Saba University

[neutro]

We do. Our conclusions are reflected in the AAMC report.

75% and ~50% is hardly enough evidence to make decisions on individuals based on a "report".
That is not very scientific.

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[gyngyn]

75% and ~50% is hardly enough evidence to make decisions on individuals based on a "report".
That is not very scientific.

It is the best evidence available and is reflective of what we see in the Match.
In this thread we are advising prospective applicants. In the threads of matriculated students, there is no real benefit to discussing these outcomes. Here it is appropriate. That includes your voice.

 

[neutro]

It is the best evidence available and is reflective of what we see in the Match.

Again, the reports that you are using as "evidence", to determine competence of candidates as residents (which you would not know until they are sitting right opposite to you and look them in the eye and interview them), has very little bearing on their career as a doctor. If there is an association, I would like to find out what it is. But it is unlikely that a caribbean student who finishes residency and is boarded in his specialty is somehow inferior than an American grad.
You talked about integrity. How exactly are you judging integrity of a person unless you know them as an individual!? You said Carib students lack integrity just because they went to a Caribbean school? Wow. I am appalled.

 

[gyngyn]

Again, the reports that you are using as "evidence", to determine competence of candidates as residents (which you would not know until they are sitting right opposite to you and look them in the eye and interview them), has very little bearing on their career as a doctor. If there is an association, I would like to find out what it is. But it is unlikely that a caribbean student who finishes residency and is boarded in his specialty is somehow inferior than an American grad.
You talked about integrity. How exactly are you judging integrity of a person unless you know them as an individual!? You said Carib students lack integrity just because they went to a Caribbean school? Wow. I am appalled.

I am not using the AAMC report as evidence of the inferiority of Caribbean applicants, I am using it as evidence of a pervasive preference for American-educated graduates.
I never said they all lack integrity, rather I pointed out that the screening criteria for Caribbean schools differs dramatically from American counterparts. Applicants with records of behavior that would not result in American matriculation can get into Caribbean schools. This makes all of them a gamble for a PD.

 

[ThoracicGuy]

You are biased, so I wont argue with you.
But I disagree with your gross generalizations.

 

[Goro]

The pool of US applicants from the Caribbean is viewed differently by Program Directors (who aren't stupid). The DDx for a Caribbean grad is pretty off-putting: bad judgment, bad advice, egotism, gullibility, overbearing parents, inability to delay gratification, IA's, legal problems, weak research skills, high risk behavior. This is not to say that all of them still have the quality that drew them into this situation. There is just no way to know which ones they are. Some PD's are in a position where they need to, or can afford to take risks too! So, some do get interviews.


Bad grades and scores are the least of the deficits from a PD's standpoint. A strong academic showing in a Caribbean medical school does not erase this stigma. It fact it increases the perception that the reason for the choice was on the above-mentioned list!

Just about everyone from a Caribbean school has one or more of these problems and PDs know it. That's why their grads are the last choice even with a high Step 1 score.

There was a time when folks whose only flaw was being a late bloomer went Carib, but those days are gone. There are a number of spots at US schools with grade replacement for these candidates.

It's likely you'll be in the bottom half or two thirds of the class that gets dismissed before Step 1. The business plan of a Carib school depends on the majority of the class not needing to be supported in clinical rotations. They literally can't place all 250+ of the starting class at clinical sites (educational malpractice, really. If this happened at a US school, they be shut down by LCME or COCA, and sued.


The Carib (and other offshore) schools have very tenuous, very expensive, very controversial relationships with a very small number of US clinical sites. You may think you can just ask to do your clinical rotations at a site near home. Nope. You may think you don't have to worry about this stuff. Wrong.

And let's say you get through med school in the Carib and get what you need out of the various clinical rotation scenarios. Then you are in the match gamble. I don't need to say a word about this - you can find everything you need to know at nrmp.org.

One really needs to talk to people who made it through Carib into residency, and hear the story from them. How many people were in their class at the start, how many are in it now? How long did it take to get a residency, and how did they handle the gap year(s) and their student loans? How many residencies did they apply to, how many interviews did they get, and were any of the programs on their match list anything like what they wanted?

The point here isn't that there are successful Carib grads. The point is how many additional obstacles to success one faces by going to a Carib school.

