Shouldn't be much of a problem without the citizenship to go to Caribbean schools. It's just another hoop to go through. The biggest hurtle is making it through the first two years and doing well on the step 1. After that, you'll be pretty much set unless you somehow screw up your clinicals big time. Besides, we need more foreign doctors in our system in the US. Not so much from Canada because why would you want to work for socialized medicine?? Benefits are unlimited to work in the US compared to anywhere else in the world. Interestingly enough, the same people who usually want to work in the US and benefit from all the opportunity, are the same people who lambast the political system. Ironic and pathetic!!!