I don't understand this risk assesment some people have. Sure, if you do an SMP you may drop another 40K, and if you apply two more cycles you still might not get in and drop another 5K. But if you go to a caribbean school, you may drop 200+K and flunk out, and then you are completely screwed. It's not uncommon to have 30-50% of first-year med students failing out. Considering SGU is the best of the best and still only 80% match into US residencies, it seems like doing an SMP/the lost income of 1-2 years is a far lesser risk than going to caribbean.