It seems like some people are in such a rush to go to medical school right after they graduate that they will settle for the Caribbean, at schools like SGU. I was looking at SGU's class of 2013 (because I have a friend going), and many of the people just graduated from really good undergrad schools, like columbia, dartmouth cornell etc in the class of '09. I just can't help but figure that some of these people could get in to a US school if they took a year or two off after graduating, applied early, did an SMP or postbac if necessary etc, applied to DO schools. Why spend 200,000+ to attend prestigious private undergrads and then risk going out of the country?
why are people in such a rush to get into medical school?
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It's pretty impossible to guess about things like this when you don't know the whole story.
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A lot of people don't want to spend an extra year when they know getting their career started will take forever to begin with.
They lack perspective. They think waiting another year is so horrible. A lot of them are probably not used to not being accepted into a program. And they think they will be the exception, the carribean student who gets a derm residency. And maybe they will, but probablyy they won't. If anything, taking off a year, improving your MCAT, doing some research, shadowing a physcian more, etc and re-applying shows you are persistent, always a good trait for a medical student/doctor.
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From a financial aspect, the ~200k turned me off to it. If it were to cost comparably, the opportunity cost of losing years of earning might offset lack of prestige of med school (assuming one is to succeed at SGU - meaning perform at a level higher than his/her us-med-graduating counterpart on usmle's to get a competitive residency). IMO, a degree from SGU keeps you in the game to be a successful doctor with a decent residency if you do well on boards.
However, two years of 20k grad work giving one a high probability of acceptance to 20k a year state med school = better expected value (which was my case).
Of course, individual factors play into any specific situation.
However, two years of 20k grad work giving one a high probability of acceptance to 20k a year state med school = better expected value (which was my case).
Of course, individual factors play into any specific situation.
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I don't want to rush to get IN medical school, I want to get OUT. As much as I like school and schooling, at some point you think "I really want to make money and have a bit more substantial 'me' time with which to use that $$."
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I agree with flow rate. I don't give two ****s about the journey. I'm ready to get to the other side, where i can stop living in crappy little apartments and feeding myself tacobell every day.
But i wouldn't go to the caribbean under any circumstances.
But i wouldn't go to the caribbean under any circumstances.
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I have no idea. My friends also held the same mentality with regards to University. I always thought that med.school would be incorporated into my being. I would be at another stage in my life that would ultimately be a constituent part of forming who or what I am to become. I will get there when I get there.
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That's a naive perspective. You are never going to have more "me" time than before med school. And you significantly damage your earning potential going offshore if you could spend a year and get into a US med school. If you consider the high attrition and longer paths of most offshore med schools, the percentage becoming physicians in 4 years is not so impressive either.
From what I've seen, most of the college students who rush off to the Caribbean instead of try to spend the year to get into a US school are (1) misinformed about the career drawbacks of offshore schools, or have gotten very bad advice (2) trying to keep up with their classmates or some artificial timetable, or (3) have never been out of school in their life and have no idea what to do if they graduate and have not matriculated someplace.
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because it's the harvard of the carib yo
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Because people want a real paycheck before they are 45.
While those people you mentioned did go to good schools, maybe they didn't do so well. A year or two off or a SMP wont really help if you can't get an MCAT above 25 by your 3rd attempt.
In the current economy, finding a job is difficult.
Although people are successful in doing so, I'm sure having a child while in med school is difficult. That creates problems for women who want children that are somewhat spread out in age. If they start med school at 27, they'll be 31 when they finish, and the bio clock is a ticking.
I would actually encourage people to take time off. One last horrah before entering a field where you will sacrafice things, to some extent, for the next 7 years.
Also, every year it just gets more competitive. People who for sure would have gotten in 5 years ago may not this year. If you take a few years off, and then aren't successful in applying, it extends your timeline. This especially impacts MCAT scores which expire after 3 years. So if you take it jr year, and take two years off, don't get in, you have to take the test again. While one might say, you can get the same score you got last time, you will still have to study for it which is a hassle. Plus imagine collecting LORs from profs 3 years after the fact.
While those people you mentioned did go to good schools, maybe they didn't do so well. A year or two off or a SMP wont really help if you can't get an MCAT above 25 by your 3rd attempt.
