This is a PM I sent to someone who asked me a few questions. He seemed genuinely interested in getting information on schools in PR so I took my time to answer them as best as I could. This might apply to many people so I decided to share it with you guys. I deleted his name and any information I saw fit, but the message is still there. Please read and if you have any questions about med schools in Puerto Rico and my experieces there you can post here or PM me if you wish.
Hello ___,
First, let me apologize for not answering your PM promptly, but I was in the middle of exams, so my time was very limited. I am glad you are interested in starting a career in medicine, even more glad you are considering Puerto Rico. First off I will tell you a thing or two about myself so you can have a clearer idea of where I come from. I was born and raised in NYC, but my family is originally from the island. I came to PR as a way to experience something different and connect to my roots. When I first came here my spanish was extremely limited, and being that I am from NYC I did experience a bit of culture shock, but it was an overall positive experience. I took a couple of undergrad courses here and earned a masters in epidemiology on the way. Although I always entertained thoughts of med school, it always remained just that, a goal that seemed far away, but I guess the road led me to med school after all.
You asked me about probable difficulties with studying in PR for someone who has never been here. My answer to that is that it depends. If you were, lets say, someone from Alaska who only speaks english and has had absolutely no experience with spanish or hispanic culture whatsoever then it will be more difficult. In your case, I imagine you can at least speak and understand some spanish, and as you have lived in _____ you shouldn't have any problems adapting to life here, so it shouldn't be at all that difficult for you. While there are certain regional and cultural differences, they shouldn't represent a problem. In order to avoid accepting students that will have extreme difficulty adapting to the island, the admissions committee does make a conscious effort to accept students who they feel have the capacity to not only function, but thrive in PR. The school I go to is a state school so they do give preference to island residents, but the other two schools, Ponce and UCC evaluate every app equally. Their student bodies are pretty diverse, more so the here at UPR.
As for my personal experiences here? Very good to say the least. The first two years are made up of lectures, clinical skills courses, small group problem based learning sessions, preceptorships (doc shadowing), standardized patients and so forth. Lectures are taught either in english or in spanish, depending on the preference of the particular faculty member. All class material, quizzes, exams, lectures presentations, EVERYTHING is in english. After every course we take shelf exams like every other med school in the US. After the second year you have to take, and pass the USMLE step 1, or you will not be allowed to go on to third year, no exceptions. After 4th year you must pass the USMLE step 2 or you will not be granted your diploma.
Since my school (UPR) is smack in the middle the largest tertiary medical care complex in the caribean, patient contact is ample and varied. Here you will see anything and everything, I guarantee it. Here is where your spanish will come in hand, as most patients mostly speak spanish, but after two years you should have had ample practice. Most third year clinical rotations are in one of the many hospitals that make up the complex, but you have the option of doing some rotations in other hospitals around the island. Fourth year students can do their electives in the US if they want. You can do them in your home city if you wish. Nurses here are pretty cool.
As for competition for residency? I am still a couple of years away, but I have only heard good things. There was a case of a residency director who kept insisting that PR med school students be classified as "foreign" which prompted the LCME (med school and residency accreditation organization) to send him a letter clearing up any "misunderstandings" as to our status as accredited US med schools. The LCME also letters out all residency directors so this shouldn't be a problem in the future. This seems to be the exception, not the rule. Now, if you plan on practicing medicine in a large urban area or someplace with a large hispanic population then studying in PR is definitely a plus. If you plan on doing your residency in, lets say, ______, ______, where the residency director never even heard of a place called Puerto Rico, then you might want to explain some obvious things to the director. But overall, it shouldn't be a problem as you will be evaluated just the same as anyone else, on your own merits.
I would like to have you understand one point that is very dear to me. Some people in their ignorance feel that any applicant with a 19 MCAT and a 2.90 GPA has a shot at a school in PR. They base their "knowledge" on MSAR stats, but they do not understand the whole picture. Most people in PR are NOT truly bilingual, so basically they are taking an MCAT in what amounts to a foreign language. Imagine you or I taking an MCAT exam in french and you get an idea of how it is. You would feel lucky to get an MCAT of 21 in such a case. In order to deal with this, the PR schools scale the test for PR residents, BUT NOT for US residents. What does this mean for you? That in order for you to have a decent chance try for at least a 25 on the MCAT, its pretty doable.
Lastly, if you have read posts by people who have actually gone to med school in PR, you would notice how fiercly we defend our schools, more so than students in US mainland schools. It is an insult to us that people assume certain things that we know not to be true, and pass it off as fact. We are proud of our schools and know the quality of education and experiences in these schools to be excellent. Go to almost any of the best residency programs in the east coast and you will probably see one or more PR med students among the residents. With a little research you can find this out for yourself. Anyway, Sorry for the rambling but I wanted to give you a clearer idea of our reality. Well take care and feel free to PM me if you have any more doubts. I promise not on ramble on the next time. Take care and good luck.
Dr Who