Why is the Caribbean a bad decision?

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scocoh19

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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!
 
premedsc19 said:
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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Use the search box...this gets answered once a week
 
Residency crunch puts FMGs at an immediate and entirely real disadvantage in placing in a US residency. US Medical schools are increasing graduates at a faster rate then US Residency slots are opening. Basic math.

Exam scores? http://img.medscape.com/article/736/510/736510-fig2.jpg

I don't have evidence on hand but I've heard of some Carib schools dismissing students who weren't going to meet certain levels of Step scores.

Financing is mostly dependent on independent wealth and private loans.

Just do a search of these forums and you'll encounter plenty of horror stories.
 
I have read previous threads about this topic, but I would like someone to speculate why people's opinions about the Caribbean on here are not consistent with the stats or students' experiences that attend these schools.
 
Deadlifts said:
Residency crunch puts FMGs at an immediate and entirely real disadvantage in placing in a US residency. US Medical schools are increasing graduates at a faster rate then US Residency slots are opening. Basic math.

Exam scores? http://img.medscape.com/article/736/510/736510-fig2.jpg

I don't have evidence on hand but I've heard of some Carib schools dismissing students who weren't going to meet certain levels of Step scores.

Financing is mostly dependent on independent wealth and private loans.

Just do a search of these forums and you'll encounter plenty of horror stories.
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So I am assuming that the exam scores graph that you posted shows the average scores for all international medical students, not just St. George or AUC. Students from those two schools also receive federal funding just like any medical student in the US. So I still don't see any disadvantage of attending either of them.
 
IMGs are at a disadvantage when applying to residency positions relative to US MDs and DOs. That is, of course, if you can make it to applying to residency as many Carib students don't. What else matters?

There is plenty of information about why going to the Carib is a bad idea if you are willing to accept it.
 
Can't this mostly be chalked up to be due to the fact that US MD students are smarter and or harder working than Caribbean medical students and as a result get better specialties and the disadvantage of going to a non-ranked medical school aka the Carib?
 
TheWeeIceMan said:
IMGs are at a disadvantage when applying to residency positions relative to US MDs and DOs. That is, of course, if you can make it to applying to residency as many Carib students don't. What else matters?

There is plenty of information about why going to the Carib is a bad idea if you are willing to accept it.
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I am willing to accept any information as long as it is valid. Clearly there is a discrepancy between what people think and what is true based on the data (and I am only talking about St. George and AUC). How is it a disadvantage when it comes to applying for residency? If you have good board scores, then you have good board scores, and that's what is most important. The board scores and match lists at these schools supports that.
 
premedsc19 said:
So I am assuming that the exam scores graph that you posted shows the average scores for all international medical students, not just St. George or AUC. Students from those two schools also receive federal funding just like any medical student in the US. So I still don't see any disadvantage of attending either of them.
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Your assumption would be wrong. C-IMG is not every international school. It's all Caribbean grads. It's a completely valid statistic. It's not like St. George is the Harvard of the Pacific but they are one of the most successful of the Caribbean schools.

http://www.medscape.com/viewarticle/736510

Feel free to vet the data yourself.

tl;dr you CAN be successful as a C-IMG. Are you putting yourself at a dangerous disadvantage (yes, >200k in debt with no residency slot IS dangerous) by attending a Carib school? Absolutely.

premedsc19 said:
I am willing to accept any information as long as it is valid. Clearly there is a discrepancy between what people think and what is true based on the data (and I am only talking about St. George and AUC). How is it a disadvantage when it comes to applying for residency? If you have good board scores, then you have good board scores, and that's what is most important. The board scores and match lists at these schools supports that.
Click to expand...

It is NOT just statistics. Preference is given to USMGs for residency positions.
 
Deadlifts said:
Your assumption would be wrong. C-IMG is not every international school. It's all Caribbean grads. It's a completely valid statistic. It's not like St. George is the Harvard of the Pacific but they are one of the most successful of the Caribbean schools.

http://www.medscape.com/viewarticle/736510

Feel free to vet the data yourself.

tl;dr you CAN be successful as a C-IMG. Are you putting yourself at a dangerous disadvantage (yes, >200k in debt with no residency slot IS dangerous) by attending a Carib school? Absolutely.



It is NOT just statistics. Preference is given to USMGs for residency positions.
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Ok well there are 60 Caribbean medical schools, so I think it's safe to say that a lot of those schools are significantly bringing the average scores down. I've looked at the numbers and match lists for St. George and AUC. I'm not saying that there isn't any risk involved at all, but in no way does it seem "dangerous".
 
