Caribbean vs. Post-bacc

[effwun]

For those of you who are in the Caribbean,

I basically have three options right now

1.) Go to the Caribbean now (let's just assume I have the stats to get in)
2.) Wait a year, re-apply to more osteo schools, especially one of the new ones opening next application cycle (had 1 osteo interview, but everything got in pretty late, which is what I think hurt my app)
3.) Do a traditional or special masters program

What I'm looking for is some insight as to why those of you in the Caribbean decided to do what you did instead of a post-bacc program. I keep going back and forth in my head. I guess, its just that even with a grad degree there's no guarantee I'd be any better off, but if I really kick ass in grad school I could get a good school, maybe even a scholarship. Then again, if I'm kicking ass in school in the Caribbean, there's a chance (albeit very small) that I could transfer out and end up in a good school. (I KNOW, everyone says be happy with the school you're at so in case you can't transfer...) And even if I don't transfer out, I'm two years ahead of where I'd be otherwise.

I mean, I'm not looking to match derm or ortho or neurosurgery, so that's not really the issue. But I really hope there are a few of you out there who considered the same thing and have some insight on this. Thanks

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[GreenShirt]

I'm not in a Caribbean school right now (I managed to get into Osteo), but I did debate between those very options you listed this year and decided I would prefer to apply to the Caribbean for two main reasons: Money and Age.

1) Money. I already had a sizable undergrad debt and I figured it wouldn't be financially prudent to take out another $30-60K in student loans before I even started Med. School.

2) Age. Although, I would be about average age for an entering student, I am female, so a post/bac or masters would cost me another 1-2 reproductive yrs.

If money and age aren't an issue for you, and you feel that by pursuing additional education you may have a chance at a good school in the US, then go for it. But personally, if going abroad for 2 yrs isn't a problem for you, I would just go for the Carib. You'll be practicing medicine sooner. Why prolong the arduous process?

 

[effwun]

I'm not in a Caribbean school right now (I managed to get into Osteo), but I did debate between those very options you listed this year and decided I would prefer to apply to the Caribbean for two main reasons: Money and Age.

1) Money. I already had a sizable undergrad debt and I figured it wouldn't be financially prudent to take out another $30-60K in student loans before I even started Med. School.

2) Age. Although, I would be about average age for an entering student, I am female, so a post/bac or masters would cost me another 1-2 reproductive yrs.

If money and age aren't an issue for you, and you feel that by pursuing additional education you may have a chance at a good school in the US, then go for it. But personally, if going abroad for 2 yrs isn't a problem for you, I would just go for the Carib. You'll be practicing medicine sooner. Why prolong the arduous process?

Yeah...the money issue is certainly something I'm thinking about. I'm pretty much in the same boat, I have about $40k debt just for undergrad, and when I think about borrowing another $20-30k for a grad program...not too appealing. Also age, I started my undergrad pretty late, and I'm almost 29. I think I'd feel different if I was looking at a grad program when I was a few years younger. I mean realistically, I don't want to be paying off my loans when the kids I have yet to have start looking at schools.

Also, as an aside, I've seen the Caribbean vs. DO thread, and I totally do not want this to turn into that. I like both of them (obviously I applied to both and interviewed at an osteo), and really, I'm not looking at becoming a physician because I want people's respect.

 

[NewHope]

Yeah...the money issue is certainly something I'm thinking about. I'm pretty much in the same boat, I have about $40k debt just for undergrad, and when I think about borrowing another $20-30k for a grad program...not too appealing. Also age, I started my undergrad pretty late, and I'm almost 29. I think I'd feel different if I was looking at a grad program when I was a few years younger. I mean realistically, I don't want to be paying off my loans when the kids I have yet to have start looking at schools.

Also, as an aside, I've seen the Caribbean vs. DO thread, and I totally do not want this to turn into that. I like both of them (obviously I applied to both and interviewed at an osteo), and really, I'm not looking at becoming a physician because I want people's respect.

There are more U.S MD and DO schools are openning. Carib may become much less appealing in the nearest future. This year the match for IMGs was tough, so I heard. Can you imagine what it's going to be like when new schools will start pumping their graduates? I'd say try to get in D.O if you can. "Saving" two years may sound like a good deal. but if you get stuck waiting for the clinicals, or not getting the residency you may loose the same 2 years, if not more. I was about to go to Carib (b/c I have the stats), but I'm back tracking on it, and I'm a lot closer to 40 than 30 years old. Just MHO.

