How good are Caribbean medical schools compared to US med schools?

[womp]

I think the word "discrimination" is used in its true sense here, not in its "human resources" terms. Discrimination would be prejudice or unfair treatment of an applicant, based on not having fully understood the nuances of his or her educational background.

When a program director chooses to rank a Caribbean graduate who is more competent and on paper has better stats (ie. US resident, US research, US letters of recommendation, US performance on rotations, basic sciences grades, USMLE scores, interview) than the US graduate, they are choosing to discriminate based on a stereotypical assessment of the location of their school and its standards. This in my opinion is unfair, but not illegal. It points to a program that is not interested in hiring the best candidates for the job.

However unfairness is the story of the game and where you went to school is always a big factor in the job that you end up landing. In this case, Caribbean graduates from the respectable Caribbean schools go above and beyond to prove to US programs that they have leveled the playing field by doing well on their standardized exams, US rotations, research, etc. This in my opinion is enough and having spent 18-24 months of your basic sciences abroad should not be an important factor in the selection process.

In general, I think most program directors understand this and in majority of cases the US graduate would land a residency position over the Caribbean graduate only because the US grad has better stats overall. Anything beyond this is equivalent to discrimination however you want to call it.

Waa waa waa... don't want to get discriminated based on your Caribbean school? Go to a US medical school.

Many US schools don't teach to the Step 1 and give their students just 5 weeks to study for it, unlike the common 6 months for many of the Caribbean schools. You ought to be thankful that medicine is not like biglaw.

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[GADoctor]

Even the top carib schools are starting to slip, IMHO. I have some really good carib grads in my program. They are some of my best residents, and I am proud of their accomplishments. I am happy to call them colleagues and get their careers launched. However, in discussing their clinical experiences as students with them, I really worry that the clinical education being delivered by these schools is really suboptimal in many respects.

If you are talking about the BIG 4 schools, it is my understanding that their clinical spots were fairly reputable with students training along side US students. I have, though, heard of students at the other Caribbean schools doing basically shadowing in private practices with a doctor who has a loose association with a teaching program, and getting credit for this as a rotation.

 

[digitalising]

Many US schools don't teach to the Step 1 and give their students just 5 weeks to study for it, unlike the common 6 months for many of the Caribbean schools. You ought to be thankful that medicine is not like biglaw.

I had five weeks to study for my Step. And I go to a Caribbean school. And yet I still outperform the Big Name American Medical School students in my rotations who prefer to sit around reading rather than actually taking care of patients (not to say that I haven't met some lovely future AMGs, but since we're stereotyping here...).

 

[Rokitansky]

Waa waa waa... don't want to get discriminated based on your Caribbean school? Go to a US medical school.

Many US schools don't teach to the Step 1 and give their students just 5 weeks to study for it, unlike the common 6 months for many of the Caribbean schools. You ought to be thankful that medicine is not like biglaw.

Head over to the Allo forum and see how much time different LCME schools give their 2nd years for Step 1 studying. Based on this http://forums.studentdoctor.net/showthread.php?t=806083 thread, quite a number of LCME schools give 8 weeks.

Why do I care? I was lucky to get into a top US school, but my older brother wasn't as lucky and he graduated from St. George's last year and he's a busy EM resident who doesn't really like to come to SDN. He had 5 weeks and 6 days of study time while also having to deal with the adjustment of moving back from Grenada, etc.

From everything he's told me and I've learned through objective (btw you should really try this whole objective thing, it might change your life - for the better) research, the people who start in the January class may get 8 or even in some cases up to 12 weeks to study, but the bigger block of students who are the August starters like my brother can't really get any more than 7 weeks max.

So this whole Carib students get months to study for Step 1, which gets thrown around SDN all the freaking time is getting really old. It's a huge generalization which is generally not true.

 

[sesigs]

.........................................

 

[bambi]

While I can see there are some problems with the argument, I agree whole heartedly with the last sentence of the post! I've worked with US trained and foreign trained doctors and have seen no differences in their training or intelligence. I will be starting medical school this fall at a Caribbean school and feel very confident that I will be receiving a great education and one similar to my peers in the States. The bottom line is there is a shortage of physicians and we need more doctors! If a doctor is skilled at what they do it shouldn't matter where they graduated from.

