAS BEEN DONE AND IT CAN BE DONE AGAIN because as a med student that never wanted to give up, I tend to be afraid when all other med students picture things as impossible
THANK YOU FOR NO GIVING UP, and pushing yourself to the limit to prove that we can get there
THANK YOU, THANK YOU, THANK YOU, THANK YOU!!!
CONGRATULATIONSS!! AND WISH YOU THE BEST IN RESIDENCY!!
Dude don't even think of applying to the Caribbean with the way you all excited. This guy was lucky and 1 in a million so a BIG exception.
 
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aPBERGn_700b.jpg
 
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Sure this could be argued for year 1 and 2, but the quality of your clinical rotations plays a large part in the quality in your 3rd and 4th education. Caribbean schools are very poor in that department historically, so you may be playing some catch up come residency time(if you match that it)

there is so much dated information about the Caribbean it seems. The schools that aren't accredited match that description but those who do are far removed from stigma in the eyes of the anyone who can recognize a good student from a bad. You have terrible students in the US and there are terrible students from IMG's. I am very excited to test my abilities, with or without all the talk on here
 
Kudos to you for following your dreams.

Go to the Caribbean, graduate and go forward. Any good physician will tell you that their training was largely auto-didactic. A very large percentage of medical students at LCME / USA schools don't even attend lectures, ignore the "required" textbooks, use online resources from the comfort of their apartments and comment (on SDN no less) that their clinical rotations are abusive, hostile and demeaning. You get out of it what you put into it. so go to the Caribbean and put much effort in it.

There is a physician who attends our church who runs the occupational health department at an HCA facility. She is making a ton of money, has 3 adult children, divorced and is playing the field as to dating. She looks fabulous, has great energy and doesn't bat an eye when asked which she school she attended: Ross U. When I asked her about her Step 1 / 2 Scores, she laughed. But there she is, doing good work and seems quite happy.

Stock up on SPF 30! :)
Thank you very much. This post made me smile today.
 
there is so much dated information about the Caribbean it seems. The schools that aren't accredited match that description but those who do are far removed from stigma in the eyes of the anyone who can recognize a good student from a bad. You have terrible students in the US and there are terrible students from IMG's. I am very excited to test my abilities, with or without all the talk on here

So you are saying that the rotations bought by your carribbean school are consistently at par with those provided by us md schools?
 
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I tried difficult to look at for the USMLE tests. I couldn't tolerate the stress of coping with the whole lot; reading for the exams, married lifestyles, domestic obligations, circle of relatives's troubles, health, price range and so on. Best assignment writing service UK
You obviously don't know how the USMLE works. It's not a writing assignment that someone can just do for you. But even if it were, your poor grammar doesn't exactly inspire confidence in how the "assignment" will turn out. Finally, that'd be cheating, so yeah, no thanks... Doyle.
 
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Dude don't even think of applying to the Caribbean with the way you all excited. This guy was lucky and 1 in a million so a BIG exception.
Actually, I am definitely not 1 in a million and that is part of the reason I decided to make this post. Half of the interns in my residency programs are from either Ross or SGU. I don't personally know anyone from this year of my med school that did not match as the vast majority of my class matched. Many of the ones that did not either applied very sloppy (late, specialties out of their reach for their stats, etc). I think many PGs have realized that if they tap into specific IMGs or DOs schools they can manage to match students that are more responsible and perhaps even smarter than what they could attract if they only focused on AMG students). I suspect this because there is a multitude of programs out there were nearly 100% of the residents are some sort of IMG (either Caribbean or foreign graduates).
So you are saying that the rotations bought by your Caribbean school are consistently at par with those provided by us md schools?
Kind of depends. A few of my clinical rotations were in hospitals that were actually rotating other medicals students, often students going to American schools. In one occasion I rotated among students from a top 10 US med school and my colleagues from Ross and myself did not lag in professionalism nor medical knowledge. To the eyes of the preceptors, we were identical, received the same treatment and kept with the learning on par.
The quality of the rotations do vary significantly. But the good part is that you have a lot of control of where you want to do your clinical. If you do a tiny amount of research regarding which rotations that your school provides are good or bad you can easily cherry pick the ones that fit your needs. One time I chose a rotation I knew was awful (preceptor was kind of a scammer and would only teach for 4h a week) just so I could have some free time to study, and it worked fine. Another time I chose an IM sub-internship that I knew was super intensive and challenging because I wanted the experience and a good letter of recommendation.
So back to your point. It is not all bad or good but rather it is what you make it be.

1 month into my residency and this is overwhelming. Offcourse I expected this so it is very exhilarating.
 
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The only attending I know that came out of Ross is a hazard to human health.
 