 

[effwun]

There are more U.S MD and DO schools are openning. Carib may become much less appealing in the nearest future. This year the match for IMGs was tough, so I heard. Can you imagine what it's going to be like when new schools will start pumping their graduates? I'd say try to get in D.O if you can. "Saving" two years may sound like a good deal. but if you get stuck waiting for the clinicals, or not getting the residency you may loose the same 2 years, if not more. I was about to go to Carib (b/c I have the stats), but I'm back tracking on it, and I'm a lot closer to 40 than 30 years old. Just MHO.

I think there are only two DO schools opening next year...and the AAMC is (I believe) just expanding the schools that are open now and that is going to be phased in over several years. The other thing, and I certainly don't have any solid sources on this, is that there may be a bit of a backlash to rate of DO expansion, maybe that the AOA is just opening all these schools to get more well known and not focusing on improving what they have. Additionally, I think there are A LOT of DO residency spots that go unfilled every year, and maybe they'd start to get filled more (pure speculation of course). And I read somewhere that the doctor shortage in the US is going to be like 80,000-200,000 by like 2020 or something...there's no way all the expansion could take care of that.

And I would think that the big 3's grads would continue to get residencies, and students at the less reputable schools would suffer (or just those with lower board scores regarless of school)...at least for a few more years, ie until I'm done with residency. In any event, I see people write over and over again that it's the board scores that count more, and it's more up to the individual than the school, so its possible that I would get (roughly) the same board score no matter where I'm at. (more wild speculation)

 

[NewHope]

Check this thread out: http://forums.studentdoctor.net/showthread.php?t=383814. I don't think it gives you all new schools that are in the works, but there will be a lot more than 2 new schools. If residency spots are not expanded than things will get a lot tougher for IMGs regardless of the Caribbean (Big 3 or Big 20) ranking. If you started 1-2 years ago you are still O'K. I'm in the same boat, and I'm not bashing carib route at all. It's very tempting, but I can't look at the reality, and just keep on convincing myself that "No, it aint so" . While the reason for epanding D.O schools is the same as Carib (mega $$$$$$$$$$$$$$$), realize that D.Os are AMG while Caribs are IMGs. Nobody guarantees anything to a foreign graduate, b/c The American graduates must be placed first. The supply and demand rule. No agenda. Anyway, that's how I see it, and I may be wrong, but the evidence of last match, and many of my friends from Ross in it gives me some food for thought.

I think there are only two DO schools opening next year...and the AAMC is (I believe) just expanding the schools that are open now and that is going to be phased in over several years. The other thing, and I certainly don't have any solid sources on this, is that there may be a bit of a backlash to rate of DO expansion, maybe that the AOA is just opening all these schools to get more well known and not focusing on improving what they have. Additionally, I think there are A LOT of DO residency spots that go unfilled every year, and maybe they'd start to get filled more (pure speculation of course). And I read somewhere that the doctor shortage in the US is going to be like 80,000-200,000 by like 2020 or something...there's no way all the expansion could take care of that.

And I would think that the big 3's grads would continue to get residencies, and students at the less reputable schools would suffer (or just those with lower board scores regarless of school)...at least for a few more years, ie until I'm done with residency. In any event, I see people write over and over again that it's the board scores that count more, and it's more up to the individual than the school, so its possible that I would get (roughly) the same board score no matter where I'm at. (more wild speculation)

 

[GreenShirt]

I don't know if you applied to the new Arizona DO school this year, ATSU-Mesa, but they recently extended their primary due date to April 15. So if you didn't put it on your list, it might be another shot to get into DO this round.

Yeah, the Med. School expansion thing is largely about $$$$. There's no shortage of people who want to be doctors and the med. school business is profitable. The real problem causing the shortage is the number of residency spots. On a recent interview the Dean told us that it costs the government something like $2 million (or more) to train each individual resident, so its not that easy just to expand the number of residency spots.

 

[effwun]

Nobody guarantees anything to a foreign graduate, b/c The American graduates must be placed first. The supply and demand rule. No agenda.

For that matter, no one guarantees anything to the American graduate. There are some in the Caribbean who could have excelled in US schools but wound up there for whatever reason, and there are probably some in the US schools that have no business being there, but somehow got in.

Also I don't see how you reason that supply and demand dictates that American grads must be placed first. I would guess board scores, and alumni connections are a big part of it, along with rotating at the hospital you want to do a residency at.

 

[GreenShirt]

Depending on what the weakest part of your application is, you might want to spend this year beefing up those areas. Re-take the MCAT, a good score can counter-balance a poor GPA. Get a lot of clinical experience; DO schools especially like a lot of clinical exposure. Then apply next year to DO schools, particularly the new ones, while concurrently applying to the Carib. schools. This way you won't spend a lot on additional courses and if things don't work out in the US again, you'll still have your shot in the Carib. You might have done this already, but go check out the Non-trad forum and see what worked for people. Maybe a good post-bac program is the boost you need, afterall.