Bea5T said:
http://educationahmadiyya.us/post/44083327291

^Read it
Click to expand...

premedsc19 said:
I am willing to accept any information as long as it is valid. Clearly there is a discrepancy between what people think and what is true based on the data (and I am only talking about St. George and AUC). How is it a disadvantage when it comes to applying for residency? If you have good board scores, then you have good board scores, and that's what is most important. The board scores and match lists at these schools supports that.
Click to expand...

board scores are most important, but you really should read that article.

with carib schools, even st georges or AUC, you run the risk of getting a subpar education. could you get good board schools having had a subpar education? possibly, if you do an immense amount of self study into highly advanced topics. Even after step 1, who knows how your clinical training will be, because once again carib schools pay to get their students into clinical training, and the results can yet again be subpar. I don't really know how you'd prepare yourself for that based on the lack of education.

so yea its easy to say board scores are all that matters, but you need to learn the material thats on the boards to do well on the boards.
 
premedsc19 said:
I am willing to accept any information as long as it is valid. Clearly there is a discrepancy between what people think and what is true based on the data (and I am only talking about St. George and AUC). How is it a disadvantage when it comes to applying for residency? If you have good board scores, then you have good board scores, and that's what is most important. The board scores and match lists at these schools supports that.
Click to expand...

So you took the data off of the school's website? I would be skeptical since there are ways to manipulate the data to make it seem like things are a lot better than they actually are.

As for your 2nd point, PDs can use whatever they wish to pick applicants. You can't just say "board scores are board scores" because it sounds fair. It is pretty well known that PDs will choose a US MD or DO over an IMG for numerous reasons. Also, as US students start to approach the # of residency spots in the coming years, IMGs will start to get squeezed out even more because programs will have their pick of AMGs and won't have to look to IMGs to fill the spots.
 
I say let the guy go to the Caribbean...no need to convince him.


The board scores are decent because their retention rate is abysmal...if students are failing out and only the strong survive, then yes, their scores will be okay. Question is: will you be one of the ones who makes it or one of the ones who gets the debt and no return on investment??? The schools don't care about how well you do...they care about whether you will pay them. They are for-profit. Period.
 
ChemEngMD said:
I say let the guy go to the Caribbean...no need to convince him.


The board scores are decent because their retention rate is abysmal...if students are failing out and only the strong survive, then yes, their scores will be okay. Question is: will you be one of the ones who makes it or one of the ones who gets the debt and no return on investment??? The schools don't care about how well you do...they care about whether you will pay them. They are for-profit. Period.
Click to expand...

👍 This is one of those threads where the OP has already made his mind up before he asks the question and then just gets mad when people disagree.
 
ChemEngMD said:
I say let the guy go to the Caribbean...no need to convince him.


The board scores are decent because their retention rate is abysmal...if students are failing out and only the strong survive, then yes, their scores will be okay. Question is: will you be one of the ones who makes it or one of the ones who gets the debt and no return on investment??? The schools don't care about how well you do...they care about whether you will pay them. They are for-profit. Period.
Click to expand...

i think that is the biggest question i have for those who pursue Caribbean.

i mean these are people who obviously could not score well enough on the MCAT to get into DO schools, but they believe that 2 years down the road they'll be able to score extremely well (extremely well because if they dont theyre dead in the water) on boards? which, should be needless to say, are much harder than the MCAT

it confuses me, but i guess its hard giving up on a dream/goal
 
ChemEngMD said:
I say let the guy go to the Caribbean...no need to convince him.


The board scores are decent because their retention rate is abysmal...if students are failing out and only the strong survive, then yes, their scores will be okay. Question is: will you be one of the ones who makes it or one of the ones who gets the debt and no return on investment??? The schools don't care about how well you do...they care about whether you will pay them. They are for-profit. Period.
Click to expand...
I'm not completely disagreeing with every negative comment about the Caribbean. But I feel like most people just give a lot of disadvantages based on the stigma rather than what is actually true. They may not prepare you as well with the basic science courses, they may have a higher failing rate, and there may be some risk when applying for residencies. But, if you really need your hand held that much through medical school, then you probably won't make it in a US school either. So if you're capable, then it seems like going to a school like St. George or AUC wouldn't be a terrible option.
 
jk1006 said:
i think that is the biggest question i have for those who pursue Caribbean.

i mean these are people who obviously could not score well enough on the MCAT to get into DO schools, but they believe that 2 years down the road they'll be able to score extremely well (extremely well because if they dont theyre dead in the water) on boards? which, should be needless to say, are much harder than the MCAT

it confuses me, but i guess its hard giving up on a dream/goal
Click to expand...
I don't totally disagree, but let's be honest, the verbal section on the MCAT doesn't say a whole lot about how well you can do in medical school.
 
I have a parent on a residency admissions committee and as of last year they no longer look at Caribbean applicants - straight to rejection. N=1 but still
 
premedsc19 said:
I don't totally disagree, but let's be honest, the verbal section on the MCAT doesn't say a whole lot about how well you can do in medical school.
Click to expand...

Verbal is actually said to be the best predictor of STEP 1 scores.....
 
premedsc19 said:
I don't totally disagree, but let's be honest, the verbal section on the MCAT doesn't say a whole lot about how well you can do in medical school.
Click to expand...