A little light reading:

https://milliondollarmistake.wordpress.com/

http://www.tameersiddiqui.com/medical-school-at-sgu

Ask. Investigate. That's what doctors do. Thats what I do in my pain practice.
Assess situations on individual basis. Collect data. Form an impression and then decide on a candidate.
Not just blindly categorize a group of individuals as "not good enough"because they went to an XYZ school.

If I was a PD, I would pick a hard working IMG over an American grad anyday because I know how hungry they are and what it means to them.

 

[truckboat]

The amount of information going on in your back and forth is phenomenal. THANK YOU

 

[neutro]

wow, while i was busy taking care of patients, I see the program directors have ganged up and spent their time on a caribbean medical school forum. I read the above, and again, despite the likes of your fanboys, few things have not been addressed. and they cannot - since those are mis-statements and quite embarrassing coming from program directors. perhaps this time could be spent on actually reading and reviewing all candidates' applications for possible interviews.

Supposedly, "caribbean" students lack integrity. I see. And please do tell me how are you deciding on "integrity" of an INDIVIDUAL based on which school they went to. I am still amazed by this statement.

I encountered absolutely TERRIBLE residents from american schools throughout residency and now see them in practice. I am shocked to see their patient management. In fact just recently a new FP did not even read the utox that he ordered on his own patient which lit up like fireworks, and yet continued to give opiates. LOL. I don't know how these people practice medicine. They must have been coddled through out residency by program directors like you who favor nationality rather than competence.
Not sure if there are studies done, but it is well known in my circles that international grads have better bedside manner, are more humble and more caring. other things: we are less likely to have addiction, depression, anxiety as students, people and doctors.
I am thankful that my program director and tons of others do not log on to sdn and are swayed by this non-sense. lol. since they see their job selecting competent students, irrespective of the fact they went to caribbean, indian, chinese or american schools. and they spend their time educating students and turning them into doctors. not malign a group of people sitting on their desk and stating ridiculous things like they "lack integrity" because they went to a caribbean school.

have a good day

 

[the argus]

wow, while i was busy taking care of patients, I see the program directors have ganged up and spent their time on a caribbean medical school forum. I read the above, and again, despite the likes of your fanboys, few things have not been addressed. and they cannot - since those are mis-statements and quite embarrassing coming from program directors. perhaps this time could be spent on actually reading and reviewing all candidates' applications for possible interviews.

Supposedly, "caribbean" students lack integrity. I see. And please do tell me how are you deciding on "integrity" of an INDIVIDUAL based on which school they went to. I am still amazed by this statement.

I encountered absolutely TERRIBLE residents from american schools throughout residency and now see them in practice. I am shocked to see their patient management. In fact just recently a new FP did not even read the utox that he ordered on his own patient which lit up like fireworks, and yet continued to give opiates. LOL. I don't know how these people practice medicine. They must have been coddled through out residency by program directors like you who favor nationality rather than competence.
Not sure if there are studies done, but it is well known in my circles that international grads have better bedside manner, are more humble and more caring. other things: we are less likely to have addiction, depression, anxiety as students, people and doctors.
I am thankful that my program director and tons of others do not log on to sdn and are swayed by this non-sense. lol. since they see their job selecting competent students, irrespective of the fact they went to caribbean, indian, chinese or american schools. and they spend their time educating students and turning them into doctors. not malign a group of people sitting on their desk and stating ridiculous things like they "lack integrity" because they went to a caribbean school.

have a good day

Goro is not a program director, in fact he's not even a physician. He is a PhD who supposedly sits on the adcom of an osteopathic medical school. He never went to medical school, never went through residency, has never taken care of a single patient.

I'm glad someone else can see the absurdity of this guy's posts. For him to make the declarations he does would be extremely funny if it wasn't so sad. The fact that he feels qualified to make such judgements about people and how they are viewed by program directors, despite the fact that he has ZERO experience in the medical field, I think says a lot about the level of credence that should be given to anything he writes.

 

[the argus]

A big problem on this website is that people make claims about how experienced they are, thus I guess trying to imply some kind of wisdom, and then proceed to proclaim things that just have no basis in reality. This is a perfect example.

As a primarily nontrad advisor for the past 15 years, along with my extensive work in medical admission process and automation for now 20 years, I used to recommend these schools to advisees on a regular basis. Some extra hard work in these places could lead to reasonably good spots in residency. However, with the growth of US based graduates in both MD and DO, and the lack of growth in residency slots, the opportunities are shrinking has for getting any slot at all for off-shore graduates. Thus I can no longer recommend them at all until an applicant looked at all other pathways.

