The Caribbean Catch-22

[Princeton Medical Student]

Advertisement - Members don't see this ad

My goal is to make this thread into a simple breakdown as to why a usual student, who would be tempted by Caribbean schools also makes the worst case student to go there. Of course there are people who match into residencies from the Carrib, however the below demonstrates why you are unlikely to be the special one person who matched ortho as an IMG last year. This is in response to various threads on SDN seeking information about the Carib option.

First let us define an average Caribbean aspirant. They typically choose to attend a school outside of the US for any of the below reasons.

A. Low GPA

B. Low MCAT

C. Lack of activities, don't want to be a filthy DO, doesn't want to go to med school in bad area, etc (Likely the rarest reasons).​

Secondly, let us look at the things a Caribbean student needs to do, in order to survive medical school there, and match in the United States.

A. Maintain high pre-clinical grades to avoid being dropped from the program. (Some programs show retention rates as low as 50%, while US programs average at 90% retention).

B. Match into a residency program.​

Lastly let's correlate the first, and the second with some facts, and assumptions.

FACT 1. Low MCAT does correlate with low Step 1 score. [1]

FACT 2. In order to match, IMGs need a higher than average Step 1 score. [2] [3]​

ASSUMPTION 1. Low GPA will likely indicate poor performance in any medical school environment.​

DEFENSE. If at the time of application, the student has had recent history of not doing well in science/non-science courses, there is no reason to believe that this will change with him/her attending medical school. It is my assumption that the Caribbean students that succeed in making it through school, likely could not attend a US school for either reason B, or reason C, or they had past issues with grades.​

Thus, we can conclude without much doubt that someone that would be an unsuccessful candidate to US medical schools also would make a terrible student for the Caribbean medical schools.

 

[lolpremed22]

Honestly if people still want to go Caribbean after being told multiple times by multiple credible sources that it's a bad idea, that's just natural selection at its finest.

 

[Turkishking]

Honestly if people still want to go Caribbean after being told multiple times by multiple credible sources that it's a bad idea, that's just natural selection at its finest.

But the fitness for some increases cause some ppl survive :?

 

[blackroses]

But the fitness for some increases cause some ppl survive :?

Just because some people survive getting mauled by a lion doesn't mean that we should all go find a lion to poke in the eyeball. A bad idea doesn't become less bad because it just so happens to work out for some people.

 

[Turkishking]

Just because some people survive getting mauled by a lion doesn't mean that we should all go find a lion to poke in the eyeball. A bad idea doesn't become less bad because it just so happens to work out for some people.

Agreed

 

[efle]

There is one kind of student where I can see going Carib as reasonable: an old GPA so low it cannot be rescued (think like, 2.5 after 120 credits) and a decent (think like, 508) MCAT.

Unless you are that person, don't do it.

 

[ciestar]

Keep in mind the upcoming merger. How will that affect IMG matches?

 

[gyngyn]

There is one kind of student where I can see going Carib as reasonable: an old GPA so low it cannot be rescued (think like, 2.5 after 120 credits) and a decent (think like, 508) MCAT.

Unless you are that person, don't do it.

It's also good for the "bucket-lister" who just wants to die with MD after his name.

 

[esob]

You also are forgetting the candidate who bombs his/her interviews even though they have good numbers. I could see that person going to the Caribbean and doing fine in class and Step 1. Their personality probably will still hinder them from getting a residency slot but they would do just fine up to that point

 

[ciestar]

You also are forgetting the candidate who bombs his/her interviews even though they have good numbers. I could see that person going to the Caribbean and doing fine in class and Step 1. Their personality probably will still hinder them from getting a residency slot but they would do just fine up to that point

Yeah, that's me. I got lucky with my acceptance. I definitely will need to spent time practicing interviewing with my school.

 

[gyngyn]

You also are forgetting the candidate who bombs his/her interviews even though they have good numbers. I could see that person going to the Caribbean and doing fine in class and Step 1. Their personality probably will still hinder them from getting a residency slot but they would do just fine up to that point

And those with IA's or criminal records that keep them out of US schools.
Or parents that require an MD.

 

[Toutie]

Another point of concern about going the Caribbean route...I have not seen an official study on this, this is only my observation from reading posts here on SDN. It seems to me around 90% of those I read about who are fired in their residency are IMG's, most coming from the Caribbean. Same is true about those who seem to come up empty in both the match and the SOAP each year. So even if you do make it through medical school there, Caribbean students seem to have much more difficulty securing and completing a residency.

