What are the chances of a caribbean grad getting a competative fellowship like derm-path or cytopath? It is clear to me that being an IMG is a major disadvantage for obtaining residency, but is it still of equal importance for fellowships? Are USMLE scores of any relavance for fellowships? With 250's and 260's on the steps, I will hopefully be able to match into a "middle teir" program, which is great, but when it comes to fellowship will there be a way of "making up" for not being a US grad. I hate to sound so pessimistic, but it's better to know what obstacles I face before I try to get past them. Thanks.