I'm not attacking you in any way but if you haven't even started med school yet you aren't really in a position to comment on knowledge/training differences as at your level even superficial knowledge will be far beyond yours and will impress you.

 

[sesigs]

..............................

 

[Damie0610]

Hi y'all, has anyone heard of these schools: Medical University of the Americas & All Saints University (Dominica)? Are they good schools?

 

[Skip Intro]

So this whole Carib students get months to study for Step 1, which gets thrown around SDN all the freaking time is getting really old. It's a huge generalization which is generally not true.

I had seven weeks.

I scored 231. I landed in a "top 25 residency program" in anesthesiology. I'm now board-certified, fully employed in private practice, and making a pretty sweet salary.

I've never looked back.

-Skip

 

[Skip Intro]

Hi y'all, has anyone heard of these schools: Medical University of the Americas & All Saints University (Dominica)? Are they good schools?

Be VERY wary...

-Skip

 

[LoudBark]

Skip,
Considering that you are through with residency and a practicing anesthesiologist, I assume you graduated a number of years ago.

Today anesthesiology is more competitive than when you applied. It is a fact, less Carib students are matching in anesthesiology than even 5-6 years ago. As recently as 2004, some anesthesiology programs would fill half of their spots with FMG's. Not so today. Those same programs fill with almost all AMG's.

Today it is harder for Carib students to match in any specialty.

Today's students should never assume what someone did years ago as far as matching will be equivalent to what they can do today.

 

[Skip Intro]

Skip,
Considering that you are through with residency and a practicing anesthesiologist, I assume you graduated a number of years ago.

Today anesthesiology is more competitive than when you applied. It is a fact, less Carib students are matching in anesthesiology than even 5-6 years ago. As recently as 2004, some anesthesiology programs would fill half of their spots with FMG's. Not so today. Those same programs fill with almost all AMG's.

Today it is harder for Carib students to match in any specialty.

Today's students should never assume what someone did years ago as far as matching will be equivalent to what they can do today.

Yes, this may be true. But, I have not been in private practice for very long (less than 3 years). And, when I got my anesthesia spot, it was definitely considered a competitive specialty. Still to this day, many Ross/AUC/St.George's grads are getting competitive spots. So are SABA grads more and more. You just have to be one of those people who is determined to succeed, and - yes - be realistic at the same time. Have a back-up plan to the back-up plan, if you will.

As an aside, one of my friends at Ross matched into Psychiatry back then. He barely scraped by Step 1. He failed Step 2-CK the first time he took it. He debated, back and forth, whether to go into Family Practice or something else. He applied widely, interviewed at both FP and psych and, believe it or not, matched 4th in Psychiatry after failing to match in his top 3 FP spots (he ranked top FP first, then started ranking psych programs he liked).

Guess what? He's now practicing in the Chicago area making close to $500k/year. Luck? Maybe. But, no one was going into Psych back then (and that was just 7 years ago), yet the need was growing. If you can foresee any fields that may need doctors in the next 7-10 years, but are being under chosen by graduating med students, pick those. Those spots exist for a reason: there is a need. And, those will be the choice specialties in years to come. But, make sure it's something you're going to enjoy spending the rest of your life doing.

Personally, I would not recommend dive into anesthesia right now unless you love it and it fits your personality. It was a hot specialty to choose 7-10 years ago. It's getting saturated now, and new grads are going to find it harder and harder to find jobs in the next few years. And, nothing is worse than practicing in a specialty that you hate... especially if it doesn't pay well.

Good luck,

-Skip

 

[Skip Intro]

... and, one more thing...

If you check Ross' website, you will see that many people have matched into Anesthesiology since 2005, when I graduated.

http://www.rossu.edu/medical-school/graduates.cfm

It can be done. My advice? Take a six-year track through internal medicine and get your GI fellowship. It's a good lifestyle, interesting specialty (with whom I regularly interact), and you will make a lot of money. (FYI: The GI docs in our area are desperate to hire female gastroenterologists, by the way.)

Or, if you've got the "stuff", do a radiology residency and work on getting into interventional. That's a GREAT lifestyle and the sky is the limit in terms of compensation.

Good luck,

-Skip

 

[surge55]

don't go to the small schools if you go caribbean.

