Why is the Caribbean a bad decision?

[scocoh19]

Depending on how this application cycle goes, I'm considering applying to either St. George or AUC. I hear from a lot of people that going to the Caribbean is a horrible decision, but I'm wondering if that's just a bunch of pre-med MD gunners that really have no idea what it's actually like. I've done some research on those schools and they both have high board passing rates, high average board scores, and match to a lot of competitive residencies (General Surgery, Anesthesia, Peds...). Can someone who actually knows about either of those schools explain any disadvantages of going that route?

Thanks!

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[Mike MD]

Depending on how this application cycle goes, I'm considering applying to either St. George or AUC. I hear from a lot of people that going to the Caribbean is a horrible decision, but I'm wondering if that's just a bunch of pre-med MD gunners that really have no idea what it's actually like. I've done some research on those schools and they both have high board passing rates, high average board scores, and match to a lot of competitive residencies (General Surgery, Anesthesia, Peds...). Can someone who actually knows about either of those schools explain any disadvantages of going that route?

Thanks!

I was actually wondering the same thing myself. Like you, I've always given serious consideration to Caribbean schools but encountered a similar stigma. I know of an individual that even attended St. George's and does not endorse the idea of following the same path. His concern seemed to mostly be centered around the lack of financial assistance/aid offered by the government, which is a legitimate gripe for most students. However, aside from this issue, he had no other qualms with the program. In any case, this taboo of Caribbean schools seems so peculiar to me.

By the way, are you applying exclusively for the Grenada program or also applying to the St.George's program that splits your time between Nicosia and London?

 

[Medstart108]

I was actually wondering the same thing myself. Like you, I've always given serious consideration to Caribbean schools but encountered a similar stigma. I know of an individual that even attended St. George's and does not endorse the idea of following the same path. His concern seemed to mostly be centered around the lack of financial assistance/aid offered by the government, which is a legitimate gripe for most students. However, aside from this issue, he had no other qualms with the program. In any case, this taboo of Caribbean schools seems so peculiar to me.

By the way, are you applying exclusively for the Grenada program or also applying to the St.George's program that splits your time between Nicosia and London?

Thats a different St Georges, SGUL. Its a British school. You can look it up http://en.wikipedia.org/wiki/St_George's,_University_of_London

They share a similar name but are different.

 

[Skip Intro]

Depending on how this application cycle goes, I'm considering applying to either St. George or AUC. I hear from a lot of people that going to the Caribbean is a horrible decision, but I'm wondering if that's just a bunch of pre-med MD gunners that really have no idea what it's actually like. I've done some research on those schools and they both have high board passing rates, high average board scores, and match to a lot of competitive residencies (General Surgery, Anesthesia, Peds...). Can someone who actually knows about either of those schools explain any disadvantages of going that route?

Thanks!

This is what most Carib grads track into...

Family Practice, Internal Medicine, Peds, Psych: relatively wide open.

Anesthesiology, preliminary Surgery, Emergency Medicine, OB/Gyn: more competitive.

ENT, Plastics, Neurosurgery, Orthopedics, Categorical Surgery: forget it.

So, it depends on what you want to do in the end. You go, you do well, and don't have any major setbacks, you should get something somewhere.

Once you're past the pre-med hype, no one cares. I've been out practicing in private practice for four years and it's not even remotely an issue.

-Skip

 

[Sportfreund]

I'm finding that when I speak to Caribbean students, not being able to get a residency is a myth however it is true that getting a GOOD residency is tough.

Tbh though if you wanna be a doctor at the end of the day and don't care about titles but just about doing a job you want then you'll do your residency anywhere for a couple years in order to get there. If you try to be picky and wait only to get a great residency then of course you're gonna have problems matching

 

[wolfvgang22]

Depending on how this application cycle goes, I'm considering applying to either St. George or AUC. I hear from a lot of people that going to the Caribbean is a horrible decision, but I'm wondering if that's just a bunch of pre-med MD gunners that really have no idea what it's actually like. I've done some research on those schools and they both have high board passing rates, high average board scores, and match to a lot of competitive residencies (General Surgery, Anesthesia, Peds...). Can someone who actually knows about either of those schools explain any disadvantages of going that route?

Thanks!

If you work hard you can do well, particularly if you are a U.S. citizen. These caribbean schools are academically good: St. George, AUC, Saba, Ross, St. Matthews. I went to Saba.

That said, I graduated almost 4 1/2 years ago with a 98 on both USMLE step 1 and 2. Since then, U.S. MD and DO schools have expanded and added a lot of seats, making it more difficult to get a good residency in the U.S., because U.S. students are now matching into those jobs that IMGs used to fill. Residency spots are not going to increase.

If you are a good enough and determined enough student to make it at the St. Georges or AUC, you ought to seriously do anything you can to get into any U.S. school that has expanded. I am not saying this as some U.S. med school student elitist - I am a Caribbean grad that was told 4 years ago not to go Caribbean. They were wrong then, they aren't now. (A broken clock is eventually right twice a day.)

It doesn't matter if you do U.S. DO or U.S. MD. Ignore anyone who says it matters - if you are even considering going Caribbean it shouldn't matter to you, as both are better than being an IMG for the purpose of Matching into residency.

I don't at all regret going to Saba, and at that time it was a good choice. It was a solid education that only hurt me with a few programs matching into Psychiatry (Tufts, for example). In today's climate, I would not choose going the IMG route again. I would move to a U.S. state with easier admissions criteria / more class seats and work there for a year just to establish residency to apply to their DO or MD med school.

 

[Skip Intro]

If you work hard you can do well, particularly if you are a U.S. citizen. These caribbean schools are academically good: St. George, AUC, Saba, Ross, St. Matthews. I went to Saba.

That said, I graduated almost 4 1/2 years ago with a 98 on both USMLE step 1 and 2. Since then, U.S. MD and DO schools have expanded and added a lot of seats, making it more difficult to get a good residency in the U.S., because U.S. students are now matching into those jobs that IMGs used to fill. Residency spots are not going to increase.

If you are a good enough and determined enough student to make it at the St. Georges or AUC, you ought to seriously do anything you can to get into any U.S. school that has expanded. I am not saying this as some U.S. med school student elitist - I am a Caribbean grad that was told 4 years ago not to go Caribbean. They were wrong then, they aren't now. (A broken clock is eventually right twice a day.)

It doesn't matter if you do U.S. DO or U.S. MD. Ignore anyone who says it matters - if you are even considering going Caribbean it shouldn't matter to you, as both are better than being an IMG for the purpose of Matching into residency.

I don't at all regret going to Saba, and at that time it was a good choice. It was a solid education that only hurt me with a few programs matching into Psychiatry (Tufts, for example). In today's climate, I would not choose going the IMG route again. I would move to a U.S. state with easier admissions criteria / more class seats and work there for a year just to establish residency to apply to their DO or MD med school.

