Serious question: why do applicants go to the Caribbean over DO?

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They simply haven't done enough research or are completely desperate. That's the end of this. If they put in the time to look into both DO and Carib, they'd know going DO dramatically better now.



This could be an insightful read for you if you have the time.
Finally got around to reading this in a fit of boredom/insomnia. Kinda hard to believe that someone capable of those board scores wasn't smart enough to figure out ortho was unattainable from the Carib. Imagine the connections the guys who actually match ortho from the Carib have. Either the PD is literally their dad or somebody's sending a fat donation check to the program on their behalf.
 
'If an MD colleague wants to talk down on my degree and intelligence, then you'd better bet I'll do every thing in my power to out-perform him and make him look like a damn fool.' @ATPsynthase123

So really your post was just to remind everyone that DOs are the same as MDs. And, that in 4 years when you're competing with IMGs with step scores higher than yours for the match that you are more deserving because you're a US DO.
Just so you know, plenty of successful doctors graduate from Caribbean schools. When you're in clinicals you might share your hospital with a few IMGs training, and these people will probably surprise you with their level of knowledge or just enthusiasm for being there... Because they did everything they could to get there and they want to be a doctor that badly. Your bias against Caribbean grads has apparently already started, and who are you- an M1? Don't judge a book by its cover.

And to address one more comment on this thread- that the people that go there don't do research into it before going- this is false. Lots of people go to Caribbean expecting to be primary care physicians. They're fine with this. Also, the ones that want to specialize or match into something more competitive usually understand from Day 1 that means that they have to be undeniably qualified- scores 10 pts higher; stronger recs; better grades. A lot of people in the Caribbean are non traditional grads, so the time saved by the Caribbean route is really the thing that makes it attractive. Will we have to work harder to prove ourselves? Yes. Will we do it 1-2 years sooner than waiting around on the perfect MCAT score/taking a masters program/waiting to hear from schools? Yes.


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'If an MD colleague wants to talk down on my degree and intelligence, then you'd better bet I'll do every thing in my power to out-perform him and make him look like a damn fool.' @ATPsynthase123

So really your post was just to remind everyone that DOs are the same as MDs. And, that in 4 years when you're competing with IMGs with step scores higher than yours for the match that you are more deserving because you're a US DO.
Just so you know, plenty of successful doctors graduate from Caribbean schools. When you're in clinicals you might share your hospital with a few IMGs training, and these people will probably surprise you with their level of knowledge or just enthusiasm for being there... Because they did everything they could to get there and they want to be a doctor that badly. Your bias against Caribbean grads has apparently already started, and who are you- an M1? Don't judge a book by its cover.

And to address one more comment on this thread- that the people that go there don't do research into it before going- this is false. Lots of people go to Caribbean expecting to be primary care physicians. They're fine with this. Also, the ones that want to specialize or match into something more competitive usually understand from Day 1 that means that they have to be undeniably qualified- scores 10 pts higher; stronger recs; better grades. A lot of people in the Caribbean are non traditional grads, so the time saved by the Caribbean route is really the thing that makes it attractive. Will we have to work harder to prove ourselves? Yes. Will we do it 1-2 years sooner than waiting around on the perfect MCAT score/taking a masters program/waiting to hear from schools? Yes.


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No, the post was to say that if someone talks down to me I'll make them look like a fool.

However, if you want to bring IMGs into this, it's important to note that whey they graduate it's a literal coin toss as to whether or not they will ever become a doctor. So even if someone is the brightest in his class at SGU, odds are his work will never pay off.


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Agree 100% with this. I've noticed a lot of posts form carib wannabes with terrible MCAT scores who magically think that somehow they'll crush USMLE.

I think some of it is denial and they think they'll be the exception who doesn't flunk/get forced out and will graduate with a high step score and multiple good matches.

Some (based on posts here on SDN) have parents/mentors who are MDs and who not only think DOs are a lesser degree (or at least less useful) and those people convince the person that they'll be ok going offshore. They may also know Carib grads who are good docs and matched (even 10+ years ago) and disregard the current match system and its effect on IMGs. Given that some of these MDs may have pull/connections, their offspring may indeed get better matches because sometimes knowing powerful people is helpful. Also MD offspring would have the $$$ to handle the tuition.

Denial is more than a river in Africa.