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I applaud you and your perseverance, but you must admit you took a hefty risk. The issue with telling people to follow their dreams and either go to the carribean or worse, stick around after failing anything, is that youre telling them to risk hundreds of thousands of dollars on a dream. Can it be done? Yes. Youve proven that. Can a 5'5" skinny dude play in the NBA? Yes. Mugsy boghes proved that.
 
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I applaud you and your perseverance, but you must admit you took a hefty risk. The issue with telling people to follow their dreams and either go to the carribean or worse, stick around after failing anything, is that youre telling them to risk hundreds of thousands of dollars on a dream. Can it be done? Yes. Youve proven that. Can a 5'5" skinny dude play in the NBA? Yes. Mugsy boghes proved that.
Another way of putting it is that yes, people win the Lotto, but I wouldn't count on it for a retirement plan.
 
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excellent work. Caribbean med school (IMG or US LCME in Puerto Rico) isn't for everyone, but there are success stories.

Went to SJB in Puerto Rico, now doing residency at Hopkins. Cheers!
 
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I think some of you guys are way underestimating the real value of ROSS and similar universities. Don't get me wrong, I was miserable when I was there but I was one among many and most of my colleagues had different experiences. Some of them loved that place. Most importantly it did prepare me very well. Despite my initial hiccups (which was, in part was exacerbated due to events out of my control) it got me into a good residency, got me plenty of interviews to have other options if I needed and frankly, my medical knowledge is very high as evidenced by the great feedback I have gotten from my program's faculty. Out of 30 official faculty statement/evaluations 20+ are markedly positive and a single one is negative (I have no clue what I did wrong to that lady to hate me so much :D) and did 95% percentile in my first ITE and 90% on my second. I don't even think im a particularly successful story from my school (AKA im not a rare snowflake in a sea of poor, unmatched candidates). In fact, ROSS matches are from what I have seen in the 90's range.
That is not to say I would recommend anyone to go there other than US school or even maybe DO. That is absolutely ridiculous and stupid. Read clearly, if you can get into US based school, don't think it, do it right away. I would have done it myself had I had the chance. I would do it myself if I had a time machine. But the hate is really undeserved (unless is fake hate because you somehow feel this is competition for DO/US MD?). The truth of the matter is, if you have 2 grams of gray matter inside your skull and you work your butt off and are willing to put through 2 years of ****ty, 3rd world caribbean nightmare, you can become a good doctor and go ahead and pursue your dreams. If in the otherhand you have a 1.9 GPA, and go to ROSS to party hard while "pretending" you are a medstudent, you will waste your money, or worse, go into deep debt and waste your time. Please don't do it for your sake.
If you, on paper, have bad credentials but you know you are smart and hardworker and can endure 2 years of hard work + 2 years of med-school, you will not regret it.
For the record. 100% of my close friends from ross matched on their first attempt and ~50% of my program's residents are either from Ross or SGU.
 
The point here isn't that there are successful Carib grads. The point is how many additional obstacles to success you face by going to a Carib school.
The point is, the obstacles in Caribbean school, although certainly difficult, are surmountable. Not getting into US MD or DO school is a hard stop to your dreams if you are not willing to consider IMG route.
 
The point is, the obstacles in Caribbean school, although certainly difficult, are surmountable. Not getting into US MD or DO school is a hard stop to your dreams if you are not willing to consider IMG route.

I would correct that by stating not getting into an allopathic or osteopathic school is only a hard stop if you aren't willing to assess why you didn't get in, correct and address those reasons, and reapply the next year. I've spoken to medical students at my state's main medical school whom had to apply two or three times before they got in, and I acknowledge that as a possible reality for myself this interview cycle. Medicine and residency matching is getting more competitive, not less.

Frankly I think its even more irresponsible for someone on the other side of a Caribbean medical school to tell others they should pursue it, compared to a pre-med that doesn't know any better.
 
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I am not oposed to attempting a second time if you think you have a good chance at getting in. A third, or more times is just a waste of time and resources. If getting an extra year to bump up your CV gets you on US allopathic/DO, that’s perfectly fine. That being said, if you find yourself contemplating a $30-50K masters degree in some crap that you know you don’t really care because it does not align with your future goals or some other nonsense like that. I would definitely recommend a good sit down and extensive thoughts into seriously considering Caribbean school. It is not the black hole some people like you make it seem. There are plenty of terrifying histories about Caribbean school but success stories are fare more common. Hard work will eventually triumph.
I am starting to think that the “competitiveness” of residencies is actually due to how many weird people are out there. I am part of my residency selection committee and I have met a lot of applicants in the last 2 seasons, and let me tell you, I see some crazy stuff and that is just personality wise, I haven’t even seen the stats on paper which I suspect are excellent because my program’s director is big on that.
 
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