Be careful with St. Matthews. They are not recognized for full, unrestricted licensure in several states.

-Skip

 

[wolfvgang22]

Be careful with St. Matthews. They are not recognized for full, unrestricted licensure in several states.

-Skip

True. I threw St. Matthews in there because they are owned by the same parent company as Saba, so quality control is probably good. Also I've worked with residents that graduated from there that I felt were good colleagues. I'm probably biased.
Goes to show that it is very important for an individual to spend a lot of time doing due diligence if considering off-shore medical schools in particular. I spent the better part of a year investigating med school options before I even applied anywhere.

 

[Skip Intro]

I spent the better part of a year investigating med school options before I even applied anywhere.

Good advice.

As for St. Matthews, I'm not sure exactly what the issue was with those particular medical boards. However, I vacationed in Grand Cayman recently and just happened to drive by their "campus"... which was in a building buried among many other businesses in an office park across the street from the Westin.

Not sure if this is part of the problem. There's probably more to it.

-Skip

 

[bedevilled ben]

If you are a good enough and determined enough student to make it at the St. Georges or AUC, you ought to seriously do anything you can to get into any U.S. school that has expanded. I am not saying this as some U.S. med school student elitist - I am a Caribbean grad that was told 4 years ago not to go Caribbean. They were wrong then, they aren't now. (A broken clock is eventually right twice a day.)

This is really what it all comes down to, and I say that as a current MS2 at SGU. For me, SGU was the best of a number of mediocre options, so this is what I chose. I don't regret doing it, and I'm fairly confident I'll be able to make it work because of my academic performance, preferred program, and CV. I do, however, get the impression that the tide is turning against IMGs. I don't think it will happen overnight, but I suspect that if things continue as they are, Caribbean schools will essentially be forcing their graduates into Family, Internal, or Peds by default.

 

[Skip Intro]

This is really what it all comes down to, and I say that as a current MS2 at SGU. For me, SGU was the best of a number of mediocre options, so this is what I chose. I don't regret doing it, and I'm fairly confident I'll be able to make it work because of my academic performance, preferred program, and CV. I do, however, get the impression that the tide is turning against IMGs. I don't think it will happen overnight, but I suspect that if things continue as they are, Caribbean schools will essentially be forcing their graduates into Family, Internal, or Peds by default.

First, the "tide turning" may or may not be wholly true. As I stated before, the fact that more U.S. spots in medical school are opening for U.S. undergraduates means that those who were forced to go to the Caribbean because they barely didn't get into a U.S. school will now have a shot at a U.S. spot. Good for students; bad for Caribbean schools.

As far as being "forced" to go into primary care, I think that this is the sole reason why there will always be more ACGME spots available than there are people to fill them. It will never be a 1:1 situation. The fact is that, yes, there is a hierarchy. There always has been. Those pretty-girl programs can choose who they want to date. But, there will always be the ugly little sister out there. If you look like Lurch, don't expect to date Heidi Klum.

But, there is an excess of spots to provide choice for those graduating seniors from U.S. schools so they're not "forced" into any program. Fact is, no one wants a resident who's going to be unhappy.

Furthermore, the programs have a distinct advantage over the applicants. I saw this in residency. They have a long track record of knowing exactly the type and caliber of med school graduate who is (a) interested in their program and (b) likely to come there. A good, but rural, program is just not going to get the Harvard/Duke/Hopkins grads going there unless by some fluke the person who went to med school there finds that same program, for instance, in their home town where they've always planned to return. On the whole, however, those stud GME candidates skip those ugly little sister programs on the interview trail.

But, there are some great programs in big cities that will offer you great training... despite being "less desirable" places to train. And, in the end, all you will need is a certificate that you completed an ABMS-certified program and ultimately to be board-certified. That's all that's really going to matter when you've completed this journey.

-Skip

 

[bedevilled ben]

My "tide turning" comment isn't just in regard to ACGME spots, though. The rapidly-inflating tuition bubble has turned new attention on for-profit schools, both in and out of the US. Seeing students as dollar-signs has led to aggressive & questionable recruiting practices. At SGU alone, our entering class size has increased by 20% just in the 18 months I've been here. The impending sale of SGU has also encouraged negative press lately. There are currently 6 US medical schools that allow Caribbean students to transfer, whereas fifteen years ago there were over 20.

I hope you're right, Skip. I hope my pessimism is a result of being in the middle of the program and being unable to see the forest for the trees. I know that a lot of my colleagues are going to be excellent physicians, but I also know a handful that I wouldn't let polish my shoes, let alone practice medicine. However, since we all made it through the program, we're all going through clinicals side by side. I guess that's nothing new, though.

 

[laricb]

My "tide turning" comment isn't just in regard to ACGME spots, though. The rapidly-inflating tuition bubble has turned new attention on for-profit schools, both in and out of the US. Seeing students as dollar-signs has led to aggressive & questionable recruiting practices. At SGU alone, our entering class size has increased by 20% just in the 18 months I've been here. The impending sale of SGU has also encouraged negative press lately. There are currently 6 US medical schools that allow Caribbean students to transfer, whereas fifteen years ago there were over 20.

I hope you're right, Skip. I hope my pessimism is a result of being in the middle of the program and being unable to see the forest for the trees. I know that a lot of my colleagues are going to be excellent physicians, but I also know a handful that I wouldn't let polish my shoes, let alone practice medicine. However, since we all made it through the program, we're all going through clinicals side by side. I guess that's nothing new, though.

The bottom line the best students will always rise to the top. You just might have to work a little harder.....

 

[OneGamecock]

I will proably have to go the Carribean route since I was not a great student. I am not a traditional student, work 60-70hours a week ay my job and trying to hold a good GPA. My previous college work was average at best so I am playing catch up very late in the game. I also don't have the life left to put in for cardiologist or such long medical specialties. I do have one advantage of paying cash for my education now but I that is about all.

 

[Instatewaiter]

Reasons why the carribean is a bad idea:
1)Attrition- one thing they don't tell you is that a lot of the students who start, never finish. So you might move to an island, spend hundreds of thousands of dollars and have no diploma to speak of.

2) Skewing statistics- this ranges from preventing some students from taking step 1 to only including certain parts of students into their statistics. Regardless, there is a lot of funny stuff with their statistics

3) High fail rate- this plays into the attrition. A lot of students fail out of school and lots fail step 1.

4) Poor match rate

5) More pressure in the match now that there are more US students.

Avoid the carribean at all costs if you can.

 

[laricb]

Good analogy, SGU has put more doctors into US residency in the last 3 yrs then any other school in the world

 

[laricb]

I will proably have to go the Carribean route since I was not a great student. I am not a traditional student, work 60-70hours a week ay my job and trying to hold a good GPA. My previous college work was average at best so I am playing catch up very late in the game. I also don't have the life left to put in for cardiologist or such long medical specialties. I do have one advantage of paying cash for my education now but I that is about all.

