The issue with off-shore schools isnt the medical education but rather the reality of opportunities for those who attend. Obviously, those who grades and MCAT prevent them from getting into a US MD or DO are also likely to have more difficulty with a medical school curriculum, so there is a higher attrition rate, though hard data on that is scarce. What do have data on is the residency placement rates, which run significantly lower US MD/DO (see my previous post with data
https://forums.studentdoctor.net/threads/sgu-md-admission.1283457/#post-19357255 ). This means the "success" rate of starting medical school, earning a degree, and actually getting any residency placement, is significantly lower than US schools. While I am not a big fan of the off-shore schools, I certainly do not rule them out as they do produce many successful graduates but they also have as many unsuccessful ones who try and either fail out or do not get a residency.
Therefore, as I've said often, before considering
any offshore school applicant must go through at least
two application cycles for both MD and DO with at
least a year break in between (ie skip a cycle) for application repair and/or enhancement. the break is necessary to analyze and understand the weaknesses in an application. Repair may be as simple as reorganizing rewriting application or it may require postbacc, SMP, MCAT, or additional extracurricular such as clinical volunteering and other items. I strongly advise that no student should consider off shore schools until the above has been done. This has the additional benefit that if an applicant has gone thru all this, they would seem to be as best prepared as possible for being successful in an off-shore school