Finally got around to reading this in a fit of boredom/insomnia. Kinda hard to believe that someone capable of those board scores wasn't smart enough to figure out ortho was unattainable from the Carib. Imagine the connections the guys who actually match ortho from the Carib have. Either the PD is literally their dad or somebody's sending a fat donation check to the program on their behalf.
 
While there is a large number of students like you mentioned, there is a significant portion that were forced to go Caribbean due to red flags on their application or constraints (financial, time, etc) that prevented retaking classes.

Personally, I can't knock these people either because if I don't have an acceptance by spring I could be applying to at least the top four as well :bag:.

Same here buddy. 🙁
 
Agree 100% with this. I've noticed a lot of posts form carib wannabes with terrible MCAT scores who magically think that somehow they'll crush USMLE.



Denial is more than a river in Africa.

I'm sitting in a T.A. meeting that is almost completely silent aside from a professor lecturing. I loled at the bolded and, needless to say, I got some great glares. I guess the professor now thinks that I believe acid-base titration is somehow hilarious. Thanks, Goro.
 
Agree 100% with this. I've noticed a lot of posts form carib wannabes with terrible MCAT scores who magically think that somehow they'll crush USMLE.



Denial is more than a river in Africa.

@zero0 This 100%. It's incredible to me that this person is clearly VERY intelligent but was so deluded in the idea "If I just work so much harder than everyone else, I'll get to my ortho dream through the Carribean". He then gets shorted and can only match internal medicine. Technically he should be grateful to be matching out of the Carribean, but this is SUCH A GOOD STORY on why you should avoid the Carribean like the plague: No matter how hard you work or how good your board scores are, you WILL NOT attain your dreams from there.
 
They simply haven't done enough research or are completely desperate. That's the end of this. If they put in the time to look into both DO and Carib, they'd know going DO dramatically better now.



This could be an insightful read for you if you have the time.

I loved this article. It's a very raw look at the reality of the situation. Very well written too. I sent this to my adviser and a couple friends.
 
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My father is a professor at a state COM. From his experience working as a faculty of an ACGME residency, some docs are biased against IMGS while others are biased against DOs. The older the doc, the more likely their bias more pronounced and immovable. However, docs who, let's say don't have gray hair, don't seem to care either way as long as you get through residency.

I have friends who went to SGU knowing the DO option existed, but they don't know anything about the DO profession. As in, my friend asked, do DOs practice in all 50 states? So you can imagine that this lack of knowledge plays a part. I also know students who attend SGU that were accepted to DO schools. Ultimately, though, the far majority of the physicians I meet say that DO>Carib by a far margin. Not even close. And personally, going the DO route would open more doors for specialities especially post merger...
 
My father is a professor at a state COM. From his experience working as a faculty of an ACGME residency, some docs are biased against IMGS while others are biased against DOs. The older the doc, the more likely their bias more pronounced and immovable. However, docs who, let's say don't have gray hair, don't seem to care either way as long as you get through residency.

I have friends who went to SGU knowing the DO option existed, but they don't know anything about the DO profession. As in, my friend asked, do DOs practice in all 50 states? So you can imagine that this lack of knowledge plays a part. I also know students who attend SGU that were accepted to DO schools. Ultimately, though, the far majority of the physicians I meet say that DO>Carib by a far margin. Not even close. And personally, going the DO route would open more doors for specialities especially post merger...

I'm really curious as to why those individuals who were accepted to a DO school opted instead for the Carib route. It literally takes less than a 20 minute Google search to figure out that DOs have greater opportunities post residency. (Not to mention better chances of getting a good residency/A residency in the first place.)


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I'm really curious as to why those individuals who were accepted to a DO school opted instead for the Carib route. It literally takes less than a 20 minute Google search to figure out that DOs have greater opportunities post residency. (Not to mention better chances of getting a good residency/A residency in the first place.)


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The number of students in this category, though, is likely less then 20 probably for all the caribbean. They are people who either have poor judgment or a misperception of what to means to be a DO. It's likely both. A more representative characterization would be that a fair chunk of Caribbean grads, at least at the top 4 programs, could have had a reasonable shot at a DO school. It's also worth noting that a large number of Canadians go to the Caribbean because getting into a US DO school is really hard as well as Canadian med schools (which are harder to get into in general). Either way, I am not too quick to criticize those who attend since I have personal friends who have gone and succeeded with a few who dropped out. It's a risk for sure.
 