If you're not a good student don't waste your money. Med school in the Carib might be more friendly then the US schools for entry, but the training is hard, much harder then the US, because they need to keep there USMLE scores high....

 

[Bathrover]

Does anyone know how the grading scheme in the Carib schools works? Is it graded on a curve against the other students or do they fail out the bottom percentage of students or is it a numerical score you get for each course?

The way I see it is that a lot of US medical students start straight off by studying for the boards alone using First Aid so I don't see why the same student can't learn just as much in the Carib even though they will end up with a less selective residency later on. If someone wants to match in neurosurgery or derm then they should have went US however most of the new US schools that are opening are aimed at graduating specifically PCPs in peds or FP so I don't see that great of an advantage to passing at the bottom of the class in a low tier US school versus top of the class in the Carib.

 

[Beargryllz]

And if you're good enough to succeed in a Caribbean program and make it to residency in the US, you're good enough to succeed at a US allopathic/osteopathic program so take the effort to matriculate into a US program.

I'm definitely good enough, but without an acceptance to a U.S. program this doesn't really help me. I need to start taking those medical courses sooner rather than later to keep my clinical skills up

 

[Skip Intro]

Good analogy, SGU has put more doctors into US residency in the last 3 yrs then any other school in the world

No. Ross has topped this.

In the past year, Ross University School of Medicine placed roughly 600 physicians in US residencies--more than any other medical school in the world. In addition, we are continually adding new teaching hospitals to our list of affiliates.

http://www.rossu.edu/medical-school/About-Ross-University-School-of-Medicine.cfm

And, this has been true for a while. Not just the past three years.

-Skip

 

[laricb]

No. Ross has topped this.



http://www.rossu.edu/medical-school/About-Ross-University-School-of-Medicine.cfm

And, this has been true for a while. Not just the past three years.

-Skip

Competition is good

 

[darklabel]

Well, there's also the matter that a lot of people entering these programs aren't exactly capable of medical school. People who have low stats and MCAT scores will just magically become better than their US counterparts, even though the people they're competing with "beat" them in entering a USMD school. Very few people successfully pull a 180 in their study habits and start doing exceedingly well after years of mediocrity/poor study habits.

However, if your goal is just being a physician and you score average on the USMLE, I'm sure you can get a primary care position as long as location isn't an issue. Saying you'll score amazing on the USMLE is easier said than done because I'm sure most of us have said the same about the MCAT 🙄.

 

[Mad Jack]

Last year there were 12,663 foreign grads in the match, out of a total of 34,355 applicants. The number of US MD and DO graduates will significantly increase in the next few years, while the number of GME positions will remain relatively static. There should be 26,000 graduating U.S. students (DO and MD) in 2018, of which at -least- 22,000 will participate in the match, which has a total of 25,073 non-preliminary positions (there are about 4,000 more total positions between the SF match, military match, and AOA match that foreign grads are basically inelligible or completely uncompetitive for). Subtract the best case scenario of 22,000 from 25,000 and you end up with one residency position for every four foreign grads, poor odds indeed, and likely in uncompetitive specialties and remote locations. The number of foreign grads is exploding, however, so your odds will probably be worse. You might be saddled with 300-400k in debt with a match chance of around 20% and no way short of death to have your student loans forgiven.

I don't have a problem with Caribbean schools, but the math really doesn't support attending one at the moment. There would have to be an explosion of new residency positions (5,000 or more per match, which will likely never happen) to make the numbers look good for Carrib grads in 2018 and beyond.

 

[Skip Intro]

The number of US MD and DO graduates will significantly increase in the next few years, while the number of GME positions will remain relatively static.

Please cite a credible, verifiable source for this specific information, because you apparently know something that even the ACGME doesn't know.

In the meantime, I've discussed this previously and broken down the numbers. You can catch-up by starting to read here:

http://forums.studentdoctor.net/threads/really-lost-need-advice.981187/#post-13848849

-Skip

 

[Mad Jack]

Please cite a credible, verifiable source for this specific information, because you apparently know something that even the ACGME doesn't know.

In the meantime, I've discussed this previously and broken down the numbers. You can catch-up by starting to read here:

http://forums.studentdoctor.net/threads/really-lost-need-advice.981187/#post-13848849

-Skip

The only reason for the large jump in GME positions this year was the implementation of the "all-in" policy. It used to be you could prematch as an IMG or DO. This removed positions from the match, a situation that the NRMP felt was unfair to match participants. Thus they implemented the all-in policy, in which, for your program to participate in the match, ALL of your positions must be in the match. This resulted in almost 2,000 positions being added to the match, and made it appear as if IMGs were matching at a higher percentage than in prior years. However, of the nearly two thousand positions added via the all-in policy, the vast majority used to go to IMGs. The end result is that even though the NRMP match rate is higher, foreign graduates actually received less residency placements overall (as many of their residency placements were achieved outside of the match in prior years and thus not shown on the NRMP match results). And by relatively static, I meant <1% growth, which was what we saw in the three years prior to the all-in policy. 1% growth per year for four years would lead to an additional 1,015 total positions, still not great odds for the ever-increasing pool of IMGs.

http://www.nejm.org/doi/full/10.1056/NEJMp1306445

The above post shows that, since the cap, 2001-20010 GME growth was a paltry 0.9% on average per year.

http://studentdoctor.net/2013/05/residency-match-2013-was-it-really-that-bad/

Above is a post by SDN that explains why FMGs and USIMGs appeared to do better in the match, though the reality is they likely fared worse overall without the prematch.

Let me also state that I have nothing against Carrib grads. I actually likely would have studied medicine abroad rather than in the States if the match weren't looking so dismal in a few years, as travel and experiencing other cultures is my passion in life, and there are some excellent programs abroad that are far more reasonably priced than those in the USA. I crunched the numbers dozens of times, even in the best scenarios I would have a 50% shot at matching. And those were -really- solid scenarios.

Ross and SGU grads will likely fare better than USIMGs as a whole, but will still be looking at a far greater chance of not matching than today, in addition to holding hundreds of thousands of dollars in debt.

 

[laricb]

The only reason for the large jump in GME positions this year was the implementation of the "all-in" policy. It used to be you could prematch as an IMG or DO. This removed positions from the match, a situation that the NRMP felt was unfair to match participants. Thus they implemented the all-in policy, in which, for your program to participate in the match, ALL of your positions must be in the match. This resulted in almost 2,000 positions being added to the match, and made it appear as if IMGs were matching at a higher percentage than in prior years. However, of the nearly two thousand positions added via the all-in policy, the vast majority used to go to IMGs. The end result is that even though the NRMP match rate is higher, foreign graduates actually received less residency placements overall (as many of their residency placements were achieved outside of the match in prior years and thus not shown on the NRMP match results). And by relatively static, I meant <1% growth, which was what we saw in the three years prior to the all-in policy. 1% growth per year for four years would lead to an additional 1,015 total positions, still not great odds for the ever-increasing pool of IMGs.

http://www.nejm.org/doi/full/10.1056/NEJMp1306445

The above post shows that, since the cap, 2001-20010 GME growth was a paltry 0.9% on average per year.

http://studentdoctor.net/2013/05/residency-match-2013-was-it-really-that-bad/

Above is a post by SDN that explains why FMGs and USIMGs appeared to do better in the match, though the reality is they likely fared worse overall without the prematch.