In the current economy, finding a job is difficult.
Although people are successful in doing so, I'm sure having a child while in med school is difficult. That creates problems for women who want children that are somewhat spread out in age. If they start med school at 27, they'll be 31 when they finish, and the bio clock is a ticking.
I would actually encourage people to take time off. One last horrah before entering a field where you will sacrafice things, to some extent, for the next 7 years.
Also, every year it just gets more competitive. People who for sure would have gotten in 5 years ago may not this year. If you take a few years off, and then aren't successful in applying, it extends your timeline. This especially impacts MCAT scores which expire after 3 years. So if you take it jr year, and take two years off, don't get in, you have to take the test again. While one might say, you can get the same score you got last time, you will still have to study for it which is a hassle. Plus imagine collecting LORs from profs 3 years after the fact.
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I think that, for some people, undergraduate loans have alot to do with it. If you decide to take time off after graduating from college, you can't often use all of that time for volunteering and extra coursework - you need to find a job so that you have some prayer of making your loan payments. That might not sound daunting to everyone, but I had some friends in college who had never had a job of any kind...ever. They had no idea where to look, or how to apply/interview, and almost all of them went straight into graduate school because it was the prescribed path that they were familiar with.
It's easy enough for everyone to imagine that they will be the Caribbean student who does well and matches into a US residency...the same way far too many pre-meds can easily imagine themselves settled in as a big shot in a competitive specialty. And, if you are a student who is stressed by the prospect of finding a job, and spending a year or two in limbo...I imagine that the fantasy only has more pull.
So, I don't think it's always about the time. For many people, it's about saying within the comfort zone.
It's easy enough for everyone to imagine that they will be the Caribbean student who does well and matches into a US residency...the same way far too many pre-meds can easily imagine themselves settled in as a big shot in a competitive specialty. And, if you are a student who is stressed by the prospect of finding a job, and spending a year or two in limbo...I imagine that the fantasy only has more pull.
So, I don't think it's always about the time. For many people, it's about saying within the comfort zone.
they probably don't know what else to do. You spend 4 years saying "I will be doing this and this only after graduation", and if it turns out that you can't do that, people have no idea what other options are out there. Maybe their advisers suck or maybe they just hate the idea of taking a year off. who knows
I was a little worried about getting into any school this cycle after a school that i thought was a sure thing rejected me. There's a moment of panic like what do I do now?!?!?! Fortunately, Carib schools were off my list of possibilities very quickly thanks to SDN, but not everyone is on here or does enough research.
I was a little worried about getting into any school this cycle after a school that i thought was a sure thing rejected me. There's a moment of panic like what do I do now?!?!?! Fortunately, Carib schools were off my list of possibilities very quickly thanks to SDN, but not everyone is on here or does enough research.
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cuz time is money
+1.
One can't assume that everyone that goes to an Ivy League has performed well. A sub 3.00 GPA is hard to fix with any amount of work. Also, I'm sure there are some Ivy Leaguers that will never crack a 30 on the MCAT.
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Oh I'm definitely not promoting caribbean. If I couldn't go MD for some odd reason, I'd reapply DO. If fail at that, then do something else.
However, I don't think it's naive to want to make money. A lot of the things I enjoy require a good amount of money that I don't have. My me time is unpredictable and dictated by my professors. I have the feeling that working full time (with the exception of specialties often on call blah blah I get it) provides more structured off time.
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That's a pretty impressive undergrad list....maybe I should consider sgu 🙄
Anyways, whether its right or wrong, naive or educated, the reasons will certainly vary from person to person. For people in their 30's I can see how they don't want to spend another year trying...especially if there's a chance you could be declined again as a reapplicant (that would so suck). I can see how comforting it is to have an acceptance in hand as opposed to the uncertainty (and expense) of reapplying.
Your postbac sounds nice on paper (rather, on-screen), but uncertainty is the one fear that most people can't handle.....and you never know, these people could have crazy hookups waiting for them as soon as they're back in the states!
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So you wouldn't even go carib if there was no other alternative? Sgu/ross isn't that bad!