My college physics tutor went Carib despite having a 30 MCAT and very good GPA. I know he is a very intelligent and capable guy. He will no doubt be successful wherever he goes. He did seem to be the type that doesn't want to do the extra stuff like volunteering, shadowing, research. His family members went Carib and turned out fine. Maybe that's why he went the Carib route.

There are two types of people at Carib schools:

1. Those who are capable enough/ with borderline stats that are just unlucky/ too lazy to apply broadly to US MD or US DO => they will be fine regardless of where they go.
2. The desperate ones.

Both groups seem to have a certain degree of bias against DO (duh!). But that's their problem, not mine lol.
 
My college physics tutor went Carib despite having a 30 MCAT and very good GPA. I know he is a very intelligent and capable guy. He will no doubt be successful wherever he goes. He did seem to be the type that doesn't want to do the extra stuff like volunteering, shadowing, research. His family members went Carib and turned out fine. Maybe that's why he went the Carib route.

There are two types of people at Carib schools:

1. Those who are capable enough/ with borderline stats that are just unlucky/ too lazy to apply broadly to US MD or US DO => they will be fine regardless of where they go.
2. The desperate ones.

Both groups seem to have a certain degree of bias against DO (duh!). But that's their problem, not mine lol.

And this is key, because those in (2) will likely fail out or struggle so much as to not obtain a residency. For instance, worst case scenario is someone barely passing their USMLE and needing to take off a year or two before some FM or IM community place takes him or her. By then you will already be nearly done with residency and began as an attending. To me, this is a gamble I simply will not take. Is it possible I will end up at a similar program as an IMG--sure. But I won't have to wait a year extra to do so, and that is worst case scenario lol.
 
And this is key, because those in (2) will likely fail out or struggle so much as to not obtain a residency. For instance, worst case scenario is someone barely passing their USMLE and needing to take off a year or two before some FM or IM community place takes him or her. By then you will already be nearly done with residency and began as an attending. To me, this is a gamble I simply will not take. Is it possible I will end up at a similar program as an IMG--sure. But I won't have to wait a year extra to do so, and that is worst case scenario lol.
What's the problem with FM or IM community program? I'm just curious, what you said is corrected though. I think for the IMGs, as long as they can get residency, they should be happy about it already. However, some of them still dream very big, and that end up not going well.
 
Poor research skills and that lust for the MD initials.

I'm really curious as to why those individuals who were accepted to a DO school opted instead for the Carib route. It literally takes less than a 20 minute Google search to figure out that DOs have greater opportunities post residency. (Not to mention better chances of getting a good residency/A residency in the first place.)


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Poor research skills and that lust for the MD initials.
When you say poor it's probably the poorest of the poor haha legitimately a 20 minute Google search would suffice! I can understand the whole initials thing but cmon it's better to be real with oneself about residency opportunities/not being able to practice at all.


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Another thing to remember: there are different calibers of schools in the Caribbean. Those who have been churning out big volumes of grads with fairly high match rates and fairly low attrition rates are still not a terrible choice. Last year their matches were as good as they've ever been. Obviously at least 10% will probably not make it to graduation, and maybe another 10% won't match into what they want, but overall these grads seem to have a fair amount of success.

The students that should worry about are the ones who go to one of the other 20+ Carib schools that offer minimal student support, degrees that don't allow for practice in every state, and have a higher risk of failure from the start, even for strong/resilient students. I would actually argue that it is more likely that more of the students described above in group 2 end up at these schools, choosing them possibly because they're cheaper/don't require MCAT/etc.
Obviously going to a DO school is a great option, but a lot of the kids who go Carib never explore it.


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What's the problem with FM or IM community program? I'm just curious, what you said is corrected though. I think for the IMGs, as long as they can get residency, they should be happy about it already. However, some of them still dream very big, and that end up not going well.

No problem, but from a numbers perspective (Steps, etc.), they are generally the easiest programs to match into. A DO can get into such programs relatively easy without jumping too many hoops. However, for an IMG these residencies still require extra legwork. I also used FM/IM community programs as an example since the vast majority of Carib grands match into such programs.
 
So I was perusing the SGU forum, and I am honestly surprised people apply to these places. Especially if they have even been on SDN, we trash Caribbean schools like they are they plague!

Like any bit of googling and you will discover the 50% match rate, the high rate of attrition, and the low student morale. Why do people not do this?