 

[mwsapphire]

That last option ( Lack of EC's) is actually an equally big issue for MD and DO programs. If anything, DO schools have a more holistic process and look more at EC's. Just ask Goro.

 

[cactusman]

That last option ( Lack of EC's) is actually an equally big issue for MD and DO programs. If anything, DO schools have a more holistic process and look more at EC's. Just ask Goro.

I don't think that's what OP meant, the last option is one or multiple of the options separated by commas. So it includes people who are competitive for DO or even get into DO but think Carib MD is better anyway.

 

[efle]

So it includes people who are competitive for DO or even get into DO but think Carib MD is better anyway.

This is exactly what happened for the Million Dollar Mistake guy!

 

[AnatomyGrey12]

You also are forgetting the candidate who bombs his/her interviews even though they have good numbers. I could see that person going to the Caribbean and doing fine in class and Step 1. Their personality probably will still hinder them from getting a residency slot but they would do just fine up to that point

So basically the guy who wrote "Million Dollar Mistake"

 

[Goro]

As the wise gyngyn has pointed out:
"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. "

My complaint is not with the students so much as it is with these educational predators who feast upon such desperate people.

 

[hellobigcat]

Every Caribbean discussion thread ends up like this:

InnocentWideEyedPreAlloInterestedinCaribbean - Guys, can I get into Caribbean?
EveryPreAlloSDNer - The Caribbean is EVIL!
gonnif - The Caribbean used to be good, but now it's bad.
Goro - If you can write a check, you'll get in. I don't suffer fools lightly.
aformerstudent - You should try SGU.
EveryPreAlloSDNer - Shut up.
OneGuyWhoSucceededinCaribbean - Um, guys, I actually did well, don't be so harsh.
EveryPreAlloSDNer - n=1, n=1! REEEEEEE
OneGuyWhoKnewThisGuyWhoKnewThisGuyWhoKnewThisGuyWhoKnewThisGuy'sCousinThatSucceededinCaribbean - Yeah, I agree with that guy.
ObviousCaribbeanShill - Looks like you're interested in "insert school here". Contact me with your bank info!
EveryPreAlloSDNer - OMG you guys should read Million Dollar Mistake, it's so enlightening!
EveryOtherPreAlloSDNer - That guy is a tool, what an idiot, I hate him, ahhggh.

The cycle will continue until it dies a natural death.

 

[efle]

I don't suffer fools lightly.

lmao nailed it

 

[mwsapphire]

Every Caribbean discussion thread ends up like this:

InnocentWideEyedPreAlloInterestedinCaribbean - Guys, can I get into Caribbean?
EveryPreAlloSDNer - The Caribbean is EVIL!
gonnif - The Caribbean used to be good, but now it's bad.
Goro - If you can write a check, you'll get in. I don't suffer fools lightly.
aformerstudent - You should try SGU.
EveryPreAlloSDNer - Shut up.
OneGuyWhoSucceededinCaribbean - Um, guys, I actually did well, don't be so harsh.
EveryPreAlloSDNer - n=1, n=1! REEEEEEE
OneGuyWhoKnewThisGuyWhoKnewThisGuyWhoKnewThisGuyWhoKnewThisGuy'sCousinThatSucceededinCaribbean - Yeah, I agree with that guy.
ObviousCaribbeanShill - Looks like you're interested in "insert school here". Contact me with your bank info!
EveryPreAlloSDNer - OMG you guys should read Million Dollar Mistake, it's so enlightening!
EveryOtherPreAlloSDNer - That guy is a tool, what an idiot, I hate him, ahhggh.

The cycle will continue until it dies a natural death.

My parents are asleep and I'm crying from laughing so hard my abssss ouch.
"OneGuyWhoKnewThisGuyWhoKnewThisGuyWhoKnewThisGuyWhoKnewThisGuy'sCousinThatSucceededinCaribbean"
🤣
And Gonnif's calm analysis amidst all the shrieking pre meds is hysterical he's the one sane man.

 

[CAFFEINE!]

