The future of Caribbean medical schools

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

tompa

Full Member
10+ Year Member
Joined
Nov 28, 2010
Messages
14
Reaction score
0
Is it true that US MD and DO will take most of the residency spots from now on? The Caribbean grads gets what's left over? This is because there are more US MD and DO schools opening up. This means the Caribbean students will take the less desirable specialty like family medicine. It's going to much harder for a Caribbean grad to match.
Does anyone know if this is true? I saw the match list for SGU and Ross, they were a lot better 4 or 5 years ago.

Members don't see this ad.
 
that is not true at all. i spoke with many people on this issue and as a matter of fact there are actually thousands of seats left for residency spots each year. thousands left over. Now just because they are left over does not mean that IMG are fighting for those seats. This is because all IMG who start there match are in the same NRMP and are all competing for seats. They do not struggle to match in the last remaining seats but actually compete with MD's and DO's for every specialty. I dont think that anytime soon atleast that 10MD's and DO's schools will open up and suddenly claim all the seats for there students that will not happen anytime soon trust me. Do some research and actually talk to professionals before throwing out such mis directed questions like yours. Look at charts/statistics/and match lists then ask a better question.
 
Members don't see this ad :)
that is not true at all. i spoke with many people on this issue and as a matter of fact there are actually thousands of seats left for residency spots each year. thousands left over. Now just because they are left over does not mean that IMG are fighting for those seats. This is because all IMG who start there match are in the same NRMP and are all competing for seats. They do not struggle to match in the last remaining seats but actually compete with MD's and DO's for every specialty. I dont think that anytime soon atleast that 10MD's and DO's schools will open up and suddenly claim all the seats for there students that will not happen anytime soon trust me. Do some research and actually talk to professionals before throwing out such mis directed questions like yours. Look at charts/statistics/and match lists then ask a better question.
Given that this is your first post and that you're a pre-med (at least according to your status), I'm not certain that you really know what you're talking about here. The question is a very reasonable and valid one.

The answer is "it's hard to tell". Predicting the future has always been dodgy at best.

Currently, there are about 22,000 PGY-1 spots, and there are 16,000 US grads. Assuming that all US grads get a spot, there will be 6,000 spots left for IMG's, DO's and others. Exactly how competitive a carib grad will be for these 6,000 spots is unclear.

Going forward, there are several forces which will decrease the number of spots for IMG's:

1. Existing allopathic US medical schools have increased their class sizes by about 10-15%.
2. Osteopathic schools have increased class sizes by a much higher percentage.
3. There are several allopathic MD schools that are opening or are planned to open in the next few years.
4. Congress might cut GME funding via medicare. As medicare's financial situation deteriorates, I think this is inevitable. When that happens, programs might decide to close positions for financial reasons.

On the other hand, there are forces which might increase the number of slots:

1. Duty hour limits have limited the amount of coverage that a single resident can provide. In order to cover the gap, some programs have decided to increase the number of resident positions they offer.

2. As the finances of medicine change, some previously non-teaching programs might open new training programs to increase cash flow or increase their prestige (and hence possibly their market share).

There may also be other changes that affect the distribution of slots, rather than the number of slots. For example, it appears that the big names in US medical education have decided to open satellite campuses in other countries. These students are essentially guaranteed rotations at their "core campus". This might prevent other international students from rotating, and give them an advantage in the match.

Also, medical schools in general have made it more difficult and more expensive for international students to rotate at US programs. Many have created large fees for doing so. If this continues, it might prevent IMG's from rotating at US programs.

Last, there have been suggestions of an all-in match. This would prevent IMG's and DO's from prematching in programs, which might affect their ability to ultimately get a spot.

Too many variables to be certain either way. Two years ago was the first time that he total number of unmatched US grads was bigger than the total number of open PGY-1 spots. I predicted that this would be the beginning of the end. I was wrong, at least for now. In this year's match, the ratio reversed again and the number of unmatched US grads was smaller than open PGY-1 spots. Only time will tell, but there should be a surge of new MD grads coming through the system as many schools increased sizes less than 4 years ago. I can't predict whether programs will expand to address duty hour issues. Only time will tell.
 