Do they desire the supposed "prestige" of an MD? Do they want to be a doctor so bad that they are willing to ignore blatant warnings? Are they just misinformed? Do they believe DOs are quacks?

Like the old pre-AMSA president at my university applied to 3 schools with a 3.4/26 our two state MD schools programs and SGU. Last I heard she was starting her second year at SGU. I honestly wonder if she even knew what a big mistake she made?

How can people who could possibly save your life be so ignorant? I honestly don't get it.


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Not everyone can get into a DO school. I have 2 friends that applied to Ross after getting multiple rejections for DO schools and got desperate. Not everyone wants to go back for a post bacc and take 60+ more credits+retake mcat.
 
I'm up feeding a baby so I think I'll address some comments here

Nice try SGU recruiter


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He is 100% correct

It's terrible to delude people that "the smart ones" always place

They do. There are way more people that match from the Carib then you want to believe, especially from SGU. The ones who would have made it at an MD or DO will make it in the Carib usually. The issue with the Carib scam is that they recruit hundreds of people who have no business being in medical school knowing they will fail out. If you or I were to go to the Carib we would have a much higher chance of matching than 25%.
Hey, I'm glad that happened to your friends, but that is certainly not the norm. That's how they sell you on it though. IF they do match, they are going to low quality programs that US students don't even want (go a head and tell me how your buddy is actually doing categorical surg at Hopkins). I think your delusional if you even consider the Caribbean a viable option. Double if you spew this garbage on here where some young ill informed premed would read it and believe you.

Willful ignorance and deceptiveness are not traits that a future physician ought to have. Keep that in mind while you defend these scam artists.


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DO match lists and Carib match lists are very similar so I wouldn't be going around saying "they only go to low tier programs" when you will be going to a DO school. Just because he understands the realities of the Carib better than you instead of the group polarization on SDN doesn't make him "willfully ignorant" or "deceptive"


Yes the Carib schools are a scam 100%. I would never recommend them to someone over a DO school. But they can be a viable way to becoming a doctor and so that is why people go there, and they will continue to go there until that changes.
 
I'm up feeding a baby so I think I'll address some comments here



He is 100% correct



They do. There are way more people that match from the Carib then you want to believe, especially from SGU. The ones who would have made it at an MD or DO will make it in the Carib usually. The issue with the Carib scam is that they recruit hundreds of people who have no business being in medical school knowing they will fail out. If you or I were to go to the Carib we would have a much higher chance of matching than 25%.


DO match lists and Carib match lists are very similar so I wouldn't be going around saying "they only go to low tier programs" when you will be going to a DO school. Just because he understands the realities of the Carib better than you instead of the group polarization on SDN doesn't make him "willfully ignorant" or "deceptive"


Yes the Carib schools are a scam 100%. I would never recommend them to someone over a DO school. But they can be a viable way to becoming a doctor and so that is why people go there, and they will continue to go there until that changes.

Best post in the thread. When everyone reads million dollar mistake, keep in mind that without the aoa match, that guy still might not have matched ortho had he gone to a DO school.

This thread is rather elitist considering we're all going to DO schools.


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I personally know somebody who went because... and these were his exact words... he "didn't want the DO initials after his name and only want Internal Medicine anyway".

It's a self esteem type of deal.

Just like the type of clothes you wear don't make you who you are...

The initials don't mean ****... well.. they don't mean much from a Caribbean school imo.
 
Have family that went there. Scored 260+ on USMLE. Is doing IM somewhere. I had told him that I'd been accepted into a DO program and if I should atleast consider the Caribbean AT ALL ( I was already decided against it).

He looked me dead in my eyes and said, "No. DO is MUCH better than Caribbean. It's not a great option anymore."

So.. take from that what you will folks.
 
The Caribbean schools were definitely a great choice in the past - I've seen cardiologists, gastroenterologists, surgeons, etc from SGU and Ross. That being said, they all stated to try to get into an American school before heading overseas. I've heard from a few Caribbean grads that DO's weren't accepted by the general public in the past, of course now this has changed. Personally, I think people don't want to explain what D.O.s are (a lot of people don't know), want an M.D. after their names, don't have the grades for D.O. school, or don't want to take additional gap years.
 
Lmao the "data" you're reading takes into account ALL Caribbean schools. You're delusional if you think you have a 25% chance to match if you attend SGU. You asked a question and I responded. Don't get mad cause you don't agree.I explicitly said I don't support going overseas, but clearly it's worked and still does for thousands and thousands of grads who match every year.

