I'm from NYC and I start med school there in august.
I know this is an optometry forum but maybe I can shed some light on your doubts about PR.
First of all OAT (and MCAT) scores are "lower" there because you have to understand that while most islanders can read and understand english, it is their second language. Just imagine being forced to take the OATS completely in spanish then you have an idea of what islanders have to go through. In order to compensate for the obviously lower scores that will result OAT and in the case of med schools, MCAt scores are scaled to reflect the social reality that PR is a mostly spanish speaking island. This obviously brings downthe average score for accepted applicants, but it doesnt necessarily apply to mainland apps.
Now med schools there still require competitive scores from mainland applicants, so while a 24 MCAT is considered a very good score for a puertorrican applicant by the addcom, they will probably look for something a bit higher in mainland apps. I may speak for med schools there but I am sure this also applies to the optometry school there. So with this in mind, the average OAT scores are misleading in many regards.
I moved there recently and I absolutely fell in love with the place. Like a poster before me stated, it does get some getting used to, but I dont regret it one bit. Surprisingly the med schools and the school of optometry are pretty competitive in regards to residency placements. Give the school a call and find out for yourself. Its a once in a lifetime chance to experience a totally new culture without technically leaving the US.
Dr Who.