Why are attrition rates at Carribbean so high?

[passionformed]

So I have been reading many things about Caribbean here on SDN. Many people mention that plenty of students drop out before fourth year. Why is this? Is it because the quality of students that enter is low, or is it because of the schools themselves?

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[music2doc]

Both. Is this post/question rhetorical or something? (Because it should be.)

 

[Mavii]

What else do you expect from a C student that got a 15 on the MCAT?

 

[circulus vitios]

I'm going to guess it's the students. The entry requirements for a Caribbean school are lower than US MD or DO schools, especially outside the big 3 Caribbean schools.

I doubt it is the schools themselves? Most medical students say that medical school is a lot of self study.

 

[mmmcdowe]

I'm going to guess it's the students. The entry requirements for a Caribbean school are lower than US MD or DO schools, especially outside the big 3 Caribbean schools.

I doubt it is the schools themselves? Most medical students say that medical school is a lot of self study.

Definitely for pre-clinicals. For clinicals you need good mentorship and a good clinical learning environment to take what you self study off hours and implement it effectively.

 

[music2doc]

Definitely for pre-clinicals. For clinicals you need good mentorship and a good clinical learning environment to take what you self study off hours and implement it effectively.

Academically & otherwise weak students + sh*tty admissions standards + marginal teaching + unreliable/insufficient/poorly monitored rotations = poor student outcomes (to say the least)

 

[HughMyron]

It's the students

 

[notbobtrustme]

less academic support + living in a 3rd world country + mostly composed of students who have no business being doctors in the first place.

 

[IslandStyle808]

So I have been reading many things about Caribbean here on SDN. Many people mention that plenty of students drop out before fourth year. Why is this? Is it because the quality of students that enter is low, or is it because of the schools themselves?

1) admitting students who don't meet the medical school standards
2) people failing USMLE step 1
3) people failing USMLE step 2
4) Having a hard time finding green book rotations in the US
5) Junk support system of the schools (they are admitting at least 300+ student per year, how does the faculty get the time to see them all)

 

[Pattycake25]

So I have been reading many things about Caribbean here on SDN. Many people mention that plenty of students drop out before fourth year. Why is this? Is it because the quality of students that enter is low, or is it because of the schools themselves?

1. Not all, or even necessarily most, students who go the Caribbean route are bad students, or inadequately prepared for medical school, but a great many are. Since the Caribbean route hinges on passing the USMLE, the Caribbean schools teach quite as much material as U.S. schools. The material is also taught at a more unrelenting pace, since the Caribbean schools depend heavily on a refresher USMLE course to boost their students scores, leaving them less time (or at the very least fewer breaks) to get through all that material. This winds up leaving many subpar students unable to make the cut. And unfortunately:

2. They are more or less on their own down there. School resources beyond lecture are very thin on the ground. It's sink or swim.

3. I've heard that the schools also do a poor job teaching/testing the material (surprise, surprise). Apparently medical trivia are much higher emphasis there than in American medical schools. Granted, this could just come from the washouts who would say the same thing about an American program...

4. It's isolated. Must be quite a mind**** to be living so far from home, and I imagine the beaches only help so much...

5. The sheer fact of a far less certain future for Caribbean grads versus American ones probably does a number on one's determination.

 

[fahimaz7]

Most Caribbean students aren't able to perform at the level required to pass. Simple as that.

 

[fahimaz7]

Definitely for pre-clinicals. For clinicals you need good mentorship and a good clinical learning environment to take what you self study off hours and implement it effectively.

Caribbean students obtain US clerkships. It's a mute point for 3rd and 4th year.

 

[PennDippody]

Caribbean students obtain US clerkships. It's a mute point for 3rd and 4th year.

..........nm

 

[mmmcdowe]

Caribbean students obtain US clerkships. It's a mute point for 3rd and 4th year.

So what you are saying is as long as the hospital is in the US it doesn't matter? My experience has been that carribean students aren't exactly learning from docs at the Mayo.... Good clinical training is far more important than where you do pre clinicals, IMO.

