Puerto Rico USMD vs Arkansas USDO

[ElBrujoBueno]

Considering MD at San Juan Bautista School of Medicine (SJBSM) and DO at Arkansas College of Osteopathic Medicine (ARCOM) with interests spanning from internal and family medicine to specialties like ophthalmology and anesthesiology. I seek advice on the residency match outlook for DOs versus MDs from Puerto Rico, given recent DO/MD residency merges and evolving perceptions.

San Juan Bautista School of Medicine (SJBSM) - MD Program:

Pros:

• LCME-accredited that would allow me to focus solely on USMLE boards, mitigating DO stigma and residency program filters.
• Affordable tuition (approx. $40k) with low living costs.
• Exposure to Spanish-speaking populations, aligning with career goals.
• Unique Puerto Rican setting providing diverse experiences.
• Small class sizes (~60 students/year).
• Solid match rate (89% of class of 2022) and graduation rate (70%) Not sure if this is a pro...
• High USMLE Step exam pass rates in 2021 (Step 1: 94%, CK: 98%) [Update: These stats are false. High % of students take LOA]. Curriculum is embedded with NBME preparation.

Cons:

• Geographical isolation may impact access to resources, network opportunities and quality of LORs.
• High natural disaster risk.
• Possible residency discrimination due to IMG misconceptions.
• Potential culture shock despite Spanish fluency.
• Lost accreditation in 2011 due to the closure of its affiliated hospital, which was a temporary setback. The accreditation has since been regained.
• Spouse's career and language barrier: Non-Spanish-speaking spouse would face professional challenges and potential pay cut in Puerto Rico. [My decision came down to this]

Here is a link to their match list: Match 2022

Here is their outcomes report: OR 2022


Arkansas College of Osteopathic Medicine (ARCOM) - DO Program:

Pros:

• Competitive tuition (~$50k) with low living cost.
• Mainland U.S. location with accessible resources.
• Modern facilities due to recent establishment (Opened in 2017).
• Increasing recognition post-DO and MD residency merger.
• Excellent match rate (out of 150 students in class of 2022, 143 entered the Match with a 99.3% Placement rate).
• Spouse's career stability: No language barrier and better career retention for my healthcare-working spouse in Arkansas.

Cons:

• Persistent DO stigma, possibly affecting certain residency placements.
• New institution lacking an established reputation.
• No affiliated hospital, potentially limiting clinical experience.
• Would likely end up taking both USMLE and COMLEX with additional OMM learning.
• Below-national-average COMLEX pass rates (LVL 1: 88%, LVL 2: 78.52%).

Here is a link to their match list: Match 2022

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[darkeon]

no need to reply directly but more of something to think about more is how important is it that your spouse moves with you for the schooling period. we have married couples in my class, where one came with their s/o but the s/o's job is fully remote. as for the remaining couples, their s/o's stayed back due to their jobs and/or kids; these married classmates do intend to practice in the states their spouses are in, or the spouses will move only if the first job after residency is in another state.

 

[voxveritatisetlucis]

I would go MD but that’s a really low graduation rate. Not really a pro

 

[DrStephenStrange]

That’s a crazy low graduation rate for an MD school. I’m surprised LCME has not placed them on probation yet. This is lower than most if not all DO schools. Definitely lower than ARCOM.

Either way graduating with a USMD will still open more doors than it would as a DO. Things are slowly improving for DO post merger, but not quite there yet. I’d go with the MD and plan to grind your butt off to make it out.

Edit: Now it makes me wonder if the reason they have a high USMLE pass rate is because they drop those that are more likely to fail very early on. Just like other Caribbean schools.

 

[darkeon]

i just caught the graduation rate... i can only speculate that those past classes were impacted by Maria and Fiona. students did drop out, took a loa, or transferred schools. and i'm not sure for which one of them, but residents were without power for a year. i can't quantify the extent of that though onto graduation rates. it's one of the schools with a smaller than average medical class too so percentages are more impacted.

 

[Hollow Knight]

89% is not a solid match rate, that's abysmal. Remember that you can't be a physician in the US without a residency. What's the match rate for the DO school?

Granted, at my mid-tier, locally respected MD, we did have one student not match last year.

Edit: their match rate is 99%, go to the DO school. Better to be a family doctor than to have a bunch of debt and not be a practicing doctor at all. (I say that as someone who wants to do family medicine, it really seems like a good life to me personally)

 

[voxveritatisetlucis]

89% is not a solid match rate, that's abysmal. Remember that you can't be a physician in the US without a residency. What's the match rate for the DO school?