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You do know that you have a one year grace period post graduation on repayment of your loans right? Even if you pass that, there are other options to push back repayment. If you don't have income, you can get an economic hardship deferment. If you have income but need to pay for med school apps, you can get a forbearance. You don't even need a reason to ask for a forbearance.
So because someone doesn't know how to do something, they should continue to shelter themselves? They shouldn't try to learn to be an adult before starting on a path that will offer little freedom once it's started?
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It's really a moot point for me. To me, there are a bunch of much better opportunities and it's something I really won't have to consider.
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While there is that, there is the concern that you might not make it through medical school if you pursue a lower-yield option. Most US MD/DO schools boast ~95% graduation rates, and the majority of those that leave self-select.
Many off-shore schools will prune-out a significant portion of their class to achieve their match percentages. If you wind up down there and get cut, you still owe them the tuition for the time you spent... this means you could be $200k in debt without the $100-300k/yr specialty to pay it off.
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LOL -- your time is significantly more your own than it will be in med school. Starting third year, you show up when they tell you and leave when they tell you. It can be 30 hours between when you show up in the morning and they let you leave the next day. Residency is worse -- you come in when you are scheduled to be there, rain or shine, whether healthy or sick, and if you are lucky they stay within the 80 hour weekly average requirement. They make up the schedule without asking you for much input, and if you are lucky you get the electives you want (but not necessarily when you want it), and maybe get to choose whether you want xmas vs New Years off.
Then after residency in many fields you see your hours bump up above this (not down), because you are the new guy in the practice and no longer have any 80 hour limitation protecting you and the older guys in the practice use you as the work-horse to keep them in the black. (The concept is called leverage -- the few older partners at the top make money working the young up and comers for a number of years). It will be quite a few years of "paying your dues" before you get to be the older guy in the practice benefiting from the fruits of others labors. You will be earning nice money, but certainly not getting the "me" time to spend it.
Or alternatively, you go into private solo practice and you end up working crazy hours trying to establish a practice and then even longer hours each year trying to earn as much as last year while the insurance companies slash your reimbursements year after year. (This is what is currently happening to the typical FP these days).
So I think the notion that rushing to get to med school to get "me" time is ludicrous. This might be a possibility if you were going into a cushy uber competitive field like derm, but you aren't getting there through the Caribbean. So more likely you are rushing into a path that is going to eliminate "me" time for years to come. Better to ease up, get everything right, and do what you can to give yourself that shot at a cushier specialty and maybe some "me" time down the road, rather than rush forward into a path that is going to require you to work extremely hard to pay your dues for many many years to come. That's why I was saying it's a naive notion.
If you think you are going to get through med school, residency and then sit back earning a lot of money for a fairly easy schedule in a path that's realistically attainable through the Caribbean, you need to talk to a few more young physicians (folks who have finished residency in the last couple of years).
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He meant more "me" time after med school (time with "me" and money). Mainly, I'm pretty sure you're confusing the expected value of a decision to go to SGU (which would factor in the possibility of one dropping out) with earning potential. I strongly disagree with your statement that you significantly damage your earning potential by going to SGU. Obviously, you will need to outperform your US-med-school counterpart on the boards to get the same residency (making top residencies harder to get - but honestly how many people deciding between SMP and carrib are aiming for neurosurgery/derm? thats barely in the equation IMO), but you are absolutely able to get competitive residencies if you do well on USMLE's.
The bottom line, to me, is that if one can assume he/she will perform well on board exams (perhaps based on success on SATs and MCATs), the loss of years of earning may be significant. HOWEVER, the ~200k to attend SGU as opposed to 80k at a state med school + ~40k in masters fees may swing the decision the other way. Perhaps it depends if you have the cash to pay up front. And can suck up the loss of prestige by not going to us med.
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It's a fine second chance route if attempts at remediation don't pan out. It should never be a first choice path rather than try to up your GPA or fix your credentials to get into a US school. It is a much much harder road. You will face tons of hurdles, ranging from high attrition to higher tuition to having to take more parts of the USMLE before residency application, to huge stigmas, and to lots of specialty doors virtually closed to you. It's simply not worth a year or two if that's what it would take to fix things. If it's offshore or never ever getting into a med school, then sure, it's a ray of hope when you otherwise have none. But this thread is talking about folks who jump the gun and go that route when alternatives exist.