I guess I'll tell my friend who matched into categorical gen surg last year and my friend this year with 23 gas invites that they should have considered other options 😉


Agree with you but homie..

Gas is a dying field anyway. They had leftover spots in SOAP... that means any IMG can get them after all US students have had a go.

The surg match is dopeeee doe.
 
Carib is still a great option.

If you want IM, FM, or Peds in a shiesty location... and if you can score like a 240 or above (which is certainly not easy).
 
Agree with you but homie..

Gas is a dying field anyway. They had leftover spots in SOAP... that means any IMG can get them after all US students have had a go.

The surg match is dopeeee doe.

These doctors are in their late 40s and 50s now. Twas' a long time ago.
 
The difference between USMD and DO/FMG is NOT intelligence. I'm pretty certain that if you did an IQ test...there would NOT be a significant difference. I say this based on being apart of medicine for more than 10 years and having worked with a ton of MDs and DOs.

The biggest difference is KNOW-HOW very early on in undergrad. The truth is that many future applicants don't have a good plan going into undergrad. They don't understand the level of competition and they don't understand what it takes to get into medical school. How can that happen in the day and age of the internet? Trust me...it happens. The internet isn't often seen as a source of information by people coming out of high school...it is seen as a source of entertainment. I can't even tell you how many people I know...some of the most brilliant people I know...who were already out of contention for MD programs by the end of their freshman year of college. They lolly-gag their way through the first 1-2 years before kicking it in gear. By then...their GPA is shot and their knowledge of Chem and Bio 1-2 is so-so...which reflects on their MCAT.

By the time they get it all figured out...it is too late for USMD. They have two options...DO and FMG. The moment of panic gets some of them searching for answers...and many find SDN and other resources that direct them to DO. Others may have a disconnect between aspirations and reality...and they go to FMG programs. Others may have family member MDs, and go to FMG to appease their family. There are others who get it figured out at the very last moment and are not competitive for DO, but could if they spent a year to re-define themselves, but they don't want to put in the work and/or time...and they go FMG.

I know tons of people who went FMG. Every one of them went for one of those reasons. Some of them made it out alive...and some even got decent residencies out of med school...but there are also quite a few who are NOT doing well right now. DO remains the much safer path...with a higher upside. USMD is still the safest with the highest upside.
 
The difference between USMD and DO/FMG is NOT intelligence. I'm pretty certain that if you did an IQ test...there would NOT be a significant difference. I say this based on being apart of medicine for more than 10 years and having worked with a ton of MDs and DOs.

The biggest difference is KNOW-HOW very early on in undergrad. The truth is that many future applicants don't have a good plan going into undergrad. They don't understand the level of competition and they don't understand what it takes to get into medical school. How can that happen in the day and age of the internet? Trust me...it happens. The internet isn't often seen as a source of information by people coming out of high school...it is seen as a source of entertainment. I can't even tell you how many people I know...some of the most brilliant people I know...who were already out of contention for MD programs by the end of their freshman year of college. They lolly-gag their way through the first 1-2 years before kicking it in gear. By then...their GPA is shot and their knowledge of Chem and Bio 1-2 is so-so...which reflects on their MCAT.

By the time they get it all figured out...it is too late for USMD. They have two options...DO and FMG. The moment of panic gets some of them searching for answers...and many find SDN and other resources that direct them to DO. Others may have a disconnect between aspirations and reality...and they go to FMG programs. Others may have family member MDs, and go to FMG to appease their family. There are others who get it figured out at the very last moment and are not competitive for DO, but could if they spent a year to re-define themselves, but they don't want to put in the work and/or time...and they go FMG.

I know tons of people who went FMG. Every one of them went for one of those reasons. Some of them made it out alive...and some even got decent residencies out of med school...but there are also quite a few who are NOT doing well right now. DO remains the much safer path...with a higher upside. USMD is still the safest with the highest upside.

Money.
 
I think a lot of it is know-how.