Let me also state that I have nothing against Carrib grads. I actually likely would have studied medicine abroad rather than in the States if the match weren't looking so dismal in a few years, as travel and experiencing other cultures is my passion in life, and there are some excellent programs abroad that are far more reasonably priced than those in the USA. I crunched the numbers dozens of times, even in the best scenarios I would have a 50% shot at matching. And those were -really- solid scenarios.

Ross and SGU grads will likely fare better than USIMGs as a whole, but will still be looking at a far greater chance of not matching than today, in addition to holding hundreds of thousands of dollars in debt.

We don't need anymore negative spin on guys who went DO and now hate the carib route, keep in mind that a DO Graduate is the first to feel the sting after USIMG'S, so you better get good grades or you'll be in the same boat...Also do me and others a favor. Go post on SDN's DO site instead of here, we all envy you because you were excepted to a DO program.

 

[Mad Jack]

We don't need anymore negative spin,s on guys who went DO and now hate the carib route, keep in mind that A DO Graduate is the first to feel the sting after USIMG'S so you better get good grades or you'll be in the same boat...Also do me and others a favor go post on SDN's DO site instead of here, we are all so jealous that you got excepted to a DO program.

Spin? Dude, I'm just throwing out the facts. I don't hate the Caribbean route by any means, I'm just stating the numbers. They don't look good over the next few years. And that is aside from the hit Carrib grads already took in competitive residency placement.

I don't know if many Carrib grads realize just how screwed they are if they don't match. Having 400k in impossible to discharge debt with no commiserate increase in income is absolutely life destroying. There is a 50-75% chance you will not match if you start a program this year if there is not a massive shift in GME policy. That's a huge risk. I'm just making sure that the OP is aware of this.

And yes, DOs will take a hit next. Might take 5 years, might take 10, but if the pace of new schools opening continues, unmatched domestic students will become commonplace. If the COCA upholds their certification requirements, this will hopefully result in the closure of excess DO schools, as the COCA requires greater than 98% GME placement. Shouldn't be a huge issue for current students, but I feel bad for kids entering DO schools in a decade or so.

 

[Doormat]

The previous poster is entirely correct about the math behind the cap in US residency spots.

Since 1997, the number of US residency spots funded by CMS was capped. No more federal dollars have since become available to increase the overall number of funded slots.

A recent (2013) New England Journal of Medicine article spells out this entire workforce dilemma in a superb article entitled "The residency mismatch."
It's available free online. Just type in"The residency mismatch" into google.

Spending hundreds of thousands in educational debt that can never, ever be discharged to attend a carib med school is a terrible idea. The outlook is grim. It's simple math.

 

[Skip Intro]

The only reason for the large jump in GME positions this year was the implementation of the "all-in" policy.

Uggh... not again. Please read and try to understand the thread I already referenced. This has nothing to do with the "all-in" policy. You are way off. I'm not even going to respond the the rest of the alarmism that follows.

-Skip

 

[Skip Intro]

The previous poster is entirely correct about the math behind the cap in US residency spots.

Since 1997, the number of US residency spots funded by CMS was capped. No more federal dollars have since become available to increase the overall number of funded slots.

A recent (2013) New England Journal of Medicine article spells out this entire workforce dilemma in a superb article entitled "The residency mismatch."
It's available free online. Just type in"The residency mismatch" into google.

Spending hundreds of thousands in educational debt that can never, ever be discharged to attend a carib med school is a terrible idea. The outlook is grim. It's simple math.

Doormat,

You are just spreading rumor and misinformation like everyone else. Please re-read the post I referenced above.

In the meantime, the same arguments have been made for the past thirty years, namely how there will be a surplus of doctors, training mismatch, etc., etc., ad nauseum. None of those dire predictions, and that's all they are, have come true. In fact, the reverse has proven true. There is a shortage of doctors. And, the fact is that the number of residency spots increased... not held the same... not decreased. The percentage that are funded vs. unfunded doesn't matter. There are enough spots and will be for the foreseeable future.

Stop telling people the sky is falling. Re-read my previous post. It contains a lot of good factual information.

-Skip

 

[Mad Jack]

My post also contained a good amount of factual information. Ten years of it in fact, showing 0.9% GME growth per year, aside from the year the all-in policy was implemented, which was not true residency growth, but rather an increase of positions in the match due to positions that were previously in existence but not in the match being included. In 2012, 25,321 students matriculated to U.S. MD and DO programs, and by 2017, there are projected to be 28,109 first-year MD and DO students that begin medical school in the U.S. In 2013, per the NRMP, there were 25,463 full positions in the main residency match. I read your prior post, and simply disagree with it. I mean, I know I'm using an absolute B.S. source, some no-name journal that goes by The New England Journal of Medicine, as my source, so I'll cut you some slack for not believing me. Yes, there is a physician shortage. Yes, there should be more residency positions. But the fact is, right now, there aren't. We can graduate as many doctors as we want, but if they can't find training, it doesn't do us any good. If any of you can provide hard, factual evidence that this is not the case, and can back it up with solid sources, I'll gladly concede defeat on the matter.

http://www.nejm.org/doi/full/10.1056/NEJMp1306445

Referenced again for your reading pleasure.

 

[prefontaine]

Mad Jack, you have it right, they just do not like the truth.

 

[DocBlin]

I have to agree with "Mad Jack"!!! I am involved directly and indirectly with two FM programs, one MD one DO. It is a numbers game, pure and simple. Too many US-MD/DO/US-IMG's graduating to fill the "available" residency spots. Over the last 3 years the applicants to these two programs I speak of have been more weighted to the US graduating side vs the IMG side. Specific numbers mean little but the general trend is present and real. If any of you plan on entering a med school, please use all means to stay in US. ONLY and I say only as a last resort chose a foreign i.e. caribbean school. And of the Caribbean schools only the "big 4"..

 

[laricb]

I have to agree with "Mad Jack"!!! I am involved directly and indirectly with two FM programs, one MD one DO. It is a numbers game, pure and simple. Too many US-MD/DO/US-IMG's graduating to fill the "available" residency spots. Over the last 3 years the applicants to these two programs I speak of have been more weighted to the US graduating side vs the IMG side. Specific numbers mean little but the general trend is present and real. If any of you plan on entering a med school, please use all means to stay in US. ONLY and I say only as a last resort chose a foreign i.e. caribbean school. And of the Caribbean schools only the "big 4"..

