Hi DjIL: I am looking into your question with regards to practicing perhaps in the Caribbean. If you have a specific place you are looking into, let me know and I will likely be able to find out for you.
Just as an FYI for practicing in North America:
The majority of us plan on practicing in the US or Canada, so we are required to do some extra testing. If your plans are for the US, you have 2 options. First, if you plan on settling in a state that accepts the
PAVE then you can write a multiple choice test before you go to clinics (usually between semesters 5 & 6 or 6 & 7). If you pass, then your clinical year will count as your clinical exam, and you are good to go once you pass the NAVLE. Australia and New Zealand also accept the PAVE.
If you plan on practicing in Canada then you will have to enter into the
ECFVG program. It is a bit more involved and expensive than the PAVE, but you can also practice in any US state that does not accept the PAVE. It involves a multiple choice test and a clinical proficiency exam (CPE) that spans 3 days and 7 sections.