A few weeks ago my university had a prehealth/grad fair type of thing and a Ross University representative was there. I HAVE scoured SDN for the last few years and I just couldn't place their school (because I don't pay too much attention to the Carib school names, tbh). But I knew they weren't on my list of places I'm considering (and I've been formulating a potential list for awhile!) but they were selling their school SO HARD. They were painting the prettiest of pictures and I was just sitting there thinking something wasn't right because if there was a school that good and a fit for me stat/EC wise, I would have probably heard about it (thanks to SDN). So I left the table and Googled them right away and then I realized it was a Carib school. The representative did not mention that at all and glossed over questions that I asked that would have even alluded to that.

I can definitely see undergrad students getting sucked into a schpeel at a school info fair.

Plus, I'm a senior and last semester (as a junior) I was in a predominantly freshman class with a bunch of pre-meds. The topic rolled around to DO schools and one kid, who was super loud, just started bashing DO schools, but also said he would go Carib because "you'd get to study in the Caribbean AND become a doctor." I tried to share just some of the things I had learned about those schools and he shot me down and wasn't interested in considering any of it. So, whatever, his deal not mine. Except, I imagine he will spread his thoughts to other students and that would probably sway some students, especially if they are borderline.



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"The difference between US DO and US MD is undergrad know-how."

This is my experience as well. The people I know who went DO...

-Didn't know they wanted to do medicine when college started
-Didn't understand that MD required a lot of "playing the game."
-Insisted on majoring in a difficult subject.
-Had a major life event happen to them in college that hurt their GPA beyond repair.

I know a lot of smart people in MD programs, but for every smart, talented, deserving MD I know, there's another who just gamed the system. This is the guy who...

-Took the easiest major possible (music history or philosophy anyone?) and tailored his curriculum for medical school from day 1.
-Volunteered passionlessly for various non-medical organizations
-Was president of a club with less than 5 people (who were all "president") for leadership.
-Paid over $6000 for MCAT tutoring and classes scoring in the low 30s.

...and then got multiple MD acceptances. I bet we all know a guy like this.

My experience with Caribbean students is very different. I know a handful of Caribbean students. All of them tried for DO, not single one of them succeeded. These were the guys struggling to get Bs in the master's programs and barely managing Cs in orgo. I fully expect all of them to fail out within the year.

Now I'm sure there are smart and capable Caribbean students. IMO if you've graduated a Caribbean school and finished residency, I'd give you the full respect I'd give any other doctor.

But if you can't get into an American DO school after 2 MCAT retakes and a Master's degree, You're probably not going to make it in medicine.
 
I think a lot of it is know-how.

A few weeks ago my university had a prehealth/grad fair type of thing and a Ross University representative was there. I HAVE scoured SDN for the last few years and I just couldn't place their school (because I don't pay too much attention to the Carib school names, tbh). But I knew they weren't on my list of places I'm considering (and I've been formulating a potential list for awhile!) but they were selling their school SO HARD. They were painting the prettiest of pictures and I was just sitting there thinking something wasn't right because if there was a school that good and a fit for me stat/EC wise, I would have probably heard about it (thanks to SDN). So I left the table and Googled them right away and then I realized it was a Carib school. The representative did not mention that at all and glossed over questions that I asked that would have even alluded to that.

I can definitely see undergrad students getting sucked into a schpeel at a school info fair.

Plus, I'm a senior and last semester (as a junior) I was in a predominantly freshman class with a bunch of pre-meds. The topic rolled around to DO schools and one kid, who was super loud, just started bashing DO schools, but also said he would go Carib because "you'd get to study in the Caribbean AND become a doctor." I tried to share just some of the things I had learned about those schools and he shot me down and wasn't interested in considering any of it. So, whatever, his deal not mine. Except, I imagine he will spread his thoughts to other students and that would probably sway some students, especially if they are borderline.



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To piggy-back on this post. On top of that they sell that ross grads are a "different breed" and better prepared. Several reps would mention studying in the caribbean overly prepares you to succeed in residency. Yeah the cream rises to the top at any school but the problem is that only the top grads get out alive.
 
I personally know quite a few people attending Caribbean schools and the reasons they do so vary. Some are so concerned with attaining what they perceive to be a prestigious degree (MD) that they don't realize they are in no way capable of completing the program. Others were impatient with the application process and decided to take what they could get instead of waiting another year just for the OPPORTUNITY to apply again (admission not guaranteed). But the majority, at least in my experience, go to Caribbean school knowing full well the disadvantages because they have friends/family at various residency programs and they know that their uncle or whoever will set up a match for them regardless of their scores. It's not often talked about, but nepotism is alive and well in the residency match.
 
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