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I don't know if your last paragraphs were in reply to me, but I already said that the carrib has nothing to do with what I'm saying. I also noted that while there may not be more personal time, it will more than likely be more structured than it is now, with money to use! This has to do with the simple nature of how working.. well.. works. Schedules and what-not. Additional time off, etc. I don't think I'd mind working for a hospital instead of a PP, either.
[this should obviously be taken to mean "as an attending".. residency really is an extension of medical EDUCATION more than it is medical WORK. Also, it should be noted that I replied tangential to the OP, which shouldn't require clarification.]
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I'm having trouble understanding your post. See my post above suggesting that you won't have much "me" time after med school. As to earning potential -- there is no specialty ceiling for the dude that goes to a US med school. However the odds of getting into one of the higher paying specialties coming from the Caribbean is very low. You basically close the door to your chances at derm, rad onc, rads, ortho, plastics, optho etc by going offshore. You are most likely to end up in FP, peds, OB, IM. Things like surgery, EM and anesthesia are longer shots. So yeah, to the extent the primary care fields pay less than the non-primary care specialties, your potential earnings are lower. On top of that, your odds of graduating, passing the boards, etc are lower. Attrition is not small and while the folks who actually do make it 4 years and graduate seem to do okay, you can't ignore that they were part of a much larger whole. That group has to be factored in because attrition in the US is negligible -- the person who spends a few years to get into a US school will graduate a doctor, the person who rushes off to Caribbean, maybe not.
Your notion that you can predict board scores or med school performance from college performance is misguided. It's a different animal, and while there is some correlation between folks who do well in undergrad and those who do well thereafter, it's hardly a direct predictor, and in fact the folks who turn things around in postbacs and SMPs tend to do fairly well. Once you are in, you are in and the slates start out clean. It's not unheard of for the person who struggled and college and squeaked into med school to find his stride and do well when he starts taking courses he cares about or is interested in. It's also not unheard of for folks who did well in college to struggle in med school once the work load increases. So you really can't make a statement like "but honestly how many people deciding between SMP and carrib are aiming for neurosurgery/derm?" In fact several of the folks I know who came the SMP route are now in top residencies -- most of the folks I know who went the offshore route never had this option. And that is sort of the point -- if you get into a US med school the door is open to anything. If you go offshore you have to be the best of the best just to have any doors open to you.
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See my above post -- I'm saying that you probably will have LESS free time as a young attending regardless of whether you work in a hospital or private practice. The young attendings are the work horses -- they have no clout and no work hour restrictions, so they often end up working more than when they were in residency. You are kidding yourself if you think you make it through residency and suddenly have "me" time. Start talking to young physicians because you aren't getting the real picture.
Sure there are some cushy specialties where you might have me time after residency, but generally you aren't in the running for those if you went offshore.
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Hey guys, yea I am from Toledo so this is my hometown med school. Also, I kinda am pretty interested in emergency medicine. Anyways, I thought it was very interesting that of the emergency medicine residents of toledo 4/8 were from carribean med schools, and another was a foreign med grad that when to the netherlands. Thats 5/8. Check it out: http://www.utoledo.edu/med/gme/em/residents.html..... i guess if you want to be a doctor. go there and kick ass. I also know a kid at St. Georges that went to Ohio State here for undergrad had a 3.8, 32 but did nothing else so he had to do carribean or take a year or so to get ECs. He ended up going to SGU he got a 274 on his step 1, and is doing rotations in saginaw michigan. We'll see where he lands a residency (he wants to do ortho, we'll see about that....)
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Finding a handful of people who did well doesn't tell you much -- if the class size at a given offshore school starts out at 500 and the graduating class is 100, and 20 end up doing something they actually were shooting for that's still lousy odds. I think the fact that so many offshore folks are ending up in toledo says something about the desirability to US grads of ending up in toledo as well. Geographic desirability is huge in residency selection.
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how about clerkships - aren't those evaluations quite important in residency applications? are caribbean med school students at that much of a disadvantage, even though they do their clerkships here?