As has been explained and proved multiple times, this nonsense is just not true. Plain and simple. If you actually look at the numbers, the increase in USMD/DO matriculation over the past 10 years has basically equalled the increase in residency positions. People overestimate the increase in USMD/DO positions, and underestimate the increase in residency positions.

How do I know this you ask? By actually looking at the data provided from the ACGME. Here is the document.
http://www.acgme.org/About-Us/Publi...Graduate-Medical-Education-Data-Resource-Book
Go to page 6 in the most recent edition. It clearly shows that the number of IMGs entering 1st year positions has basically remained stable for the past 10 years. The idea that there has been a major decrease in the number of IMGs getting residency positions over the past decade, or that "opportunities are shrinking," is just blatantly false.

http://www.nrmp.org/wp-content/uploads/2016/03/Advance-Data-Tables-2016_Final.pdf (see page 7, Table 4)
As for the residency opportunities, they are much worse than people realize and the data clearly shows it. In the table in the link above there are some other numbers to be noted that tend to be overlooked: the withdrew and no rank, which are not included of the match/unmatched percentages discussed above (NRMP mixes two totals and two percentage groupings) These are applicants who apply for residency but either withdrew from selection (often for not passing boards) or did not complete the process by submitting a ranking list (often cause they did not get an interview). For the US Seniors, withdrew was 2% and no rank was 0.3%. Adding that to unmatched a total of 7.9% of the applicants who originally applied did not match into a spot. For IMG-US Citizens, if we take all who applied to residency but did not get a slot either by unmatched, withdrew, or no rank, it comes to a whopping 61.5% or nearly 8 times the US percentages.

In US school 97% of all who start earn their degrees. Only 8% of these dont get a match. Effectively 90% of those who start medical school match into a slot
In Carib school, lets be generous and say 75% who start graduate. Over 60% of these dont match. Effectively 45% who start match into a slot

There is so much presumption and poor reasoning in this diatribe that I'm not even quite sure where to start. To be brief, the first major point is that there is still a significant number of spots obtained outside the NRMP, so using just the stats from the NRMP to make conclusions is just incorrect. Saying everyone who withdrew from the match was unsuccessful in obtaining a position is just factually incorrect. This is proven by the fact that in 2014, 6355 IMGs matched through the NRMP, but 6837 IMGs started in 1st year positions that year. That's a difference of 482, or ~7% of the total IMGs that matched. That's a significant number of people that obtained positions outside the match.

The other major point is that comparing USMD senior data to US-IMG data from the NRMP data reports is comparing 2 completely different data sets. US-IMG data includes seniors and previous grads, and previous grads are a significant percentage of the people included in this report. How do I know this, because if you look at the charting outcomes documents, you will see that the mean time since graduation for the unmatched cohort of US-IMGs is 5.7 years. The way you are using this data to make assumptions about the percentage of caribbean grads who match is a complete misuse of the data and shows that you don't fully understand it. By including re-applicants with fresh grads, you are way oversampling the unmatched cohort. If you want to use this data to say "this percentage of US-IMG grads match," like you are attempting to do, then you have to include all the successful matches from the past years as well, otherwise you are way oversampling the yearly unmatched cohort that continues to apply year after year.

http://www.acgme.org/About-Us/Publi...Graduate-Medical-Education-Data-Resource-Book
http://www.nrmp.org/wp-content/uplo...tional-Medical-Graduates-Revised.PDF-File.pdf
http://www.nrmp.org/wp-content/uploads/2016/04/Main-Match-Results-and-Data-2016.pdf

 

[Skip Intro]

My point to all this is as now primarily an advisor, I need to make recommendations to those considering off shore schools. So I repeat: with the growth of US based graduates in both MD and DO, and the lack of growth in residency slots, the opportunities are shrinking has for getting any slot at all for off-shore graduates. Thus I can no longer recommend them at all until an applicant looked at all other pathways.

This is a fair point and times they are a changin'... but... as I've said before on this forum, the fact that US spots for matriculants - across the board - are increasing is a good thing. Many applicants who, 15 years ago when I applied and went to Ross, may never have had a chance at getting in now have a far better chance of getting a spot somewhere. So, yes, apply to U.S. first. At least two cycles. Exhaust those options. If, after that, you still really, really want to be a doctor and that you can hack the years of discipline and training, then consider going to one of the reputable, established, and well-known Caribbean schools - beyond all other choices that are out there. And there are a lot of them. Very, very bad choices. Which are equivalent to a craps shoot.