 

[cee]

im waitlisted at 2 DO schools now and its a forgone conclusion that i'm going the carribean route. I just want to get started already. I could care less about moving to another country.. or the stigma attached to being a foreign grad.


my only issue is the horrendous attrition rate at a lot of these island schools. if not the attrition to pass the classes, i am also concerned about not being able to get the appropriate grade on a lot of these schools' usmle diagnostic tests in order to be eligible to take step 1.

just being an entering class is 150 students (or so), doesnt mean all 150 will get to take step 1 in the desired amount of time (let alone pass the damn thing)

 

[NewHope]

For that matter, no one guarantees anything to the American graduate. There are some in the Caribbean who could have excelled in US schools but wound up there for whatever reason, and there are probably some in the US schools that have no business being there, but somehow got in.

Also I don't see how you reason that supply and demand dictates that American grads must be placed first. I would guess board scores, and alumni connections are a big part of it, along with rotating at the hospital you want to do a residency at.

I don't think you understand the process of obtaining the residency well. American graduates come first. Even if you have 99/99 on your USMLE...some programs don't take FMGs. Period. If we were to apply your logic than nobody guarantees one crossing the street safely. G... I hope not, but I'm talking about notfailing out of U.S school, and therefore not making it to residency. The supply is a total # of residency spots, the demand is an increasing # of U.S med school graduates. Since you are entering the postgraduate training in U.S, and not Caribbean, the U.S graduates have a first pick. The board scores are equally important. But you need to make it to that stage to be consindered. And it's heck of a lot more difficult as an IMG than AMG. I'm not saying it for the sake of an arguement. Remember, I'm in the same boat as you at this point. However, it's easy to get caught up in the justifications as to why you are studying medicine outside of U.S. I'm not a slacker, and wanted to go Carib just to shave a couple of years on premed crap, b/c otherwise my app is quite competative. But make no mistake about it. People autamatically assume that you didn't get in U.S schools. Fair or not you'll see it again and again. So hopefully the sky is not falling just yet. But AMG is always beating IMG as far as choices are concerned.
Hope it helps.

 

[effwun]

I don't think you understand the process of obtaining the residency well. American graduates come first. Even if you have 99/99 on your USMLE...some programs don't take FMGs. Period.

Maybe you're right, and I don't understand the process well. But surely, I would have to think that PDs who never ever pick IMGs are relatively few and far between. I mean, if the inverse was the case, then PDs everywhere would always pick AMGs over IMGs for the more competitive spots, and no IMGs would ever match into these regardless of how well they did on the STEP. Clearly this isn't the case. Additionally, what I meant by not being guaranteed anything is that there are AMGs who don't match. Right?

The board scores are equally important. But you need to make it to that stage to be consindered. And it's heck of a lot more difficult as an IMG than AMG.

Are you saying it's harder to get to MS4 where you're about to take Step 2?
I'm not disagreeing with this, but I assumed that it had more to due with the higher attrition rate, and presumably the (average) lower caliber of IMGs.


And as far as people assuming you didn't get in to US schools. Well, yeah, I mean, there are probably zero to no people who get into a US school and decide to go the the Caribbean, so its a safe assumption, but that is also true of many DOs. And surely, the Caribbean schools aren't entirely composed of people like you or I who were very close to getting into a US school. Also I'm curious to see how this would play out in the workplace...I mean if the AMG looks down on the IMG for 'only' going to a Caribbean school, even though he/she passed the boards, what does that AMG think of the nurse, or PA? Does the AMG look down on them because they couldn't even get into a Caribbean school? Does the AMG look down on the DO and assume the DO didn't get into an allo school? If that's the case, it'd be a pretty a pretty frictional workplace, and probably not in the best interest of the patients. And besides, I don't want to do this for the admiration of my colleagues, so the hell with what they think of whatever degree I end up getting, as long as I'm not killing patients left and right due to my incompetence.


As an aside, I kinda doubt (but obviously have no proof for) PDs automatically assuming DO-AMGs are better than IMGs. I mean, I don't think PDs have any specific loyalty to a DO just because he/she studied basic sciences in the US.

I do understand your opinions though, and to be honest, this has all come about recently and now I'm kinda leaning more towards a graduate degree, as long as I can get an assistantship. I thought it was too late to apply to any of these, and what I was mostly concerned with was borrowing 30-50k and possibly still having to go the Caribbean. But getting a stipend and a 'free' MS on top it seems like a better idea.