Granted, at my mid-tier, locally respected MD, we did have one student not match last year.

Edit: their match rate is 99%, go to the DO school. Better to be a family doctor than to have a bunch of debt and not be a practicing doctor at all. (I say that as someone who wants to do family medicine, it really seems like a good life to me personally)

I bet most schools have a real match rate at about this level since most schools lie about the data by considering SOAP as matching

 

[Hollow Knight]

I bet most schools have a real match rate at about this level since most schools lie about the data by considering SOAP as matching

You know, I never considered that.

The guy who didn't match was in a transition year. But I didn't even think about people SOAPing.......

And of course, since dude got a transition year, my med school brags about its "100% match rate!".....

 

[ElBrujoBueno]

That’s a crazy low graduation rate for an MD school. I’m surprised LCME has not placed them on probation yet. This is lower than most if not all DO schools. Definitely lower than ARCOM.

Either way graduating with a USMD will still open more doors than it would as a DO. Things are slowly improving for DO post merger, but not quite there yet. I’d go with the MD and plan to grind your butt off to make it out.

Edit: Now it makes me wonder if the reason they have a high USMLE pass rate is because they drop those that are more likely to fail very early on. Just like other Caribbean schools.

mind if I send you a pm?

 

[ElBrujoBueno]

i just caught the graduation rate... i can only speculate that those past classes were impacted by Maria and Fiona. students did drop out, took a loa, or transferred schools. and i'm not sure for which one of them, but residents were without power for a year. i can't quantify the extent of that though onto graduation rates. it's one of the schools with a smaller than average medical class too so percentages are more impacted.

That is something I did not fully factored in but do remember reading about students transferring. Thanks darkeon!

 

[DrStephenStrange]

mind if I send you a pm?

Not at all. I’ll PM you.

 

[17protons]

Considering MD at San Juan Bautista School of Medicine (SJBSM) and DO at Arkansas College of Osteopathic Medicine (ARCOM) with interests spanning from internal and family medicine to specialties like ophthalmology and anesthesiology. I seek advice on the residency match outlook for DOs versus MDs from Puerto Rico, given recent DO/MD residency merges and evolving perceptions.

San Juan Bautista School of Medicine (SJBSM) - MD Program:

Pros:

• LCME-accredited that would allow me to focus solely on USMLE boards, mitigating DO stigma and residency program filters.
• Affordable tuition (approx. $40k) with low living costs.
• Exposure to Spanish-speaking populations, aligning with career goals.
• Unique Puerto Rican setting providing diverse experiences.
• Small class sizes (~60 students/year).
• Solid match rate (89% of class of 2022) and graduation rate (70%) Not sure if this is a pro...
• High USMLE Step exam pass rates in 2021 (Step 1: 94%, CK: 98%). Curriculum is embedded with NBME preparation.

Cons:

• Geographical isolation may impact access to resources, network opportunities and quality of LORs.
• High natural disaster risk.
• Possible residency discrimination due to IMG misconceptions.
• Potential culture shock despite Spanish fluency.
• Lost accreditation in 2011 due to the closure of its affiliated hospital, which was a temporary setback. The accreditation has since been regained.
• Spouse's career and language barrier: Non-Spanish-speaking spouse would face professional challenges and potential pay cut in Puerto Rico.

Here is a link to their match list: Match 2022

Here is their outcomes report: OR 2022


Arkansas College of Osteopathic Medicine (ARCOM) - DO Program:

Pros:

• Competitive tuition (~$50k) with low living cost.
• Mainland U.S. location with accessible resources.
• Modern facilities due to recent establishment (Opened in 2017).
• Increasing recognition post-DO and MD residency merger.
• Excellent match rate (out of 150 students in class of 2022, 143 entered the Match with a 99.3% Placement rate).
• Spouse's career stability: No language barrier and better career retention for my healthcare-working spouse in Arkansas.

Cons:

• Persistent DO stigma, possibly affecting certain residency placements.
• New institution lacking an established reputation.
• No affiliated hospital, potentially limiting clinical experience.
• Would likely end up taking both USMLE and COMLEX with additional OMM learning.
• Below-national-average COMLEX pass rates (LVL 1: 88%, LVL 2: 78.52%).