Thanks for your response! I'm applying to DO schools. This is definitely the better option for me.
 
Given that this is your first post and that you're a pre-med (at least according to your status), I'm not certain that you really know what you're talking about here. The question is a very reasonable and valid one.

The answer is "it's hard to tell". Predicting the future has always been dodgy at best.

Currently, there are about 22,000 PGY-1 spots, and there are 16,000 US grads. Assuming that all US grads get a spot, there will be 6,000 spots left for IMG's, DO's and others. Exactly how competitive a carib grad will be for these 6,000 spots is unclear.

Going forward, there are several forces which will decrease the number of spots for IMG's:

1. Existing allopathic US medical schools have increased their class sizes by about 10-15%.
2. Osteopathic schools have increased class sizes by a much higher percentage.
3. There are several allopathic MD schools that are opening or are planned to open in the next few years.
4. Congress might cut GME funding via medicare. As medicare's financial situation deteriorates, I think this is inevitable. When that happens, programs might decide to close positions for financial reasons.

On the other hand, there are forces which might increase the number of slots:

1. Duty hour limits have limited the amount of coverage that a single resident can provide. In order to cover the gap, some programs have decided to increase the number of resident positions they offer.

2. As the finances of medicine change, some previously non-teaching programs might open new training programs to increase cash flow or increase their prestige (and hence possibly their market share).

There may also be other changes that affect the distribution of slots, rather than the number of slots. For example, it appears that the big names in US medical education have decided to open satellite campuses in other countries. These students are essentially guaranteed rotations at their "core campus". This might prevent other international students from rotating, and give them an advantage in the match.

Also, medical schools in general have made it more difficult and more expensive for international students to rotate at US programs. Many have created large fees for doing so. If this continues, it might prevent IMG's from rotating at US programs.

Last, there have been suggestions of an all-in match. This would prevent IMG's and DO's from prematching in programs, which might affect their ability to ultimately get a spot.

Too many variables to be certain either way. Two years ago was the first time that he total number of unmatched US grads was bigger than the total number of open PGY-1 spots. I predicted that this would be the beginning of the end. I was wrong, at least for now. In this year's match, the ratio reversed again and the number of unmatched US grads was smaller than open PGY-1 spots. Only time will tell, but there should be a surge of new MD grads coming through the system as many schools increased sizes less than 4 years ago. I can't predict whether programs will expand to address duty hour issues. Only time will tell.

Agree with this. If you look back at some of the press releases from the ACGME back in 2005, you can see that some of the impetus for pushing med schools to increase their enrollment is that US schools should completely fill US needs, and that the training received by individuals trained at programs not under the supervision of the LCME was suspect. It's pretty clear some of the motivation was to make more US med school spots for the better students who had historically been going offshore, and otherwise try to push the cottage industry of offshore programs that prayed on the hopes of americans out of business.

I would also suggest that the landscape is changing a bit in that NPs are getting "doctor" degrees, and since midlevels seem to have found favor with the current US administration, that should expedite government tax saving plans to cut back on Medicare funding for residency. So I wouldn't put much hope in there being more residency slots over the next few years, even with the cut back in duty hours. It will likely mean existing residents get worked harder, and more midlevels will get brought into the fold.

Finally, I would point out that this past match suggested a renewed interest by US seniors in some of the primary care fields, something med schools have been trying to promote for a number of years. This could be bad news for the offshore crowd, which was to some extent taking advantage of the fact that some of the specialties they were most competitive for were ones the US grads often found less desirable. Now that may be changing.
 
From the NRMP website:

NRMP TO IMPLEMENT "ALL-IN" POLICY

At its May 16, 2011 meeting, the NRMP Board of Directors voted unanimously to require programs participating in the Main Residency Match to place all positions in the Match. The so-called "All-In" Policy will become effective for the 2013 Match that opens for registration on September 1, 2012. The policy will affect all PGY-1 positions and PGY-2 positions in advanced programs.

The NRMP will continue to accept comments on implementation of the policy, especially as it relates to possible exceptions for residents who enter training off-cycle, GME programs in rural and geographically underserved areas, combined clinical-research programs, and accelerated programs. Final implementation rules will be adopted in May 2012.
 
Last edited:
Top