You guys make me laugh I have a friend who isnt even a US citizen and he had 36 interviews this yr

 

[Skip Intro]

I mean, I know I'm using an absolute B.S. source, some no-name journal that goes by The New England Journal of Medicine, as my source, so I'll cut you some slack for not believing me. Yes, there is a physician shortage. Yes, there should be more residency positions.

Go directly to the NRMP and the ACGME websites. That's the actual data. Not an opinion piece in the NEJM based on what might happen.

I'm not going to reference it for you again.

-Skip

 

[Skip Intro]

You guys make me laugh I have a friend who isnt even a US citizen and he had 36 interviews this yr

Good thing it was this year. Because, in four years that number is going to be zero. The NEJM is never wrong.

-Skip

 

[prefontaine]

I have interviewed many non-US citizens this year that have had 20+ interviews...however, they are all attending US, Canadian or Puerto Rican medical schools.

You guys make me laugh I have a friend who isnt even a US citizen and he had 36 interviews this yr

 

[laricb]

I have interviewed many non-US citizens this year that have had 20+ interviews...however, they are all attending US, Canadian or Puerto Rican medical schools.

My friend attended SGU

 

[Skip Intro]

Actually, I have a little time... and I'll help you with your reading comprehension from that NEJM, throwing in my own analysis when appropriate.

Quoted from your source, a "Perspective" article (i.e., an opinion piece and not a study) in the NEJM:

Now, entering [U.S. MD-granting] classes are projected to reach 21,434 students by the 2016–2017 academic year, almost a 30% increase over 2002 [sic].

http://www.nejm.org/doi/full/10.1056/NEJMp1306445

That means that the 2021 graduating class of traditional MD-granting schools in the U.S. will have only 21,434 students vying for match positions.

Colleges of osteopathic medicine have been growing for the past 20 years, doubling in number from 15 to 30 and increasing enrollments from 6892 students in 1990 to 21,743 in 2012.

http://www.nejm.org/doi/full/10.1056/NEJMp1306445

Wrong and misleading as written! There are not 21,743 students per class starting in 2012. There were 20,633 total students in all levels of training across all schools in 2011-2012, i.e. MS1-4. So, not exactly sure how he referenced his numbers.

In 2011-12, first-year enrollment rose by 7 percent, to 5,788 students.

http://www.aacom.org/data/Documents/Trends-apps-enroll-grads.pdf

So, that means in 2016 that will be 5,788 osteopathy student graduates added to the mix, not 21,743, of independent applicants in the NRMP (that's what they consider them, just like US-IMGs).

Let's look at the projected number of U.S. allopathic (i.e. MD-granting) applicants in 2016.

Table 1: Summary of Baseline and Current First-Year Enrollment, and Projected First-Year Enrollment through 2017

2012 First Year Enrollment: 19,517 (page 6)

https://members.aamc.org/eweb/upload/12-237 EnrollmSurvey2013.pdf

So, in the 2016 graduating (and thus Matching) class, there will be U.S. MD + U.S. DO a total of 25,305 graduates alone from these two groups vying for residency via the Match. This is still far less than the total number of spots available even this past year's (2013) Match cycle.

Now, forget the NRMP all-in nonsense for a minute, and let's look at the growth trend of the total number of ACGME spots to 2013:

Number of Residents, by Academic Year (page 13)
2010-2011: 113,142
2011-2012: 115,293
2012-2013: 117,717

https://www.acgme.org/acgmeweb/Port...s/2012-2013_ACGME_DATABOOK_DOCUMENT_Final.pdf

So, over the past three cycles, the total number of spots has increased at a rate of 1.9% and 2.1% per year respectively. So, let's call that two percent growth per year (and this has been more or less consistent over the past ten years).

That means we should expect a similar number in growth of first-year spots. So, extrapolating this, we would expect by 2016 that there would be growth of the total spots (i.e., across all training levels) to reach about 124,922 spots or 7,205 additional physicians in GME training programs - and that is if nothing else is done. Even with a giant injection of U.S. medical graduates, there is no reason to believe that training programs won't adjust their numbers up.

However, the bottom line - as I've said before numerous times - is that the overall growth of U.S. medical schools and expansion of U.S. osteopathy schools is good for applicants and bad for Caribbean schools. This means there are more spots for near misses rather than ever before for people who otherwise should've gotten into a U.S. medical school but had to go Caribbean. How is this a bad thing for the student?

You guys are living in the now. That's your problem. And, this alarmist propaganda piece written in the NEJM is nothing to worry about because the problem will take care of itself.

Yes, if you decide to enroll in a Caribbean school starting in 2016, you might want to make sure that you've exhausted all possibility of getting into a U.S. school first (which will be much easier then than it is now because there will be a lot more spots). But, until then, you've got little to worry about. Don't let anyone scare you away from your dream. Just be smart, work hard, and you'll do fine. And, you should expect the numbers of spots to continue to adjust upwards in the meantime, despite what the NEJM opinion piece says.

-Skip

 

[Skip Intro]

Happy New Year, and let me frame this point slightly differently...

Yes, if you decide to enroll in a Caribbean school starting in 2016, you might want to make sure that you've exhausted all possibility of getting into a U.S. school first (which will be much easier then than it is now because there will be a lot more spots).

First year enrollment in 2012 at U.S. MD-granting schools was 19,517. By the 2017 entering class, that is projected to grow to 21,434. That is, over five years, an increase of 1,917 spots.

Now, where do you think those students are going to come from?

I'll tell you: it will be the "close call" U.S. pre-med graduate who, as of right now, barely didn't get into U.S. MD program. The only ones who will get hurt are Osteopathic and Caribbean medical programs that have relied on those "near misses" to fill their programs. But, there will still be spots available even if one chooses an "alternative" pathway. As far as GME, you will see less "true" IMGs coming to the U.S. to do residency and get licensed, a cohort that currently makes up about 25% of the practicing physician workforce in the U.S.

Nowhere have I ever argued that it won't get more competitive. But, gone? No.

This NEJM article misses the target. This "problem" will take care of itself.

-Skip

 

[Mad Jack]

Happy New Year, and let me frame this point slightly differently...



First year enrollment in 2012 at U.S. MD-granting schools was 19,517. By the 2017 entering class, that is projected to grow to 21,434. That is, over five years, an increase of 1,917 spots.

Now, where do you think those students are going to come from?

I'll tell you: it will be the "close call" U.S. pre-med graduate who, as of right now, barely didn't get into U.S. MD program. The only ones who will get hurt are Osteopathic and Caribbean medical programs that have relied on those "near misses" to fill their programs. But, there will still be spots available even if one chooses an "alternative" pathway. As far as GME, you will see less "true" IMGs coming to the U.S. to do residency and get licensed, a cohort that currently makes up about 25% of the practicing physician workforce in the U.S.

Nowhere have I ever argued that it won't get more competitive. But, gone? No.