I went to Ross and in terms of matching they are the best, followed by SGU and SABA.

you'll mostly get IM (I prematched this year at a top community program near where I grew up), FM, Peds but you can also get pretty much everything else. a friend in my class got Rads, many got surgery and even one got Ortho.

work hard, do not fail the step and get the best score you can, and you will be fine as long as you are realistic and do your homework before the match.

 

[Temperature101]

There are only four good medical schools in the caribbean (SGU, AUC, ROSS, SABA) . The problem is that when people talk about caribbean schools they lump these schools with alll the other crap out there, which I think is unfair. Anyone who ventures to go to any schools other than these four I mentioned is taking a big risk. Also, if you wanna become a primary care physician, its ok to go to one these schools. But if you wanna do a competitive specialty, it would be better to consider DO...Use the caribbean schools as your last resort

 

[drno31]

I went to Ross and in terms of matching they are the best, followed by SGU and SABA.

you'll mostly get IM (I prematched this year at a top community program near where I grew up), FM, Peds but you can also get pretty much everything else.

Congrats on pre-matching, but this was the last year that it's being offered.

Also, for anyone who is interested: SGU is the best in terms of matching, followed by Ross and SABA. Haha.

 

[surge55]

Congrats on pre-matching, but this was the last year that it's being offered.

Also, for anyone who is interested: SGU is the best in terms of matching, followed by Ross and SABA. Haha.

best what? rate or number? Ross matches the most I know that.

and thanks. I was lucky.

 

[Blitz2006]

Interesting thread, thought I would chip in my 2 cents.

I think Anesthesia is very tough now for IMGs, particularly for non U.S citizens.

Here is the SGU Match list: https://baysgu35.sgu.edu/ERD/2012/ResidPost.nsf/BYPGY?OpenView&RestrictToCategory=PGY1&Count=-1

14 matches in Anesthesia, and this is from arguably the 'best' carribean school.

And in 2011, 68 IMGs (and I guess roughly one quarter of those from SGU) matched Gas (1.5%) -> http://www.nrmp.org/data/resultsanddata2011.pdf
Table 12

So I think Anesthesia is in fact quite tough/near impossible if I may dare say.

Radiology is even tougher, and if you check out the Rads forum, there is a lot of doom and gloom in the future (saturation of jobs).

 

[RussianJoo]

Interesting thread, thought I would chip in my 2 cents.

I think Anesthesia is very tough now for IMGs, particularly for non U.S citizens.

Here is the SGU Match list: https://baysgu35.sgu.edu/ERD/2012/ResidPost.nsf/BYPGY?OpenView&RestrictToCategory=PGY1&Count=-1

14 matches in Anesthesia, and this is from arguably the 'best' carribean school.

And in 2011, 68 IMGs (and I guess roughly one quarter of those from SGU) matched Gas (1.5%) -> http://www.nrmp.org/data/resultsanddata2011.pdf
Table 12

So I think Anesthesia is in fact quite tough/near impossible if I may dare say.

Radiology is even tougher, and if you check out the Rads forum, there is a lot of doom and gloom in the future (saturation of jobs).

you have to look at the pgy-2 year of the match https://baysgu35.sgu.edu/ERD/2013/ResidPost.nsf/BYPGY?OpenView&RestrictToCategory=PGY2&Count=-1

well over 20 people matched into anestehsia, and 16 people matched into Radiology this year. 2 people matched into cornell, for anesthesia so it's definitely doable.

 

[Blitz2006]

you have to look at the pgy-2 year of the match https://baysgu35.sgu.edu/ERD/2013/ResidPost.nsf/BYPGY?OpenView&RestrictToCategory=PGY2&Count=-1

well over 20 people matched into anestehsia, and 16 people matched into Radiology this year. 2 people matched into cornell, for anesthesia so it's definitely doable.

Yeah, its def doable, but I dunno, 20 is still a relatively low number.

And I'm pretty sure all those rads/anesthetics guys are banging out 250/250 on the boards, which is easier said than done.

I hate being a downer, but I try to look at things realistically.

but yeah, if you got the guns, go for it.

 

[Skip Intro]

So I think Anesthesia is in fact quite tough/near impossible if I may dare say.

