no one intends to be the bottom 10-20%
I don't know exactly how competitive those schools are, but I'm assuming all the students were top college students
you never know what will happen in life.... I know a few AMGs that had cancer and what-not strike during med school, affecting grades and having to take LOAs... all which create red flags they never intended, making the match more difficult. Should that happen as an IMG, well, I use the word devastating because as my earlier post mentioned, not matching can mean not only the end of a clinical career forever before it starts, but also being crushed with debt and poor job propects.
whether that's merely bad vs devastating from one person to the next I do not know
I fully intended to get top grades in med school, and it just didn't happen. I was an above average college student and an average med student. That's life. Nothing can really prepare you for med school it's a totally different ball field. And every person is selected for being an academic badass, and then the curriculum and tests such as USMLE and school exams are purposefully designed to take the top 1% they've recruited and *create* a spread, a bell curve distribution amongst you.
sure, maybe it won't happen to you. it will happen to someone, 10-20% to be exact.
if I handed you a revolver with a bullet in it to play Russian roulette I'm betting you wouldn't play. that's what people are doing with their financial futures when they go Carribbean. If I went Carribbean I would make my app attractive to apply for FM, path, and psych simultaneously to whatever I truly wanted to do, as well as build a resume that might allow me non-clinical pathways more easily. I would want both bench research skills (knowing how to work a centrifuge, purify DNA, and run electrophoresis all good skills to have!) and clinical trial experience.