This NEJM article misses the target. This "problem" will take care of itself.

-Skip

Those residency figures also include fellowship and subspecialty positions, which you can't match into PGY-1. You need to look at the pipeline positions, which are those that lead to initial board certification. Page 18 pretty much puts the whole question of whether more international grads entered the pipeline or not this year to rest. 6,988 foreign-trained physicians entered training this year, compared to 6,933 the year prior. Page 14 shows the total number of pipeline positions available, which only increased by 237 positions since last year. A lot of the GME position growth has come from the fellowships you can see on the same chart, as there's 525 new fellowship positions that have been added year-over-year.

Let's say that the number of PGY-1 positions increases by a generous 300 per year for the next four years. That gives about 28,174 pipeline positions in the ACGME match. There's about 2,192 pipeline osteopathic positions. This gives us roughly 30,466 spots total if there is just over 1% GME growth year over year, with roughly 25,000 US MD and DO grads after attrition (about 1,000 total of the 20,000 MD and 6,000 DO students starting in 2014 will not finish school) matching in to them.

I was being pretty lazy with my math earlier by not including the osteopathic GME pathway, my bad. With them accounted for and a small amount of GME growth, you end up with 5,466 spots for foreign grads, which really isn't all that bad compared to today. Even neglecting GME growth there'd still be 4,266 positions for foreign grads. Looks like you're right on this one, Skip. The sky isn't falling, etc.

Edited numbers to reflect that the SF and Military match are supposedly accounted for in the ACGME report, though I will have to verify that this is true.

 

[Skip Intro]

Those residency figures also include fellowship and subspecialty positions, which you can't match into PGY-1. You need to look at the pipeline positions, which are those that lead to initial board certification. Page 18 pretty much puts the whole question of whether more international grads entered the pipeline or not this year to rest. 6,988 foreign-trained physicians entered training this year, compared to 6,933 the year prior. Page 14 shows the total number of pipeline positions available, which only increased by 237 positions since last year. A lot of the GME position growth has come from the fellowships you can see on the same chart, as there's 525 new fellowship positions that have been added year-over-year.

Okay, well, no problem. I won't contest anything you said here.

My bigger point was, there continues to exist some "mythology" that the number of GME spots is fixed and not growing. That was the real take-home message. And, people seem to always want to focus on funded vs. unfunded, which is irrelevant provided that the program you're in leads you to ABMS board-certification. Doesn't ultimately matter how the program subsidizes your training. That's their problem.

And, these articles also always seem to assume - which is an even bigger point of mine - an absolutely do-nothing attitude from here on out. That it can't and won't be fixed. This is regardless of the obvious growth and expansion of U.S. spots, both MD and DO, which are going to admittedly crowd the field in a few years. The real talk should focus on creative solutions to defray the cost of both medical school education and residency, for example going back to allowing partial third-party billing by residents directly to patients.

There are a lot of ideas. I just reject these "stick your head in the sand" articles on their face value. No one - no one - knows right now exactly what is going to happen, but similar worry-wort talk has been going on like this for the past 30 years. As I said, the sky is not falling. It's actually getting better for those students who otherwise before barely didn't get into a U.S. school. And, we need doctors. That's for sure. I don't want to be taken care of by a mid-level, because that's only who's available, when if and when I get really sick.

The world is full of Chicken-Littles. I strive on a daily basis not to be one of them. If you make decisions from fear, they will be bad ones. Trust me. I see this everyday. And, it's a large part of why our current healthcare system is broken in the first place. Just have a good plan and stick to it. You'll be fine. (Of course, you still need a good back-up plan!)

-Skip

 

[clarkbar]

Having worked with medical students from the 'top 4' of the Caribbean, I can say with complete certainty that your clinical rotations are a wash. The SubIs I have worked with were not at the level of a student who finished their basic core rotation. We are talking of deficiencies like not knowing how to complete an H&P or treat common bread and butter internal medicine conditions like CHF and COPD. When they're rotating among US Allopathic/DO's it becomes more pronounced. At the end of the day, it doesn't matter how well you do on your Steps if your clinical skills are garbage. And if you're good enough to succeed in a Caribbean program and make it to residency in the US, you're good enough to succeed at a US allopathic/osteopathic program so take the effort to matriculate into a US program.

I'm curious about this perception. From my understanding, Caribbean schools fail out large cohorts of their students, which makes the clinical science years more difficult. Granted, clinical science years are mostly an exercise in pain, but...

 

[mpnyc]

I'm in my last year of med school from AUC -- on the interview trail for the 2014 match. The OP needs to know it's a tough road. I can only speak from my experience. If at all possible try to stay in the US -- either allopathic or osteopathic. The US DO students are doing very well with interviews and matching.

1. I only considered SGU & AUC at the time. The reasons were that I had some buddies at SGU that liked it and AUC was in St. Maarten. In the end I chose AUC because at the time I figured all Caribbean schools were essentially the same in terms of matching to a residency and I REALLY liked St. Maarten (versus Grenada) and also the class size was only 100 students versus SGU & Ross. If you've never been St. Maarten is incredibly modern for a Caribbean islands. Lots of resorts -- a French side & a Dutch side. Air France flies directly to Princess Julianna airport and is the 2nd largest airport in the Caribbean behind San Juan, Puerto Rico. The Dutch side is very 'American' -- McDonald's, Burger King, Subway, etc as well as fantastic ethnic foods from China, Japan, Lebanese, Indian, etc The French side has Grand Case which has some fantastic cuisine. There were $40 million yachts cruising in to St. Maarten all the time. A ton of tourists all the time. Modern resorts with all kinds of casinos. Its a great vacation spot.

2. At least for AUC, the myth of weeding out is absolutely false. At least when I was there 2010-2011, the professors were quite good and always had the sense they were on your side and rooting for you to succeed. Because AUC is in St. Maarten we always had fantastic visiting professors -- Duke, Dartmouth, Columbia, UMass, Northwestern, Hopkins, U of AZ, etc
Many of the visiting profs were the ones that wrote chapters in the standard medical textbooks that are used by all. Majority of the faculty were US Ph.D. or MDs that
were at the tail end of their academic career and just loved St. Maarten and were retiring down there.
So although they were no longer on the cutting edge of research they absolutely LOVED to teach
which is why the same ones came down with their families semester after semester.

3. As far as attrition rate: The bottom line is for the most part all the students were there because they couldn't get into an American medical school. Although there were many that had tremendous GPAs and MCAT scores but for whatever reason fell through the cracks and could not get placed in an American med school. Also, there were students there that probably had no business being down there and if they failed it was certainly not because there wasn't enough support. We have tutors, office hours, fellow students all there to make sure we succeed in the basic sciences. The way it works is that if you fail 17 credit hours, you had to go in front of a board and plead your case. For the most part unless you were very convincing you were given the boot. 17 credit hours equates to failing approximately 3 classes.