I think the "anesthesia wave" has crest, and you either caught it and are surfing happily in front of it or you are behind it sitting on your board staring at the beach wondering when the next big one will come.

Take my advice above. There is absolutely nothing wrong with going Internal Medicine and getting into a sub-specialty. Pulm/CC is going to be hot for the next 6-10 years. GI is hot now and will remain so. Psych is growing and, especially child psych, will stay hot for a while.

Go into anesthesia only because you love it. I think in the next 5-7 years there's going to be a "market correction" and subsequent huge change in the landscape. Mark my words, if you're not already in the boat you're gonna be paddling hard to keep your head above water. Don't pick it because of the perceived lifestyle, which will no longer be there (likely) by the time you finish residency (especially if you're an MS3 or MS4 now).

-Skip

 

[rgk27]

What are the rate matches for going into internal medicine and doing a fellowship with cardiothoracic? Or even matching into derm?

 

[Skip Intro]

What are the rate matches for going into internal medicine and doing a fellowship with cardiothoracic? Or even matching into derm?

"Cardiothoracic" is a surgical sub-specialty. Cardiology is a medicine sub-specialty. Categorical surgical residency (not prelim) is difficult to get. Cardiology is dependent on which IM program you get into, who you get to know, how well you do, and whether or not you're lucky. Cardiology is definitely do-able for carib grads, but competitive.

Dermatology residency is difficult even for U.S. graduates to obtain.

-Skip

 

[dragonfly99]

Chances to match into derm from a Caribbean school = vanishingly small. You can get into IM, but getting cards fellowship from community IM residencies as a FMG/IMG will be tough...if you do IM try to get into a university program and you would have a shot at cards. If you don't success at first, could do 1-2 years research or as a hospitalist doc and reapply.

 

[Blitz2006]

yeah, thats the thing about IM. I call it a 'trap'.

Sure its 'easy' to match into Internal, but people forget that getting a fellowship is a whole other story, since the IMG stigma is still stuck with you.

You basically have to know what sub-speciality you want before taking the dive into IM as IMG. If you want endocrinology or rheumatology, then most programs should suffice. If you want GI/Cards....even going to a solid univ. program...it is still tough to match into those 2.

 

[Blitz2006]

I agree with you, but since this is a carribean thread, we have to see through the eyes of carribean grads.

I really don't think Pulm/CC and (and most definitly not) GI will be attainable for most IMGs (realistically) over the next few years.

There are over 10-15 new medical schools opening up in the U.S in the next 3-4 years, and that is only going to increase the bottle neck effect for residency matching...

I think the "anesthesia wave" has crest, and you either caught it and are surfing happily in front of it or you are behind it sitting on your board staring at the beach wondering when the next big one will come.

Take my advice above. There is absolutely nothing wrong with going Internal Medicine and getting into a sub-specialty. Pulm/CC is going to be hot for the next 6-10 years. GI is hot now and will remain so. Psych is growing and, especially child psych, will stay hot for a while.

Go into anesthesia only because you love it. I think in the next 5-7 years there's going to be a "market correction" and subsequent huge change in the landscape. Mark my words, if you're not already in the boat you're gonna be paddling hard to keep your head above water. Don't pick it because of the perceived lifestyle, which will no longer be there (likely) by the time you finish residency (especially if you're an MS3 or MS4 now).

-Skip

 

[Skip Intro]

There are over 10-15 new medical schools opening up in the U.S in the next 3-4 years, and that is only going to increase the bottle neck effect for residency matching...

Well, look at it this way: there are going to be more chances for those competitive applicants who barely missed getting into a U.S. program to not have to go to the Caribbean in the first place. This is a problem for the established Caribbean schools, not the applicant.

Those who are in school now need not worry.

-Skip

 

[Skip Intro]

One more thing...

I really don't think Pulm/CC and (and most definitly not) GI will be attainable for most IMGs (realistically) over the next few years.

Not with that attitude.

I'm an optimist. But, like Edison, I realize that genius is 1% inspiration and 99% perspiration. And, I've always (and even now as a board-certified practicing partner in an anesthesiology group making $400+k/year) had a back-up plan. If you shoot for the moon and miss, you'll still be among the stars.

