First, none of us here has ever suggested that Caribbean grads will get "top choices" in "competitive specialties" (assuming you mean derm, ortho, plastics, rad onc, neurosurg, etc.). However, I have always recommended that prospective students and students who are looking at where to submit their applications for the Match should look at the programs that have historically accepted graduates from that school into GME programs. There are many who get into radiology, emergency medicine, anesthesiology (like myself) and not just primary care fields, although those form the bulk of Matches, by choosing this system. I trained side-by-side with mostly U.S. allopathic graduates, some D.O.s and a few other Carib graduates. I did quite well. Yes, that was almost ten years ago now.
Secondly, in this new era of exposing and challenging prejudices, I find it funny that this is still allowed to be openly expressed and wonder why it is not questioned. There are subsequently many qualified graduates who, once they get into a Carib program, excel. They are often the exception, clearly, but to summarily dismiss them just because they went to St. George's or AUC or Ross seems like it should be consider among the worst forms of profiling. Likewise, I'm sure you met more than one or two students, MallorWeiss, in your class who struggled. They were I'm sure stellar students in undergrad and maybe had the same MCAT scores that the Carib students had but, for whatever reason, they got their invitation to the U.S. allopathic party and the other kid didn't. These students in your class who struggled were likely coached along because "attrition" is a dirty word in U.S. medical school, subsequently passed their exams, got their letters, and went on interviews with the imprimatur of your school emblazoned on their curriculum vitae. Is this anymore fair that a weak U.S. student automatically gets access to certain programs just because of their pedigree? Excluding a stronger Carib graduate from the residency selection process at a particular program simply because they went the Carib route now sounds an awful lot like bigotry to me. What would you say if we were talking about allowing a white person into a country club and excluding someone else simply because of their race or religion? Before you call that a straw man you're going to have to demonstrate to me precisely how it's different.
Lastly, as I've said mulitple times before, the tides are changing. There are far more U.S. allopathic schools opening. There are more spots at the current ones. The caliber of student who barely didn't get into a U.S. program and choose to go the Caribbean route will be changing dramatically over the next few years. So, in essence, I can't say that the Caribbean pathway will be the same ten years from now as it was ten years ago. But, I can say that people continue to and have been having these types of discussions and offering these kinds of warnings since the Caribbean pathway became a reality. Not much has changed. The only thing that is certain is that more U.S. spots means more options for U.S. citizens and graduates of premedical programs. How this is a bad thing for them is beyond me.
-Skip