4. The one advantage that I saw at AUC versus Ross was that at AUC if you failed a course, you just simply re-took that course -- I've heard that Ross makes you repeat the whole semester for just failing one course which seems to be a big money maker for Ross, not to mention at that time both Ross and SGU were taken in like 500 students at a time.

5. Out of my class of 98 about 50% made it to 5th semester ON TIME. Not to say that 50% left. A couple people left first semester, a couple 2nd semester, a couple 3rd semester, and then many got held back a semester for failing a class. Although 50% made it on time by 5th, I would estimate that 70-80% eventually got to 5th semester and left basic sciences to sit for Step 1.

6. I finished in the top 10 students of my class and I would say my Step scores were average for the top 10% of the class (233, 242). I know many from my class that have scored in the 250s & 260s for the USMLE Step 1 & 2. But once again these are the same students that would of done well ANYWHERE in the world. They were just brilliant.
for the rest of the people scores have ranged from just passing on up.

7.There are a ton of student organizations on campus as well as research opportunities and teaching opportunities. And of course there is all the nightlife/strip clubs/casinos/snorkeling/zip lining/ -- whatever you're into

8. In the 5th semester, they require you to pass the NBME comprehensive before leaving as well as the Kaplan comprehensive. They want to make sure you have at least the minimum passing knowledge -- that's probably why we've had a 96%-100% pass rate in the last couple of years. They bring down the Kaplan guys for integrative workshop. For instance Dr. Lionel Raymon that does the Pharmacology videos for Kaplan comes down and integrates all the basic science for us. He is absolutely amazing in person!

9. Then you leave the island, study for Step 1, pass and then you can enroll for clinical rotatons. We have 3 hospitals that you can do the whole core track -- NUMC (Long Island), Bronx Lebanon (Bronx, NYC) Providence Hospital (Michigan). Or you can opt to jump around to different clinical sites all over the country as well as England. We've got a bunch in NYC, Connecticut, Maryland, Michigan, California, Florida, and other random places.

10. If you have any questions you can post them here and I'll try my best to answer them. All I can say is for me it has worked out. I have received a lot of interviews from good university programs. Remember, you will not have a shot at the top university programs but you will definitely get interviews from the lower-middle tier university programs. Don't even waste your money trying to apply to the top programs. It won't matter if you have a 270 -- you're not getting an interview from Columbia 🙁
However, if you are applying to Family Medicine, Psychiatry, you do have a shot at the upper tier. We've had people go into Family medicine at Ivy league programs.
Of course they had amazing scores 🙂

Also -- unless a program has taken a SGU, Ross, or AUC student before -- most programs think all Caribbeans programs are the same and will discriminate you.
The northeast programs particularly NYC are familiar with SGU/Ross/AUC because so many of us rotate through the community hospitals there. You will rotate with NYCOM DO students, AT Still DO students, SUNY downstate, Einstein, etc and other US students that are rotating through these community teaching hospitals.

11. Also, my information is a little outdated. I started in 2010. Things could of changed especially since DeVry bought AUC so AUC and Ross are now sister schools.
DeVry has just spent millions re-vamping the campus, I think to bring in bigger classes so they can make more money. You can check out the campus at aucmed.edu.
In the end, DeVry is out to make a crap load of money -- but the actual basic science professors are some of the most caring people there are. I really adore most of them and have the utmost respect for them. The basic science campus and the people because they are in St. Maarten are sort of disconnected from corporate DeVry -- you don't really feel the profiteering until you get into clinical rotations. That office is out of Miami.

There are several things you need to succeed. You need the maturity and the focus. There are so many distractions on the island. If you're immature you will get sucked into all the distractions and going to end up with horrendous debt. You need ambition and extreme drive -- it is very difficult to be away from friends and family and then thrown into a mix of people from all over the country and so if you're not an adaptable sort of person this can be very draining.
When I say you can get sucked into to stuff, let me give you 1 very heart wrenching example. We had a student die of a drug overdose. He was into drugs before he came and got into it more since it's so accessible on the island. This is no joke. This is your life and so think very carefully about your decision and really know what you're getting into before you head down to the Caribbean. I made the most of it while I was there. I was a student leader and got involved in all kinds of organizations and stuff -- but there were also people that were loners -- people that got depressed -- high level of stress from block exams every month. It is an emotionally grueling endeavor so please take some
time to consider all factors.

Bottom line -- if you're smart and motivated -- you'll get through and match.
If you're a borderline student, emotionally immature -- this could really suck for you and be expensive.

I'm just excited that I'm almost done. I have to get through the rest of my interviews this month and then here I come residency!!!!!!

 

[scocoh19]

I'm in my last year of med school from AUC -- on the interview trail for the 2014 match. The OP needs to know it's a tough road. I can only speak from my experience. If at all possible try to stay in the US -- either allopathic or osteopathic. The US DO students are doing very well with interviews and matching.

1. I only considered SGU & AUC at the time. The reasons were that I had some buddies at SGU that liked it and AUC was in St. Maarten. In the end I chose AUC because at the time I figured all Caribbean schools were essentially the same in terms of matching to a residency and I REALLY liked St. Maarten (versus Grenada) and also the class size was only 100 students versus SGU & Ross. If you've never been St. Maarten is incredibly modern for a Caribbean islands. Lots of resorts -- a French side & a Dutch side. Air France flies directly to Princess Julianna airport and is the 2nd largest airport in the Caribbean behind San Juan, Puerto Rico. The Dutch side is very 'American' -- McDonald's, Burger King, Subway, etc as well as fantastic ethnic foods from China, Japan, Lebanese, Indian, etc The French side has Grand Case which has some fantastic cuisine. There were $40 million yachts cruising in to St. Maarten all the time. A ton of tourists all the time. Modern resorts with all kinds of casinos. Its a great vacation spot.

2. At least for AUC, the myth of weeding out is absolutely false. At least when I was there 2010-2011, the professors were quite good and always had the sense they were on your side and rooting for you to succeed. Because AUC is in St. Maarten we always had fantastic visiting professors -- Duke, Dartmouth, Columbia, UMass, Northwestern, Hopkins, U of AZ, etc
Many of the visiting profs were the ones that wrote chapters in the standard medical textbooks that are used by all. Majority of the faculty were US Ph.D. or MDs that
were at the tail end of their academic career and just loved St. Maarten and were retiring down there.
So although they were no longer on the cutting edge of research they absolutely LOVED to teach
which is why the same ones came down with their families semester after semester.

3. As far as attrition rate: The bottom line is for the most part all the students were there because they couldn't get into an American medical school. Although there were many that had tremendous GPAs and MCAT scores but for whatever reason fell through the cracks and could not get placed in an American med school. Also, there were students there that probably had no business being down there and if they failed it was certainly not because there wasn't enough support. We have tutors, office hours, fellow students all there to make sure we succeed in the basic sciences. The way it works is that if you fail 17 credit hours, you had to go in front of a board and plead your case. For the most part unless you were very convincing you were given the boot. 17 credit hours equates to failing approximately 3 classes.

