I thought I would share some of the things my wife and I have learned in researching the option to go to medical school in the Caribbean. Hopefully this may help someone else. I don't believe that I'm going to share anything earth shattering, but yet it did take a lot of digging and I'm happy to help someone avoid the same level of effort.
My wife is 33 years old. Our kids are 12, 10 and 1.5. She gradated two years ago from a local State university. Her GPA was 3.8 with 3.7 in the sciences. By the time she graduated she had racked up a seriously impressive list of extra curricular activities, cancer research, volunteer hours at the hospital, community involvement, leadership, and even a shadowing internship at the local hospital in which she spent ten hours a day for a month with a variety of specialists. She had strong letters of recommendation from her faculty adviser, from her research adviser, and from several physicians who she had shadowed. So far it was the medical school application from heaven.
She was pregnant when she took the MCAT, and when she got her score, it was a serious blow. 20. Science 8, Physics 6, Language 5.
The obvious course of action was to take it again, but before that would be possible, we had our third child. By the time she was recovered enough to think about getting ready to re-take, that just didn't feel like the right thing to do. We're not getting any younger, and rather than take the time to retake the MCAT, we decided together to try and find a school that would accept her as is. Also, her desire is not to be in the upper echelons of doctors at a world famous clinic. She will be perfectly happy at a hospital in a mid sized city.
We looked into MD schools in the states and ruled them out. None of them would take a 20 MCAT score. She applied to almost a dozen DO schools and got the same response: "Your application is impressive, when you have a new MCAT score please reapply."
Reluctantly, we began to look at Caribbean schools. The more we looked into this option, the more we set out our fears aside. Granted, we had reservations, but overall we came to conclude that it was a path that would allow her to meat her goals. When I say "we looked into this option", here's what I mean:
- We have three personal friends who are MD's. One is a general practitioner, one is an OBGYN and one is a radiologist. We asked all three their opinions on Caribbean schools. The general practitioner was strongly negative towards the idea. The radiologist was neutral, and the OBGYN said it's a solid, viable option.
- All three said they knew docs in the area who had gone to school in the Caribbean, and all of them are respected physicians who excel in their field. We asked our friends to facilitate an introduction, and in the cases where that was possible, we asked the Caribbean grads deep, probing questions.
- We got online and did some preliminary research and quickly decided to limit our scope to the top 3 schools. We noticed that AUC was going to host an open house near our home, so we went. We were favorably impressed.
- Based on cost, class size, and location, we decided to limit our focus to AUC.
- We found blogs from current and past students and read them all. We emailed the owners of the blogs and asked them the same kind of probing questions we asked the Caribbean graduate MD's in our area.
- We called AUC and asked them the same questions.
Based on all this research, here are the conclusions to which we came. These are not iron clad, scientific findings. You may dispute them, and if so, that's fine. But we think these are based on a solid understanding of AUC, and likely the other top Caribbean schools as well.
Passing the USMLE's:
- AUC boasts a 94% pass rate on the USMLE's. While that's impressive, it's also misleading. That number represents the students who sit for the exam and pass, and not the number of incoming freshman who eventually pass. (The reports on the percentages of incoming freshman who ended up sitting for the exam were so varied depending on who we asked that it wouldn't be fair to speculate. The best estimates were 85% and the worst were 60%.)
- A shockingly high number of students either drop out or flunk out before taking the first round of exams. Every school has drop-out's and flunk-outs, but AUC's (and all Caribbean schools??) rate is really high. AUC representatives would try to evade this question, but the students and grads we emailed were more open about this yet were unable to give exact percentages.
- The drop-outs were typically kids who showed up on the island believing that because AUC was easier to get into, that it would therefor be easy to get through as well. They thought it was the "easy" path to MD. When they learned that there was serious work involved, they bailed.
- The flunk-outs were kids who got too involved in the trappings of island life, didn't study enough, and were shown the door when grades came out.
- And there are always just some students who, upon getting into med school, decide it's not what they want, and for whatever personal reason, they opt out.
- Of the students who remain, all are required to take several practice USMLE's before the actual exams. Only those who do well on the practice tests can sit for the real thing. (From what we heard, most but not all pass the practice exams).
- By the time you've filtered out the drop-outs, the flunk-outs, the students who leave for personal reasons, and the students who just can't pass the practice exams, 94% of who's left pass their first round of USMLE's and move on to clinical rotations back in the States.
Matching for Residency:
- Just about every graduating class of AUC usually has a small number (ie:1-3) who end up in a highly competitive, prestigious residency.
- Roughly 40% to 50% get their first choice of match. But keep in mind that these students are realistic about their "first choice" and usually don't apply to Johns Hopkins, Mayo, or Cleveland Clinic. But still, they are getting into the same programs as kids from second and third tier MD schools in the States, and in many cases are beating out the DO school grads.
- Most of the others still match, just not their first choice. Keep in mind that some who did not get their first choice did, in fact, apply to the top tier programs in hopes of a miracle.
- A certain percentage don't match at all. This is typically because their rotations were disastrous, usually due to personality reasons. They did fine in a classroom and on exams, but in an actual hospital, they just couldn't perform. Nobody would write them a letter of recommendation.
Actual Jobs:
- Our friend the radiologist sits on the board which hires new recruits out of residency. He said they don't care where their recruits went to school or where they did their residency. They care about 1) Are they licensed to practice, 2) Are they board certified, 3) Do they come with strong letters out of residency, and 4) Do they interview well. They have never had a Caribbean school student apply, but if one ever does, they would not hold that against them.
- The Caribbean grads who we met are now practicing in solid careers and enjoying a comfortable life. They work for impressive clinics, practices and hospitals in a market of 100,000 people that is an hour outside the Twin Cities. They have no regrets about where they went to school.
- AUC grads seem to congregate in certain locations such as NYC. Don't think mid-town Manhattan. Think Brooklyn, Staten Island, and just outside the city on Long Island. There are also a high percentage in California. Think middle markets like Bakersfield. A smaller percentage scatter all over the country in between the coasts. During the open house we attended in Minneapolis, a general surgeon was scheduled to come meet us, but he was called into emergency surgery and couldn't make it.
Bottom line: If you are realistic about how hard you have to work, if you pass the USMLE's, and if you can include some leadership and extra curricular activities while in med school (ie: medical missions, leadership, etc), you stand a good chance of getting into a strong residency program. By "strong" I don't mean the super elite programs, just good the ones. If you don't get a "good" match, you should still get into a second or third tier program.
After residency, you should be able to enjoy a rewarding career as a doctor in your chosen field. Don't plan on being in the upper crust of the elite crowd, but do plan on being a good solid MD in a small or even medium sized market. By "small" I don't mean ultra-small-town rural. I mean towns like mine of ~100,000. And keep in mind that even the docs in these markets still make darn good money.
That's about it. Like I said... there is nothing scientific about all this. It's just our own conclusions based on what we think was some fairly vigorous research from people who are in the know.
Her application is in to AUC. We should know soon.
Thanks for reading .