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I totally agree and I understand the effects of sample size, but to tell you the truth, people that are very capable of becoming good doctors are turned down by schools simply because there just aren't enough spots. And, Even though this is true sometimes applicants that don't end up becoming good doctors are accepted. Admissions is not a perfect science. The real problem arises when people who really have no aptitude to be a doctor attend the offshore schools (i dunno 2.8 gpa 25 mcat and no real exposure to the field to know they have a desire)... this shows in their high drop out rate, but there are people that go because they just didnt play the US admissions game right... Also, were going to need all the help we can get from these capable carribean grads with this impending doctor shortage...
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I'm not sure if heme/onc counts as "cushy", but I shadowed a first-year attending heme/onc who had plenty of time and was part of a PP with several much older doctors. I haven't done as much shadowing as I would like, for sure, and I know an ER doc who works a whole lot. But anyway, I didn't dispute the "less raw amount of time" prediction in the first place.
Take it for what it's worth, but it's not the end of the world to sit back and do something different for a year or two before getting into medical school. I think some studies are finding that male docs are burning out in their late 30's becuase of being so gung-ho medicine their whole life and not having a chance for a true break.
I was recently driving home one Thursday night and they had an interview on with a recently retired CEO of one of the major upstream energy players. It was a smaller firm and not a shell, bp, exxon, etc. but a major player nonetheless. Basically, he had been gung-ho his entire life and if had to give himself advice when he was in college, he'd recommend taking a year off and go to Europe, or do something else before jumping into the corporate world.
Depending on what you do in medicine, it can really strip you of your identity. Sometimes you have to take a step back in order to move forward. Things not going your way is sometimes for the better.
I was recently driving home one Thursday night and they had an interview on with a recently retired CEO of one of the major upstream energy players. It was a smaller firm and not a shell, bp, exxon, etc. but a major player nonetheless. Basically, he had been gung-ho his entire life and if had to give himself advice when he was in college, he'd recommend taking a year off and go to Europe, or do something else before jumping into the corporate world.
Depending on what you do in medicine, it can really strip you of your identity. Sometimes you have to take a step back in order to move forward. Things not going your way is sometimes for the better.
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Not all loans follow that policy - my grad plus loans, for example, entered repayment 60 days after the final disbursement and I had to fight tooth and nail just so that they would suspend repayment until I entered medical school and could actually defer (I only had a 3 month gap between finishing one program and starting another...yet, still an issue). Yes, there are protections built in, but they are not always easy to get into effect
And, I'm not defending anyone who rushes into a career just because they don't know what to do in the real world. I'm just saying that it happens.
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I agree...I think MANY of the people at SGU who are recent graduates of college are just misinformed or stubborn about other options that they (SMP,postbac etc.) Many probably worked really hard in college but for one reason or another (tough major, slightly lower GPA) just weren't able to make it into a US school immediately after graduation, but probably would have gotten in within 1-2 years. I don't think these folks are the ones who have to worry about flunking out- like you said, it's those who have no aptitude and just slacked around all college expecting to get an MD abroad that will likely fail out.
But what surprises me the most is the number of people at Caribbean schools who just simply overlook the DO degree. Many of the people I know there easily could have gotten into goodDO schools, and yet still opted to go abroad...apparently the MD title is super important to some.
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For the same reason people buy lottery tickets instead of putting money into a 401k.
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Nope, unless the hospital has a no-moonlighting policy
As a student attending a caribb. school I will say this:
I understand where you are all coming from with "just take a year off and reapply", however you need to try and see things from someone else's perspective other than your own. Doing a SMP or taking time to boost scores/grades etc doesn't guarantee admission into a medical school. I know of students who did this and didn't get into a med school and lost two years of time and are now in debt. I think the important thing is to look at what kind of student you are. If you barely passed undergrad, got an abysmal mcat score, and you live in fantasy world of "im going to attend a caribb. med school, sit on the beach, and become a dermatologist" you will fail out in a second. A LOT of students who attend caribb. schools unfortunately have this mentality, and thus, fail out. I personally have always said that I would like to be a hospitalist (primary care) so when I looked at the sgu match list and saw a majority of them went into im or fp i wasn't deterred. I did well in undergrad and not so well on my mcat but have always been a hardworking and bright student so deciding to go to the caribb. was ok because I knew that if I put in the work I would be ok. You could make the argument that I should have done a SMP or taken a year or two off but time and money are of concern to me.