4. The one advantage that I saw at AUC versus Ross was that at AUC if you failed a course, you just simply re-took that course -- I've heard that Ross makes you repeat the whole semester for just failing one course which seems to be a big money maker for Ross, not to mention at that time both Ross and SGU were taken in like 500 students at a time.

5. Out of my class of 98 about 50% made it to 5th semester ON TIME. Not to say that 50% left. A couple people left first semester, a couple 2nd semester, a couple 3rd semester, and then many got held back a semester for failing a class. Although 50% made it on time by 5th, I would estimate that 70-80% eventually got to 5th semester and left basic sciences to sit for Step 1.

6. I finished in the top 10 students of my class and I would say my Step scores were average for the top 10% of the class (233, 242). I know many from my class that have scored in the 250s & 260s for the USMLE Step 1 & 2. But once again these are the same students that would of done well ANYWHERE in the world. They were just brilliant.
for the rest of the people scores have ranged from just passing on up.

7.There are a ton of student organizations on campus as well as research opportunities and teaching opportunities. And of course there is all the nightlife/strip clubs/casinos/snorkeling/zip lining/ -- whatever you're into

8. In the 5th semester, they require you to pass the NBME comprehensive before leaving as well as the Kaplan comprehensive. They want to make sure you have at least the minimum passing knowledge -- that's probably why we've had a 96%-100% pass rate in the last couple of years. They bring down the Kaplan guys for integrative workshop. For instance Dr. Lionel Raymon that does the Pharmacology videos for Kaplan comes down and integrates all the basic science for us. He is absolutely amazing in person!

9. Then you leave the island, study for Step 1, pass and then you can enroll for clinical rotatons. We have 3 hospitals that you can do the whole core track -- NUMC (Long Island), Bronx Lebanon (Bronx, NYC) Providence Hospital (Michigan). Or you can opt to jump around to different clinical sites all over the country as well as England. We've got a bunch in NYC, Connecticut, Maryland, Michigan, California, Florida, and other random places.

10. If you have any questions you can post them here and I'll try my best to answer them. All I can say is for me it has worked out. I have received a lot of interviews from good university programs. Remember, you will not have a shot at the top university programs but you will definitely get interviews from the lower-middle tier university programs. Don't even waste your money trying to apply to the top programs. It won't matter if you have a 270 -- you're not getting an interview from Columbia 🙁
However, if you are applying to Family Medicine, Psychiatry, you do have a shot at the upper tier. We've had people go into Family medicine at Ivy league programs.
Of course they had amazing scores 🙂

Also -- unless a program has taken a SGU, Ross, or AUC student before -- most programs think all Caribbeans programs are the same and will discriminate you.
The northeast programs particularly NYC are familiar with SGU/Ross/AUC because so many of us rotate through the community hospitals there. You will rotate with NYCOM DO students, AT Still DO students, SUNY downstate, Einstein, etc and other US students that are rotating through these community teaching hospitals.

11. Also, my information is a little outdated. I started in 2010. Things could of changed especially since DeVry bought AUC so AUC and Ross are now sister schools.
DeVry has just spent millions re-vamping the campus, I think to bring in bigger classes so they can make more money. You can check out the campus at aucmed.edu.
In the end, DeVry is out to make a crap load of money -- but the actual basic science professors are some of the most caring people there are. I really adore most of them and have the utmost respect for them. The basic science campus and the people because they are in St. Maarten are sort of disconnected from corporate DeVry -- you don't really feel the profiteering until you get into clinical rotations. That office is out of Miami.

There are several things you need to succeed. You need the maturity and the focus. There are so many distractions on the island. If you're immature you will get sucked into all the distractions and going to end up with horrendous debt. You need ambition and extreme drive -- it is very difficult to be away from friends and family and then thrown into a mix of people from all over the country and so if you're not an adaptable sort of person this can be very draining.
When I say you can get sucked into to stuff, let me give you 1 very heart wrenching example. We had a student die of a drug overdose. He was into drugs before he came and got into it more since it's so accessible on the island. This is no joke. This is your life and so think very carefully about your decision and really know what you're getting into before you head down to the Caribbean. I made the most of it while I was there. I was a student leader and got involved in all kinds of organizations and stuff -- but there were also people that were loners -- people that got depressed -- high level of stress from block exams every month. It is an emotionally grueling endeavor so please take some
time to consider all factors.

Bottom line -- if you're smart and motivated -- you'll get through and match.
If you're a borderline student, emotionally immature -- this could really suck for you and be expensive.

I'm just excited that I'm almost done. I have to get through the rest of my interviews this month and then here I come residency!!!!!!

mpnyc - That was a really helpful post. Thanks for taking the time to share your experience. I'm curious to hear your take on the ECFMG certification for residency. I have been looking at different residency programs for different specialties on the AMA website and they all say that the ECFMG certification is required, but is that before you can even apply to programs? I've read that sometimes you only need a verified certification that shows you are projected to complete all requirements on time, and sometimes they require the full certification (with a final diploma) to even apply for residency, which would delay residency a year after completing medical school. Did you contact each residency program that you applied to to find out which requires a full certification or just a verified certification to apply? How much do you think the ECFMG certification limits your options for residency in terms of specialty or program if you want to begin the following year after finishing school?

 

[Skip Intro]

Did you contact each residency program that you applied to to find out which requires a full certification or just a verified certification to apply? How much do you think the ECFMG certification limits your options for residency in terms of specialty or program if you want to begin the following year after finishing school?

You do not need to have your ECFMG certificate in your hand to go through the Match (i.e., you do not have to wait a year). You can apply for residency so long as you are meeting the requirements to get it on-time. Mine was issued after I graduated. And, I already had gone through the NRMP and secured a spot in a residency program.

You have to be in their system, though. Just go to their website and follow their instructions.

-Skip

 

[ChrisGriffen]

We don't need anymore negative spin on guys who went DO and now hate the carib route, keep in mind that a DO Graduate is the first to feel the sting after USIMG'S, so you better get good grades or you'll be in the same boat...Also do me and others a favor. Go post on SDN's DO site instead of here, we all envy you because you were excepted to a DO program.

You should, at least, envy how he knows the difference between the words "accepted" and "excepted".

 

[laricb]

You should, at least, envy how he knows the difference between the words "accepted" and "excepted".

Oh you picked up on a misspell, You're parents must be so proud.

 

[Skip Intro]

Um, ahem... speaking of exeptions.... nice Ullman exception, Chris Griffin.

http://www.flayme.com/flame/04-psychology.shtml#Spelling

And, maybe he was "excepted", in that he would have gone MD except he couldn't get in? Ever thought of that?

-Skip

 

[Top Gun]

You should, at least, envy how he knows the difference between the words "accepted" and "excepted".

You, sir, are a tool.