Every Caribbean discussion thread ends up like this:

InnocentWideEyedPreAlloInterestedinCaribbean - Guys, can I get into Caribbean?
EveryPreAlloSDNer - The Caribbean is EVIL!
gonnif - The Caribbean used to be good, but now it's bad.
Goro - If you can write a check, you'll get in. I don't suffer fools lightly.
aformerstudent - You should try SGU.
EveryPreAlloSDNer - Shut up.
OneGuyWhoSucceededinCaribbean - Um, guys, I actually did well, don't be so harsh.
EveryPreAlloSDNer - n=1, n=1! REEEEEEE
OneGuyWhoKnewThisGuyWhoKnewThisGuyWhoKnewThisGuyWhoKnewThisGuy'sCousinThatSucceededinCaribbean - Yeah, I agree with that guy.
ObviousCaribbeanShill - Looks like you're interested in "insert school here". Contact me with your bank info!
EveryPreAlloSDNer - OMG you guys should read Million Dollar Mistake, it's so enlightening!
EveryOtherPreAlloSDNer - That guy is a tool, what an idiot, I hate him, ahhggh.

The cycle will continue until it dies a natural death.

This is aggressively accurate. You should make more of these for other common SDN topics 🤣

 

[hellobigcat]

This is aggressively accurate. You should make more of these for other common SDN topics 🤣

Thanks 😀. I've always been amused by how every Caribbean thread devolves into people arguing over whether MDM should be pitied, ridiculed, or despised. Yet again and again, it is brought up as a textbook that Caribbean hopefuls must read.

It's like MDM is that one Greek tragedy that we have to read for English class. A long, arduous journey undertaken by a talented hero that has a fatal flaw that ultimately causes his downfall.

I've observed several other memes on SDN! Maybe I'll post on it later! lol.

 

[Goro]

Thanks 😀. I've always been amused by how every Caribbean thread devolves into people arguing over whether MDM should be pitied, ridiculed, or despised. Yet again and again, it is brought up as a textbook that Caribbean hopefuls must read.

It's like MDM is that one Greek tragedy that we have to read for English class. A long, arduous journey undertaken by a talented hero that has a fatal flaw that ultimately causes his downfall.

I've observed several other memes on SDN! Maybe I'll post on it later! lol.

What would SDN be without memes, like "I got a B in my Orgo class. Am I doomed?"

 

[Danny L]

FACT 1. Low MCAT does correlate with low Step 1 score. [1]
​

​

I'm looking at this on my phone so maybe I'm reading the table wrong but the correlation between highest MCAT and Step 1 is .34 and between first MCAT and step 1 is .28

So low MCAT may correlate with a low Step 1, but that relationship seems weak at best

 

[efle]

​

I'm looking at this on my phone so maybe I'm reading the table wrong but the correlation between highest MCAT and Step 1 is .34 and between first MCAT and step 1 is .28

So low MCAT may correlate with a low Step 1, but that relationship seems weak at best

Biggest/best meta analysis I ever found on the subject had predictive validity at ~0.65

 

[Goro]

This is completely perfect, except you needed one last post:

InnocentWideEyedPreAlloInterestedinCaribbean - Oh okay. I think I'm still gonna go though.

👍👍👍🤣🤣🤣🤣🤣🤣🤣🤣🤣🤣🤣

 

[watermelon master]

Biggest/best meta analysis I ever found on the subject had predictive validity at ~0.65

This means there is a linear regression model to predict step 1 score from mcat score?

 

[Goro]

​

I'm looking at this on my phone so maybe I'm reading the table wrong but the correlation between highest MCAT and Step 1 is .34 and between first MCAT and step 1 is .28

So low MCAT may correlate with a low Step 1, but that relationship seems weak at best

It's weak, but it's there, and multiple med schools have found this to be true. At my school, we've found that higher MCAT takers perform better in our curriculum.

 

[moggat]

Biggest/best meta analysis I ever found on the subject had predictive validity at ~0.65

also @Goro
At a couple of my interviews they mentioned that the predictive value of MCAT decreases above 40. As in, students who get over a 40 tend to have WORSE outcomes in medical school than those in the high 30s. (I think they were talking about med school success generally, not necessarily Step scores specifically). Have either of you seen data that supports this??
I would have asked but it seemed rude to just challenge the program director for citations in an interview lol.