You need to understand that not everyone shares you goal of being a neurosurgeon at a top program or going into a competitive residency. If you want to go into these competitive fields then yes, dont go to caribbean. Reading a lot of your posts, I can tell that a lot of you dont know a lot about caribb. school yet make comments like you know what your taking about. There are MANY caribb school, there only to take your money. There is what as known as the BIG 4 schools that have a long standing reputation of putting students into US residencies (some competivive). Looking at attrition rate percentages are misleading in some regards as better school like sgu and ross are lumped with a med school that opened two years ago taking anyone with a check regardless of mcat, gpa, etc. If you are willing to work then going to caribb isn't a bad SECOND option. (Notice I said second)
I understand where you are all coming from with "just take a year off and reapply", however you need to try and see things from someone else's perspective other than your own. Doing a SMP or taking time to boost scores/grades etc doesn't guarantee admission into a medical school. I know of students who did this and didn't get into a med school and lost two years of time and are now in debt. I think the important thing is to look at what kind of student you are. If you barely passed undergrad, got an abysmal mcat score, and you live in fantasy world of "im going to attend a caribb. med school, sit on the beach, and become a dermatologist" you will fail out in a second. A LOT of students who attend caribb. schools unfortunately have this mentality, and thus, fail out. I personally have always said that I would like to be a hospitalist (primary care) so when I looked at the sgu match list and saw a majority of them went into im or fp i wasn't deterred. I did well in undergrad and not so well on my mcat but have always been a hardworking and bright student so deciding to go to the caribb. was ok because I knew that if I put in the work I would be ok. You could make the argument that I should have done a SMP or taken a year or two off but time and money are of concern to me.
You need to understand that not everyone shares you goal of being a neurosurgeon at a top program or going into a competitive residency. If you want to go into these competitive fields then yes, dont go to caribbean. Reading a lot of your posts, I can tell that a lot of you dont know a lot about caribb. school yet make comments like you know what your taking about. There are MANY caribb school, there only to take your money. There is what as known as the BIG 4 schools that have a long standing reputation of putting students into US residencies (some competivive). Looking at attrition rate percentages are misleading in some regards as better school like sgu and ross are lumped with a med school that opened two years ago taking anyone with a check regardless of mcat, gpa, etc. If you are willing to work then going to caribb isn't a bad SECOND option. (Notice I said second)
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Yeah but 5/8 in one department of one hospital...that's pretty good news if you're a carib student!
- Joined
- Feb 7, 2009
- Messages
- 395
- Reaction score
- 1
This is huge concern for me in the event that I don't get in this cycle....it sounds easy enough to just go out and get a better mcat score, better gpa, more ec's....but aren't the chances for a reapplicant far lower than a first year applicant? And if your chances are even less, and you don't get in the second year, that's two years that are just gone 😱. This isn't a statement of fact, it's just me thinking aloud to myself...not sure what I'm going to do if I don't get in this cycle (but I feel pretty good 😀).
I have read posts on this site where an applicant turns down an acceptance to sgu to try and reapply at US schools but ends up not getting in the second time...then they reapply to sgu and get in, but they're taking first semester classes when they could've been starting clinicals.
- Joined
- Aug 22, 2005
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- 776
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I didn't get into med school the first time applied. Not that big of a deal. I spent the next few years traveling all over europe, south america, and asia. Wouldn't trade those experiences for anything. I also got a job and paid off tons of undergrad student loan debt. My group at work also published several articles on our research. It was quite fascinating stuff. All in all, i'd say not getting into med school the first time was a blessing in disguise.
- Joined
- Oct 8, 2007
- Messages
- 602
- Reaction score
- 5
Out of curiosity I wonder what kind of services are available to caribbean students. Do they have things like academic counseling, psychological services, etc.?
- Joined
- Feb 17, 2008
- Messages
- 550
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- 270
I think most people would concede that.