I posted this sometime back. Maybe it's worth a re-read for some:

http://forums.studentdoctor.net/showpost.php?p=11136724&postcount=12

-Skip

 

[Blitz2006]

Don't get me wrong, I agree with you. I'm all about pursuing your dreams, and I agree with your 12 step plan 100%.

Problem is, there are many AMGs who are doing your 12 step plan, so unfortunately, the applicants that get squeezed are IMGs (and that is any IMG for that matter, not just carribean students).

I'm also glad to hear you've achieved great success, along with some of your friends. But correct me if I'm wrong, but you matched about 5-6 years ago? A lot has changed even in just 5 years, I've been following the trend (particularly categorical Gen Surg). 5 years ago Gen Surg was a fighting chance for IMGs...now its basically prelim. This trickle effect has even dropped into IM (getting into a solid univ. program was realistic for IMGs 5 years ago), now it seems like 75% of IMGs are hitting up community programs.

I'm a stats guy, so I just base my 'real life' decisions on NRMP tables, etc.

Probably a bad thing, but I'd rather play my cards safe than get burned

 

[Unzbuzzled]

I'd rather play my cards safe than get burned

A quote to live by. If you are good enough to get into the top 4 carib schools, you are probably good enough to get into a postbacc/SMP. Not to toot my horn, but that's what i did and now i have an acceptance at a US school and a masters degree. Yeah it took an extra year, but the masters alone is worth that even if you don't get in (it adds to your resume and allows you to gauge how you would fare in real medical courses). It seems like an SMP is a risk, but it's a thousand times less risky than packing up your life and moving offshore for an education that may end up sinking you rather than helping you.

The bottom line is that it's harder to succeed at a foreign school, and the decision you make now will have repercussions your entire life.

 

[Skip Intro]

But correct me if I'm wrong, but you matched about 5-6 years ago?

Actually, seven.

A lot has changed even in just 5 years, I've been following the trend (particularly categorical Gen Surg). 5 years ago Gen Surg was a fighting chance for IMGs...now its basically prelim.

Same thing seven years ago, too.

This trickle effect has even dropped into IM (getting into a solid univ. program was realistic for IMGs 5 years ago), now it seems like 75% of IMGs are hitting up community programs.

Listen, if you're not willing to be flexible and mobile (i.e.,you HAVE to live in a certain area), then you're only gonna get what you're gonna get.

I'm a stats guy, so I just base my 'real life' decisions on NRMP tables, etc.

Good strategy if your personal stats suck.

Probably a bad thing, but I'd rather play my cards safe than get burned

If I'd had that attitude, I'd never be where I am today.

Just sayin'...

-Skip

P.S. Many, if not most, of my patients don't read the medical textbooks or journals. If they did, life would be a whole lot simpler and predictable. (Put another way... the latest study, Cochrane meta-analysis, review article, etc. may be good for categorizing populations, but that usually doesn't mean jack at the bedside when you're trying to figure out a specific problem for a particular patient. Trust me, they don't care what the latest journal article says should be happening to them either. That data may help guide you, but it doesn't assure an outcome. If you haven't learned this already, you will. Now, do you follow me? What do you have to lose applying... except the chance to hear "no" and maybe get your ego a little bruised? If that's the real problem here, then go ahead and "play it safe". Or, maybe you just don't want it bad enough and/or are unwilling to delay gratification to make your dreams happen.)

 

[Socrates25]

Waa waa waa... don't want to get discriminated based on your Caribbean school? Go to a US medical school.

Many US schools don't teach to the Step 1 and give their students just 5 weeks to study for it, unlike the common 6 months for many of the Caribbean schools. You ought to be thankful that medicine is not like biglaw.

That day is coming. With the hundreds of new med schools opening up like Rocky Vista we are approaching a day when the grads from Harvard/Hopkins get mad respect and the people laugh at the third tier trash programs.

 

[Skip Intro]

That day is coming. With the hundreds of new med schools opening up like Rocky Vista we are approaching a day when the grads from Harvard/Hopkins get mad respect and the people laugh at the third tier trash programs.

Huh? This is not the problem at all.

The real problem is that the midlevel providers are trying to take over and want your job... at a fraction of the cost. If you're an insurance company exec, who do you think wins for Joe Blow patient (not their family or loved ones, mind you) while we're busy arguing about stupid **** like this?