 

[efle]

I am shocked there is even enough data to make that kind of claim, only like 100-200 people used to score 40+ each year, and any individual school tracking it internally would have like a dozen people in that range per class at most (even top 10s had their 90th percentiles around 39-40). I've never seen any evidence of this and would expect it to be something like the median Step1 came out lower but the confidence band would be massive and overlapping with high 30s.

If it was true though, my best guess would be that as a group, they're more used to relying on brainpower > effort/memorization. Like some savant that took a math major and rarely needed to study suddenly can't pass anatomy, something like that.

 

[Goro]

also @Goro
At a couple of my interviews they mentioned that the predictive value of MCAT decreases above 40. As in, students who get over a 40 tend to have WORSE outcomes in medical school than those in the high 30s. (I think they were talking about med school success generally, not necessarily Step scores specifically). Have either of you seen data that supports this??
I would have asked but it seemed rude to just challenge the program director for citations in an interview lol.

As efle pointed out, the n is so small that we're dealing with anecdotes (unless the school was WashU or U Chicago, I suppose). I surmise that some people are just good at taking standardized exams, and so these people may not have mastered the skills needed for success in med school, had poor coping skills to the stress of med school, or life event, or didn't really want to be doctors.

MCAT scores are more useful when they're poor (ie < 500). Then you know those people at high risk for doing poorly!

 

[Princeton Medical Student]

My whole point is that with a low GPA (at least recently) you cannot expect to not be dropped from a carrib, and with a low MCAT you cannot expect to do well on USMLE.

 

[moggat]

Yeah I looked around a bit for MCAT stats but there's almost no analysis of scores 40+ on ANY metric. Figured maybe one of you might have seen more data. Seems like the population is just too small to consider. (The percentile conversion charts don't even go that high) I suspect both of these schools were relying on anecdotal evidence lol as they were solid schools but not avg MCAT of 39 types.

My suspicion was that, someone who drops out of medical school with a sub30 mcat is more likely to have had a problem with study skills/material/etc. while the few 40+ mcat-ers who drop out are more likely to have some other problem (they realize they hate medicine/patients or want to do research or something else instead).

 

[mwsapphire]

I actually think people with insanely high MCAT scores are just as likely to struggle as people with the weaker scores. Those with weaker scores may not be good at studying/test taking, whereas those with higher scores skated through college and the MCAT with almost no effort, relying on brainpower, and never actually had to learn how to study. Then they get to med school and meet their match. Like I'd say both sides of the curve would have issues in medical school.
It's the same as that kid in HS who was at the top of the class, 2300 SAT, 5's on AP exams, gets into a top UGrad school, and then crashes and is at the bottom of the class. It's because they never had to learn how to study, and now that they actually have to try it doesn't come as easily.

 

[AnatomyGrey12]

I actually think people with insanely high MCAT scores are just as likely to struggle as people with the weaker scores. Those with weaker scores may not be good at studying/test taking, whereas those with higher scores skated through college and the MCAT with almost no effort, relying on brainpower, and never actually had to learn how to study. Then they get to med school and meet their match. Like I'd say both sides of the curve would have issues in medical school.
It's the same as that kid in HS who was at the top of the class, 2300 SAT, 5's on AP exams, gets into a top UGrad school, and then crashes and is at the bottom of the class. It's because they never had to learn how to study, and now that they actually have to try it doesn't come as easily.

Eh I don't think so. These people can also get through med school without much effort. If they are struggling there is something else affecting it.

 

[mwsapphire]

Eh I don't think so. These people can also get through med school without much effort. If they are struggling there is something else affecting it.

Uuuhh" not much effort" can still be more than what they did in UGrad/HS. But I guess both can be true.

 

[moggat]

I actually think people with insanely high MCAT scores are just as likely to struggle as people with the weaker scores. Those with weaker scores may not be good at studying/test taking, whereas those with higher scores skated through college and the MCAT with almost no effort, relying on brainpower, and never actually had to learn how to study. Then they get to med school and meet their match. Like I'd say both sides of the curve would have issues in medical school.
It's the same as that kid in HS who was at the top of the class, 2300 SAT, 5's on AP exams, gets into a top UGrad school, and then crashes and is at the bottom of the class. It's because they never had to learn how to study, and now that they actually have to try it doesn't come as easily.