Here is a link to their match list: Match 2022

I honestly think there is more of a stigma with IMGs than DOs. It is much more difficult to get into residencies as an IMG, to the point where my pre-med committee would tell us specifically not to apply to Caribbean schools. So maybe I am a little biased. But, the match rates you posted speak for themselves. I see plenty of DOs working in the hospital I volunteer at, a good number of DO surgeons as well if you are thinking about surgery or a similarly competitive surgery. Being a DO does not mean you can only go into family medicine! I am going to an MD school, but a DO from my volunteer organization was one of the first DOs to get into a surgical residency at Harvard and now works as an attending at another Ivy. They obviously worked very hard and have a lot of research, but it seems like you would need to do that hard work either way.

Also, 70% graduation and the fact that they lost accreditation (even though it's back) seems like a big red flag to me.

Best of luck with your decision!! I hope it works out well for you 🙂

 

[DrStephenStrange]

I honestly think there is more of a stigma with IMGs than DOs. It is much more difficult to get into residencies as an IMG, to the point where my pre-med committee would tell us specifically not to apply to Caribbean schools. So maybe I am a little biased. But, the match rates you posted speak for themselves. I see plenty of DOs working in the hospital I volunteer at, a good number of DO surgeons as well if you are thinking about surgery or a similarly competitive surgery. Being a DO does not mean you can only go into family medicine! I am going to an MD school, but a DO from my volunteer organization was one of the first DOs to get into a surgical residency at Harvard and now works as an attending at another Ivy. They obviously worked very hard and have a lot of research, but it seems like you would need to do that hard work either way.

Also, 70% graduation and the fact that they lost accreditation (even though it's back) seems like a big red flag to me.

Best of luck with your decision!! I hope it works out well for you 🙂

Puerto Rico MD students aren’t IMGs. Their schools are accredited by the LCME which is the same body that accredits schools in the US. Puerto Rico is a US territory.

 

[Mr.Smile12]

I would compare the PR schools to HBCUs since they are MSIs, not to the Caribbean IMGs.

 

[med56813]

For anyone following this post, as a current student I can add the following if it helps make a decision:

• Tuition is actually nearly 50k for OOS and nearly 40k for instate. Living costs have gone up a lot and in PR and there is 11.5% tax which makes living here expensive, look for apts on classificados and you will see. You also have to have a reliable car by time you get to third year, cars are extra expensive here. They don't include purchasing a car in your cost of living for federal loans, which means you better have an alternative way to purchase a car. Third year rotations are between caguas, san juan, cidra, manatí, and other places. There is no functional/reliable public transport available.
• Graduation of 70% sounds accurate, could be more or could be less. People take LOAs to study longer for step (most common and great option to perform well first time), fail step 1 and have to take LOA to study more, or have personal reasons.

 

[moosesloth]

For anyone following this post, as a current student I can add the following if it helps make a decision:

• Tuition is actually nearly 50k for OOS and nearly 40k for instate. Living costs have gone up a lot and in PR and there is 11.5% tax which makes living here expensive, look for apts on classificados and you will see. You also have to have a reliable car by time you get to third year, cars are extra expensive here. They don't include purchasing a car in your cost of living for federal loans, which means you better have an alternative way to purchase a car. Third year rotations are between caguas, san juan, cidra, manatí, and other places. There is no functional/reliable public transport available.
• Graduation of 70% sounds accurate, could be more or could be less. People take LOAs to study longer for step (most common and great option to perform well first time), fail step 1 and have to take LOA to study more, or have personal reasons.

hi! I’m actively considering SJB vs another DO school this cycle. Do students take LOA because the school doesn’t give enough time? Doesn’t make sense since the curriculum is NBME standardized so you’d think students would have an easier time prepping for step…

 

[darkeon]

hi! I’m actively considering SJB vs another DO school this cycle. Do students take LOA because the school doesn’t give enough time? Doesn’t make sense since the curriculum is NBME standardized so you’d think students would have an easier time prepping for step…

there's been an uptick in students taking LOA across US MD schools nationwide (presumably for step 1) and our school isn't different there. And yes, our exams are nbme exams but step 1 pass/fail now reflects more something like Uworld or the Free120 , as opposed to the old nbme. it still helps but just not as much as it used to.

 

[moosesloth]

there's been an uptick in students taking LOA across US MD schools nationwide (presumably for step 1) and our school isn't different there. And yes, our exams are nbme exams but step 1 pass/fail now reflects more something like Uworld or the Free120 , as opposed to the old nbme. it still helps but just not as much as it used to.