Therefore, it really won't matter where you graduate from. Every program will be considered third-tier trash if that happens. Meanwhile, the midlevels are going to cherry pick all the low-hanging fruit and steal all of your "easy" patients... until there's a problem, that is.

Then again, that's coming from someone who is actually out there practicing and has a clue about the real world.

So, go ahead and argue about this program being better than that one, or which school is better than the other. BSNs with two+ years additional training and the title "DNP" (Google it if you don't already know) are going to start calling themselves "doctor" (heck, they already are), and next they'll have your job while you're still trying to pick fights with your brethren.

-Skip

 

[Socrates25]

Huh? This is not the problem at all.

The real problem is that the midlevel providers are trying to take over and want your job... at a fraction of the cost. If you're an insurance company exec, who do you think wins for Joe Blow patient (not their family or loved ones, mind you) while we're busy arguing about stupid **** like this?

Therefore, it really won't matter where you graduate from. Every program will be considered third-tier trash if that happens. Meanwhile, the midlevels are going to cherry pick all the low-hanging fruit and steal all of your "easy" patients... until there's a problem, that is.

Then again, that's coming from someone who is actually out there practicing and has a clue about the real world.

So, go ahead and argue about this program being better than that one, or which school is better than the other. BSNs with two+ years additional training and the title "DNP" (Google it if you don't already know) are going to start calling themselves "doctor" (heck, they already are), and next they'll have your job while you're still trying to pick fights with your brethren.

-Skip

I'm glad you brought that up. While we're fighting the good fight, I already emailed this joker C Lee Parmley at Vanderbilt who is SPEARHEADING a "fellowship" program for NPs in Anesthesia/Critical Care Medicine at Vanderbilt. I assume that you will join me in emailing that idiot and asking him why he's selling out his own field. Hopefully he'll listen to you since anesthesiology is your specialty.

http://www.mc.vanderbilt.edu/reporter/index.html?ID=12364

http://www.vanderbilt.edu/vanderbiltnurse/2012/04/on-a-patients-worst-day/

 

[Skip Intro]

I'm glad you brought that up. While we're fighting the good fight, I already emailed this joker C Lee Parmley at Vanderbilt who is SPEARHEADING a "fellowship" program for NPs in Anesthesia/Critical Care Medicine at Vanderbilt. I assume that you will join me in emailing that idiot and asking him why he's selling out his own field. Hopefully he'll listen to you since anesthesiology is your specialty.

http://www.mc.vanderbilt.edu/reporter/index.html?ID=12364

http://www.vanderbilt.edu/vanderbiltnurse/2012/04/on-a-patients-worst-day/

Already well-aware of this problem. Truth be told, Vanderbilt doesn't give a rat's arse what I think.

However, I am already active in the state within which I practice both at the state medical society level as well as the state specialty society level. I attend meetings and voice my opinion, which is a lot more than many of my colleagues currently do. I also know the key "power players" personally. The best I can do is to continue to argue for my state's rights and let the national societies, through contributions to their PACs, fight for us. They have a lot more muscle than does one lowly petitioner in a state in which he or she is not clinically active.

Listen, I've given a lot of good advice since I've been out in the real world on this (and other) thread(s). It's up to everyone else to either heed it or ignore it. That's your choice. Still, I see a lot of bickering about crap that doesn't really matter in the end. That's because many of you are too deep in your own stuff right now to see outside of the forest. Heck, I know most of you are still staring at the trees.

In the end, you gotta focus on yourself and make yourself the best candidate possible. That means that, unlike a lot of other physicians out there, you need to grow a spine, fight for your own rights, become a true expert in your field, and fight for your rights as well as the rights of your colleagues. And, you accomplish this by working within your sphere of control. I am doing this locally and on a state level.

Someday if-and-when I'm involved in national-level decision making, I'll take on bigger issues. Right now, I've got enough fish to fry in my own backyard. Part of that is trying to shepherd some of you to the light of realizing what is and what is not important. This is one of the few "national" (dare I say international) places that maybe I can reach some of you beyond what I'm doing locally.

After all, when the conditions are right, it only takes one match to start a forest fire...

-Skip