I don't think that's as common. It's not hard to get a 2300+ on the SAT if you're just good at taking tests. The MCAT requires so much memorization of information that if you can beast it with 40+ not studying at all, you're not going to have a problem with medical school (at least the academic part. the dealing with people part may be a different story).

 

[GypsyHummus]

You can add another one:

"You go to podiatry school before going to the caribbean. You even go to pharmacy school before going to the caribbean."

Every Caribbean discussion thread ends up like this:

InnocentWideEyedPreAlloInterestedinCaribbean - Guys, can I get into Caribbean?
EveryPreAlloSDNer - The Caribbean is EVIL!
gonnif - The Caribbean used to be good, but now it's bad.
Goro - If you can write a check, you'll get in. I don't suffer fools lightly.
aformerstudent - You should try SGU.
EveryPreAlloSDNer - Shut up.
OneGuyWhoSucceededinCaribbean - Um, guys, I actually did well, don't be so harsh.
EveryPreAlloSDNer - n=1, n=1! REEEEEEE
OneGuyWhoKnewThisGuyWhoKnewThisGuyWhoKnewThisGuyWhoKnewThisGuy'sCousinThatSucceededinCaribbean - Yeah, I agree with that guy.
ObviousCaribbeanShill - Looks like you're interested in "insert school here". Contact me with your bank info!
EveryPreAlloSDNer - OMG you guys should read Million Dollar Mistake, it's so enlightening!
EveryOtherPreAlloSDNer - That guy is a tool, what an idiot, I hate him, ahhggh.

The cycle will continue until it dies a natural death.

 

[787593]

"Who knew this guy's cousin...."

Every Caribbean discussion thread ends up like this:

InnocentWideEyedPreAlloInterestedinCaribbean - Guys, can I get into Caribbean?
EveryPreAlloSDNer - The Caribbean is EVIL!
gonnif - The Caribbean used to be good, but now it's bad.
Goro - If you can write a check, you'll get in. I don't suffer fools lightly.
aformerstudent - You should try SGU.
EveryPreAlloSDNer - Shut up.
OneGuyWhoSucceededinCaribbean - Um, guys, I actually did well, don't be so harsh.
EveryPreAlloSDNer - n=1, n=1! REEEEEEE
OneGuyWhoKnewThisGuyWhoKnewThisGuyWhoKnewThisGuyWhoKnewThisGuy'sCousinThatSucceededinCaribbean - Yeah, I agree with that guy.
ObviousCaribbeanShill - Looks like you're interested in "insert school here". Contact me with your bank info!
EveryPreAlloSDNer - OMG you guys should read Million Dollar Mistake, it's so enlightening!
EveryOtherPreAlloSDNer - That guy is a tool, what an idiot, I hate him, ahhggh.

The cycle will continue until it dies a natural death.

 

[SuaveCardigans]

I actually think people with insanely high MCAT scores are just as likely to struggle as people with the weaker scores. Those with weaker scores may not be good at studying/test taking, whereas those with higher scores skated through college and the MCAT with almost no effort, relying on brainpower, and never actually had to learn how to study. Then they get to med school and meet their match. Like I'd say both sides of the curve would have issues in medical school.

I think you are overestimating the number of people that score 40+ that are Will Hunting-style savants. Many are just smart kids who studied hard and are good test takers, and they probably honed their skills in undergrad.

 

[McdreamyMD]

Honestly if people still want to go Caribbean after being told multiple times by multiple credible sources that it's a bad idea, that's just natural selection at its finest.

Can we close this thread now? xD​

 

[futureDocDD]

Take a look at the recent shooting in Bronx hospital, the killer is a Ross graduate and got "kicked out" (...well he quit) from the residency, then lived in homeless shelter in lower Manhattan before going on the wild shooting.

 

[cactusman]

Take a look at the recent shooting in Bronx hospital, the killer is a Ross graduate and got "kicked out" (...well he quit) from the residency, then lived in homeless shelter in lower Manhattan before going on the wild shooting.

I don't know about Caribbean students and other FMGs/IMGs, but anecdotally the only Canadian med student I know is NotASerialKiller.

 

[Goro]

I don't know about Caribbean students and other FMGs/IMGs, but anecdotally the only Canadian med student I know is NotASerialKiller.

And then there was AFormerStudent

 

[Goro]

BTW, while we all talk about MDM, keep this in mind as well:
Medical School at SGU