Thank you for this! Any take on SJB vs UNECOM? I’m close ties to both PR and the New England area. Native Spanish speaker with intention to practice in Latino/Hispanic communities. Ideally just trying to match peds in NYC. Appreciate your time!

 

[darkeon]

Thank you for this! Any take on SJB vs UNECOM? I’m close ties to both PR and the New England area. Native Spanish speaker with intention to practice in Latino/Hispanic communities. Ideally just trying to match peds in NYC. Appreciate your time!

Easily doable either or. For the mainland matches, SJB tends to match in hispanic-dense cities so there have always been grads off to nyc. UNECOM will get that job done too though, being a powerhouse of a DO school. Peds very attainable either route

I chose SJB (my only US MD) over my DO acceptances not so much for relative ease granted with the MD degree into matching, but rather just because i resonated more with the mission of serving hispanics. That said, please don't think you can waltz into competitive specialities simply cuz you have a MD. I also just wanted more time to study for my exams and not be troubled by OMM. I was curious i admit to learn about omm but decided it wasn't enough to justify learning it in med school. And i'm glad I thought that because i saw things in M1 like anatomy lab as a huge time-sinker so at least i didn't have to do more miscelleanous things. I also valued a small class which SJB is (60), versus the usual estimate of 200 students per more most of the DO classes

You'll meet several out of staters who were in the same predicament as me. I do know of some folks who went DO over US MD in PR, and I get it. Living in PR does require, I dare say, more a stringent adjustment than moving to other states. For my peeps that have gone DO over PR, it's been fine for them so far and I don't think there is a huge difference in outcomes between the two, especially for noncompetitive specialities.

I will say, if cost is a factor, I don't know UNECOM tuition, but cost of living in PR will be cheaper than just about anywhere in the states (but again, a steep learning curve to face when adjusting to life on the island)

I can't speak of matching into nyc peds with just COMLEX if you opt to just take that and not STEP alongside it. I think it should be fine but I am not experienced enough to comment so others' input on that matter should be taken more seriously than mine

as cheesy as this sounds, follow your heart and you won't make the wrong choice.

 

[moosesloth]

Easily doable either or. For the mainland matches, SJB tends to match in hispanic-dense cities so there have always been grads off to nyc. UNECOM will get that job done too though, being a powerhouse of a DO school. Peds very attainable either route

I chose SJB (my only US MD) over my DO acceptances not so much for relative ease granted with the MD degree into matching, but rather just because i resonated more with the mission of serving hispanics. That said, please don't think you can waltz into competitive specialities simply cuz you have a MD. I also just wanted more time to study for my exams and not be troubled by OMM. I was curious i admit to learn about omm but decided it wasn't enough to justify learning it in med school. And i'm glad I thought that because i saw things in M1 like anatomy lab as a huge time-sinker so at least i didn't have to do more miscelleanous things. I also valued a small class which SJB is (60), versus the usual estimate of 200 students per more most of the DO classes

You'll meet several out of staters who were in the same predicament as me. I do know of some folks who went DO over US MD in PR, and I get it. Living in PR does require, I dare say, more a stringent adjustment than moving to other states. For my peeps that have gone DO over PR, it's been fine for them so far and I don't think there is a huge difference in outcomes between the two, especially for noncompetitive specialities.

I will say, if cost is a factor, I don't know UNECOM tuition, but cost of living in PR will be cheaper than just about anywhere in the states (but again, a steep learning curve to face when adjusting to life on the island)

I can't speak of matching into nyc peds with just COMLEX if you opt to just take that and not STEP alongside it. I think it should be fine but I am not experienced enough to comment so others' input on that matter should be taken more seriously than mine

as cheesy as this sounds, follow your heart and you won't make the wrong choice.

THANK YOU🙏🙏🙏🙏

 

[ElBrujoBueno]

Hi! I just wanted to provide a brief update for anyone in a similar position. I’m about halfway through my first year, and I’d say I’m currently content with my choice. That said, I think I underestimated the time and effort OMM requires. However, I believe it’s worth it for the opportunity to stay close to home (I chose UIWSOM in San Antonio).

As I mentioned before, my decision was primarily based on personal reasons related to family. If you’re not in a similar situation, don’t mind living in Puerto Rico, or have any aspirations for a competitive specialty, I’d encourage you to think it through, talk to current and former students, and weigh your options carefully.

Ultimately, I’ve come to realize that my success depends more on me than on my medical school. That being said, if you don’t have to do OMM, save yourself the trouble—haha!