 

[music2doc]

So what you are saying is as long as the hospital is in the US it doesn't matter? My experience has been that carribean students aren't exactly learning from docs at the Mayo.... Good clinical training is far more important than where you do pre clinicals, IMO.

This...is what I would have thought. My understanding has always been that these students get the worst of the worst teaching hospitals in the States, many of which are hardly appropriate for training their own communities' EMTs and RNs, much less future MDs.

 

[IslandStyle808]

So what you are saying is as long as the hospital is in the US it doesn't matter? My experience has been that carribean students aren't exactly learning from docs at the Mayo.... Good clinical training is far more important than where you do pre clinicals, IMO.

No

This...is what I would have thought. My understanding has always been that these students get the worst of the worst teaching hospitals in the States, many of which are hardly appropriate for training their own communities' EMTs and RNs, much less future MDs.

When foreign medical students do their rotations in US hospitals, their core rotations have to be greenbook certified. This means that they have to do their core rotations with an ACGME approved residency. Otherwise, no residency program in the country would take a FMG (even if one graduates and passes step I and II). It is one extra hoop that FMGs have to jump through and thus leaves them scrambling for green book certified rotations across the country.

 

[wholeheartedly]

You also have to factor in that it boosts the stats/board scores of the schools if the under performers wash out before taking boards.

 

[SpecterGT260]

Caribbean students obtain US clerkships. It's a mute point for 3rd and 4th year.

Aphasia?

They don't get good rotations on average. Skeezing a rural or inner city hospital to let your students come hang out isn't the norm for US students

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[KnuxNole]

Just because it's in a hospital that has a residency associated with it doesn't make it a good place to rotate at. The aspect that isn't spoken about in terms of the Caribbean discussion as much is the 2nd half of med school. Although I'm of the belief that you can turn a subpar rotation experience into a good one by making the best out of it, that doesn't discount poor clinical training.

Someone can easily jump in and correct me, but Ross students don't take clinical shelf exams. A Ross 4th year was bragging during the interview trail how he loved 3rd year because he didn't ever need to study. On one hand, he is a lucky SOB, but then again, the main reason I kicked *** on Step 2 is due to trying to do well on shelf exams...

 

[IslandStyle808]

Just because it's in a hospital that has a residency associated with it doesn't make it a good place to rotate at. The aspect that isn't spoken about in terms of the Caribbean discussion as much is the 2nd half of med school. Although I'm of the belief that you can turn a subpar rotation experience into a good one by making the best out of it, that doesn't discount poor clinical training.

Someone can easily jump in and correct me, but Ross students don't take clinical shelf exams. A Ross 4th year was bragging during the interview trail how he loved 3rd year because he didn't ever need to study. On one hand, he is a lucky SOB, but then again, the main reason I kicked *** on Step 2 is due to trying to do well on shelf exams...

Had a question about this. How much prep time do you need for Step II since studying for the shelf exams and rotations is also like prep?

 

[KnuxNole]

Most people I talked to(including me) took about a month to study for it. I'm sure there are people who spend less time, and some who spend 6-8 weeks. It also helps if you have a light rotation or a small break when studying for Step II 😀

 

[IslandStyle808]

Most people I talked to(including me) took about a month to study for it. I'm sure there are people who spend less time, and some who spend 6-8 weeks. It also helps if you have a light rotation or a small break when studying for Step II 😀

Cool. Thanks for the info 👍

 

[CoolWhipp]

because it's a scam. they have no problem matriculating a gigantic class and cutting many of them after because it is to their benefit to keep the best students and then say that "such and such percentage pass the boards". this way they don't have to pay for the academic support either.

 

[Law2Doc]

because it's a scam. they have no problem matriculating a gigantic class and cutting many of them after because it is to their benefit to keep the best students and then say that "such and such percentage pass the boards". this way they don't have to pay for the academic support either.

