In answer to your question, the reason it took Ross the time to gain approval rights was because Texas was not accepting any FMGs to practice. They were not even accepting applications for a while. Make your own observations about what one state thought, or what its reasons were, but at the same time, bear the following in mind: Many countries around the world have never even heard of DOs, and DOs are NOT ALLOWED TO PRACTICE there. Is this a reflection on the quality of education? I would say certainly not. It is to do with a lack of knowledge and recognition on the part of the Medical regulation boards of these particular countries.They are not familar with the education process involved in obtaining a DO degree and thus ( understandibly so) cannot grant that individual rights to practice medicine without a review of their schooling. As we all know the bureaucracy involved with such matters severly hinders expedition. The same was the case in Texas. Once they reviewed Ross' case, they accepted them, as they deemed their standard of education equivalent to that provided in US allopathic and osteopathic schools. So please don't make an ass of yourself by oversimplifying complex medical regulation procedures. By using your own rational the DO degree is of lesser or no quality in many countries around the world. That is not my opinion as I take a BALANCED look at all things. Also, use common sense people. This is the pre-osteopathic forum. If you post here with the OPs question, what were you expecting, " oh no, go Carribean MD, the DO degree is terrible" ( employ the circuitry God gave you...once you get into medical school it will make the transition that much easier..seriously) My decision to go carib MD included my ability to work back in my country of origin. I was accepted to two osteopathic schools in the midwest and declined both....principally for this reason. Finally, whoever was mkaing ponits about the USMLE pass rates being at around 60% for FMGS, that figure is an average of all FMGS including those that barely speak a lick of english, or whose programs or not geared towards the USMLE( clearly this is not the case for the big three....again common sense?) . For AUC, Ross, And Sgu the pass rates are much higher....somewhere I believe in the 75%-90% according to the last official sources I looked at. To all in their respective schools, good luck, just please try to pass around ACCURATE information so that future readers can make informed and unbiased decisions.