-Skip

 

[the argus]

You're right the numbers are right there, below from the charts as a picture will speak a thousand words. From 2005-2006 to 2014-2015, the total number of pipeline residency slots went from 24,368 to 27,534 for an increase of 13%. During the same period the number of US MD/DO filling those slots went 17,447 to 20,705 for an increase of 18.5%. The total number of IMGs filling those slots during the same time frame went from 6,773 to 6,837 for an increase of under 1%. The increase in the number of US MD/DO filling pipeline slots at 18.5% has outpaced the increase in the number of the pipeline slots at 13%, while the number of IMG filling those slots has remained almost completely flat. Indeed, the rate of the increase has US MD/DO is 40% faster than the rate of increase for residency slots. With 18.5% number of US MD/DO pipeline residents and only 13% increase in residency slots, I stand by my statement in its entirety. And I mean in its entirety if you had read carefully. Do you see me saying never attending off shore schools? No, I say explore all other pathways first.






The only presumption here is your assuming conclusions beyond the scope of what I clearly stated I was comparing, namely US MD Seniors to any US-IMG grads in the match. It states that question clearly and refers solely to the match and uses the data for that purpose. Comparison of any defined group in the match to another is not only statistically acceptable under the scope of the model, it reflects the social reality that applicants should consider: what are my chances in any particular match cycle within my particular status. With US Seniors as the "standard" for comparison to all others, regardless how long it either took them to complete a degree or how long since they earned the degree, is fair. But since you are crying about it, taking all US allopathic graduates, whether senior or beyond, from NMRP in 2016, who did not match, did not rank, or withdrew from the match was 2,728 out of a total of 20,407 or 13.4% of total who originally put in an application to the match. Compare that to 61.5% of US IMGs . Or to flip that, if you are a senior or graduate of a US MD school, So you have an 86.6% of matching, compared to a 38.5% chance for an US IMG. Thank you for helping me make the over 2 to 1 ratio clear to all

So now lets examine further down the food chain of residency slots. In 2016, there were 3914 eligible US MD Senior/Graduates for SOAP with 717 accepting positions or about 22%. For all US IMG, there were 4,090 eligible for SOAP and 92 who got positions or about 2%. So how and where did these approximately 400 others you site get positions? They got what was left over. They likely didnt get the program they wanted or the city they wanted or even specialty they wanted. They spent 4 years in an off shore school, now to be in medicine at the bottom of the practicing physician barrel. Then of course there is below the barrel, those who never get any slot of any kind and cant practice medicine at all. An MD degree and far too much debt. We can get a rough estimate of how many. If there were 4,090 eligible for SOAP and 482 got slots outside of the match (SOAP, off-cycle, independent contracts, etc), then roughly 3500 didnt get any slot. Since the year to year US-IMG cohort remains about the same and the match rate and numbers remain the same, about 3500 drop out each year. Where do they go? I only can give one example, All the anatomy lab instructors at one Ivy I have worked with are all off-shore grads. Well, its medicine I suppose but probably not what they wanted to do when they thought about becoming a doctor

For those who do want to find out who I am, what my experience is, etc, they can see my affiliation on my avatar. If they were to goggle my screen name along my affiliation, they would see all that I have done in this area for the past 15 years and likely get my home phone number as well.

My point to all this is as now primarily an advisor, I need to make recommendations to those considering off shore schools. So I repeat: with the growth of US based graduates in both MD and DO, and the lack of growth in residency slots, the opportunities are shrinking has for getting any slot at all for off-shore graduates. Thus I can no longer recommend them at all until an applicant looked at all other pathways.

It's very nice that you have spent so long trying to help people in a field that you aren't a member of, that's very commendable. Unfortunately it doesn't change the fact that the key point of your argument is just factually incorrect and is based on bad math. Namely,

"with the growth of US based graduates in both MD and DO, and the lack of growth in residency slots, the opportunities are shrinking has for getting any slot at all for off-shore graduates"

Trying to use percentage increase among the different cohorts to somehow prove that USMD/DO grads are outpacing residency positions is just mathematically incorrect. The difference in growth of spots is on an absolute number basis, not percentage. The same increase in absolute number, i.e. growth of spots, will cause a different percent increase depending on the starting number. For instance, an increase in 2,000 from 20,000 to 22,000 is an increase of 10%, but an increase in 2,000 from 1,000 to 3,000 is an increase of 200%. Same absolute increase, wildly different percentage increased.