Yeah it's. Combo of schools and students. The students are often already folks looking for a last ditch chance at med school. Their track record for academic success is often poor. And they are going to school on a resort beach with a couple hundred other people who party too hard -- what could go wrong?

at the same time,these schools prey on young people's dreams, and their business plan involves failing out a big chunk of the class each year. Truth of the matter is there aren't even enough 3rd and 4th year rotation spots to accommodate everyone, so they have to fail and hold back a certain percentage of the class regardless -- that's by design. So they take money from people knowing full well that any won't be there next year. They don't have a stake in your success the way the US programs do.

So kudos for those few who make it through, because the deck is stacked against them.

 

[fahimaz7]

So what you are saying is as long as the hospital is in the US it doesn't matter? My experience has been that carribean students aren't exactly learning from docs at the Mayo.... Good clinical training is far more important than where you do pre clinicals, IMO.

This...is what I would have thought. My understanding has always been that these students get the worst of the worst teaching hospitals in the States, many of which are hardly appropriate for training their own communities' EMTs and RNs, much less future MDs.

last time I checked I didn't do my clerkships at Mayo and I manged to do just fine during third year. I'll put my shelf and step 2 scores up against anyone on from Mayo, BWH, MGH, Vandy, Duke, etc.

Individual efforts >>> Name

 

[music2doc]

last time I checked I didn't do my clerkships at Mayo and I manged to do just fine during third year. I'll put my shelf and step 2 scores up against anyone on from Mayo, BWH, MGH, Vandy, Duke, etc.

Individual efforts >>> Name

Absolutely, but I would guess your school's rotations were done at a solid institution with good funding, a reasonably diverse pt population, experienced physicians, etc. Sure, they probably weren't perfect but at least reasonable, right?

 

[notbobtrustme]

last time I checked I didn't do my clerkships at Mayo and I manged to do just fine during third year. I'll put my shelf and step 2 scores up against anyone on from Mayo, BWH, MGH, Vandy, Duke, etc.

Individual efforts >>> Name

True, but at the same time, generalites can be made that will apply to the vast majority of cases. On the average, Caribbean students are going to be a fair deal poorer than US students.

 

[fahimaz7]

Absolutely, but I would guess your school's rotations were done at a solid institution with good funding, a reasonably diverse pt population, experienced physicians, etc. Sure, they probably weren't perfect but at least reasonable, right?

Good funding? What does NIH research money have to do with the faculties ability to relay medical information to the medical student? It sure doesn't ensure a quality educational clerkship or a productive environment to thrive in. My hospital is probably outside the top 100 in NIH funding and our medical school is in the bottom 1/4 of ranked medical schools. We have lots of people over 250's on step 1 and plenty over 260/270 on step 2.

We also have quite a few carribean grads in residency here that are exceptional doctors. Off the top of my head I can think of a urology resident that is a stud as well as a recent IM graduate that is now in a cards fellowship at a top tier training site.

The only generalization you can really make is that most people who start medical school on the islands don't finish. Since I didn't attend these schools, I can't comment on the exact reason, but I do believe that there are schools down there that provide plenty of resources for the students to succeed. I bet the attrition rate is more of a direct reflection on the students lack of ability/effort/motivation/tenacity than that of the program failing to do enough.

 

[Ichiban88]

Not only distracted students but also distractions.

 

[typicalindian]

What else do you expect from a C student that got a 15 on the MCAT?

harsh lol

 

[shawn829]

What else do you expect from a C student that got a 15 on the MCAT?

the avg scores of students at sgu are similar to DO schools...but thats probably due to all the Canadian students

 

[music2doc]

the avg scores of students at sgu are similar to DO schools...but thats probably due to all the Canadian students

I don't know about SGU, but most consider Ross the top of the Big 4 and the numbers they submitted a few yrs ago to their accreditation board were 6s and 7s on all 3 sections or around a 20 avg MCAT. Sure, some DO schools have averages in the low 20s but most are taking (m)any sub-20 scorers. Oddly enough, their admissions people are reporting numbers that don't agree with the official ones they submitted to the gov't there. Interesting contrast we've got here..... 😉