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Regardless, you are at a serious disadvantage. You must focus with laser intensity on all aspects of residency application. Target programs with a history of accepting IMGs , especially from your school. Try to schedule audition rotations at programs where you have the best chance. Show up early, stay late, volunteer to give presentations or take new assignments. Get a letter from a faculty or PD at that program. You might need a gap year. Any way, you are in a tough place, but not impossible. Get busy. Good luck and best wishes!Sir, I'm sorry to say that I really feel sorry for your patients if you were a medical student or a physician.. I didn't go into medical school in the Caribbean because it was an easier option. I didn't go there for the prestige of the profession. I didn't go there after the label( M.D.). I simply went there to study the subject I love and I always dreamed of. I'm just a regular person who is so passionate about medicine. I passed the NBME comprehensive basic science exam on my first attempt, I passed step 1 on my first attempt. I passed the NBME comprehensive clinical science exam on first attempt. I have never failed any exam in medical school, have you?. Thank you.