The same goes for the increase in USMD/DO grads and the increase is ACGME residency positions. All that is needed is simple addition and subtraction to disprove the central point to your argument. The growth of US-based graduates has basically equalled the growth in residency spots. There is no debating this fact.

In 2006 there were 24,368 residents entering pipeline positions, and in 2015 there were 27,534. That's a difference of 3,166.
In 2006 there were 17,477 USMD/DO entering pipeline positions, and in 2015 there were 20,685. That's a difference of 3,208.

Do those 2 numbers seem similar to you?

Yes, the percentage of total ACGME positions that is going to IMGs is decreasing, but the absolute number of spots is staying basically the same. That doesn't mean that opportunities for IMGs are shrinking, that means opportunities for IMGs are staying the same.

Again, as I have stated numerous times on this forum I think people should go through at least 2 or 3 cycles of USMD/DO admissions before contemplating going to the caribbean for med school. The problem is once people are at that point, the misinformation that you and others consistently spew about this topic on this forum makes it incredibly difficult to make an informed decision. Yes, the schools don't offer the information either, which adds to the difficulty. But your analysis of the available data is just factually incorrect.

And again, I'll state it continues to really chap my ass when I see non-physicians make comments like this,"now to be in medicine at the bottom of the practicing physician barrel." You don't have the background, expertise, or experience to make claims like this. The majority of physicians working in the hospitals and programs that you are trashing are US medical school graduates. The ease at which you slam these people who are working in ACGME-certified programs, having never gone through the process yourself, is astonishing.

 

[gyngyn]

And again, I'll state it continues to really chap my ass when I see non-physicians make comments like this,"now to be in medicine at the bottom of the practicing physician barrel." You don't have the background, expertise, or experience to make claims like this. The majority of physicians working in the hospitals and programs that you are trashing are US medical school graduates. The ease at which you slam these people who are working in ACGME-certified programs, having never gone through the process yourself, is astonishing.

I see a lot of chapping in your future.
Informed, effective career advisors do not need to be physicians.

 

[the argus]

I see a lot of chapping in your future.
Informed, effective career advisors do not need to be physicians.

Lol, the point is that neither of these "career advisors" seem to be very well informed... They don't have the background, experience, or expertise to back up many of the declarations they make. Much of what they say is also just factually incorrect.

People are allowed to take career advice from any source they choose. I'll just continue to point out that what these guys present as fact is mostly just opinion coming from 2 non-physicians with no personal experience actually practicing in the medical field, and that much of what they say about future IMG residency prospects is based on poor and incorrect analysis of the available data.

 

[PossibleDOC?]

So I'm thinking about applying to Saba University School of Medicine and would like to know the pros and cons from the perspective of current and alumni of the school. How was the loan/financial aid process? How was the education? Matching experience and life on the island in general. Any information positive or negative will help.

OP I am going to give you probably some of the realist advice you'll ever get.....DON'T GO TO THE CARIBBEAN! Its a waste. People like argus are classic modern success stories who love the caribbean (and more power to them) but realistically you need to score higher on your boards, higher on tests, you just need to be a better student than a lot if not all of the American medical students. The match is difficult regardless wherever you come from. It only gets harder from a Caribbean school. You need to be realistic with your specialty choices, no ortho, derm, anything ultra competitive like that. Again is this path doable, yes, is it a path for me no (I was recently accepted into a DO program), but at the end of the day it's your choice.

The billion dollar mistake blog going around, the guy was a fool. He wanted to do ortho from a caribbean school, and he was a jerk throughout it (trying to bully his way to an ortho rotation and such just because he was smart). He was upset to be in primary care and ended the blog saying "why do I have to be smart" you know what he isn't the man I'd want as my doctor. At the end of the day this is your choice but be forewarned we all can't be the argus, or a skip, sometimes we may just be an average med student who can't perform above average at a caribbean school as needed. We all find our own path, just don't make yours a costly and life altering one on the way to finding yours.

Good Luck to you

**Cue the roasting from everyone