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I think the pressure that his soon-to-be wife had already matriculated into a MD school just played with his head. He didn't want to be a DO while his wife was an MD. He probably thought, "once I finish at the Caribbean school and doing my surgery residency, I'll have MD after my name and the caribbean thing will just be a footnote that no one knows or cares about."

Some of us know older doctors from Caribbean or Guadalajara med schools. Those people were more favorably accepted into the US medical community and residencies since usually their only "flaw" was that they had been nontrads. They weren't the 2.6 GPA, 22 MCAT students the caribbean med schools are now accepting.
 
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