People who are self motivated enough and worked hard enough to get a residency out of a carribean medical school are probably smart enough to get into a US med school. Don't be lazy.
 
premedsc19 said:
I don't totally disagree, but let's be honest, the verbal section on the MCAT doesn't say a whole lot about how well you can do in medical school.
Click to expand...

maybe, maybe not. i always took critical reading as just a test of analytical skills. it requires intelligence, short term memory skills, quick processing, ability to imply and infer

i mean you read a passage and sometimes you get asked questions on details, most of the time its about what the author implied or what the passage implied. or what information is missing or what information needs to be added.

i think it requires high levels of analytical skills, which i think is useful as a doctor, and, generally, in life

people on this site dont do well because theyve become trained to focus on subjects. know the material -> answer the questions. pretty much all science classes are like that. memorize material - answer question (be careful of tricky answers)

as for an MCAT score being low because of verbal i could see that, like a 10, 10, 6 or something. definitely would hinder MD school, maybe DO. so no argument there.
 
Students who enter the match from the Caribbean (they are all categorized as international medical graduates even if they are US citizens) have about a 50% chance of matching into any residency program. If you're not a citizen, that number is lower.

If you go to DO school, your chance is 75% that you will match through the MD match, and this doesn't include students who just don't want to enter the MD match and enter the DO match instead. I think this statistic says it all. These data are freely available and published for everyone.

If you have a low MCAT score - and I've been there - just be patient, take one or two years off, improve your score or your grades and reapply broadly to MD and DO. If you find that you can't get an acceptance to a DO school even after that...you might want to consider the Caribbean.

In a few years, we WILL have more US medical school seniors (MD and DO) than we have residency spots to match them with. So, they question becomes, who will be the first to go? I can promise you it will be IMGs.

Personally, I think if you pass the boards and get through med school in the caribbean or in the US, you should have a shot at being a doctor, but in the real world that just isn't what happens.
 
Also keep in mind what Caribbean schools mean when they say that their students "matched" successfully...

Where do the Caribbean school's students match?

The be all and end all indicator of success is a medical school's match list, many of which are published on schools' websites. But, interpret these lists carefully. First of all, you want to know what percentage of graduating fourth year students obtain categorical matches. Why is this significant? Preliminary positions are only one year and do not guarantee a specialty match or board eligibility. Categorical positions, on the other hand, are specialty matches and do guarantee board eligibility. Many published school lists do not distinguish between preliminary versus categorical matches. One major Caribbean medical school recently disclosed at a faculty meeting that 15% of its graduating students did not obtain categorical positions last year. This information, is not easy to obtain, however, and for obvious reasons schools rarely disclose this raw data to prospective students and their parents.
Click to expand...

http://studentdoctor.net/2011/01/caribbean-medical-schools-what-to-consider/

Essentially, a percentage of Caribbean graduates may be able to land a prelim spot, but will ultimately only be there for one year and will not be asked to stay for a categorical spot. This is essentially as good as not matching at all. Why give them prelim spots in the first place? Basically a free set of extra hands for tasks that the actual residents and attendings can't be bothered with.
 
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premedsc19 said:
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!
Click to expand...

Search function. Use it.
 
premedsc19 said:
I am willing to accept any information as long as it is valid. Clearly there is a discrepancy between what people think and what is true based on the data (and I am only talking about St. George and AUC). How is it a disadvantage when it comes to applying for residency? If you have good board scores, then you have good board scores, and that's what is most important. The board scores and match lists at these schools supports that.
Click to expand...

Board scores aren't the end all be all for residency. Clinicals are the HUGE disparity. Clinicals at most hospitals for US-IMGs are piss poor and not regulated at all. With a US school, you KNOW you are getting a strong clinical training, which is the most important thing. Clinicals are vitally important to function well as a resident. Just because you return to the states after Step 1 & went to NYC or NJ or wherever, doesn't mean you are getting even close to a good education. Also, for IMGs, applying to hospitals which takes IMGs are preferred. There are bias to take students that they know performed well. I.e. if they taken SGU students who are lazy and horrendous, they might be hesitant to take more. Even though it's a selection bias, it can occur.
 
ChemEngMD said:
Verbal is actually said to be the best predictor of STEP 1 scores.....
Click to expand...

This.

Just let the guy apply carib guys. No harm to anybody else and its not worth the argument.
 
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There's essentially three bottlenecks in the Carib.

1. Pre-clinical classes.
2. Step 1.
3. Matching.

At every step, you lose a significant fraction of the class. Every single one of those people who ultimately fail believe that they are going to be "that guy" who aces their classes/boards and matches surgery at MGH or w/e it is nowadays. The hard fact is that between 50% and 70% of the class gets weeded out. And with the coming residency crunch, IMGs are going to have to be superstars to match in even crappy programs due to DO grads from new schools crowding them out.
 
Because in 4 years, you will be very unlikely to match as an IMG.

You obviously don't want to hear that, but it's the truth. Retake the MCAT and go DO.

Oh and peds is not a competitive specialty at all.
 
premedsc19 said:
I have read previous threads about this topic, but I would like someone to speculate why people's opinions about the Caribbean on here are not consistent with the stats or students' experiences that attend these schools.
Click to expand...

Because the schools manipulate the data to make the statistics look better. They're not going to tell you what their drop out rates are, or that many of their "matches" are actually pre-lim spots and/or in undesirable locations and specialties.

The students you hear from while they're in the schools aren't going to tell you the school is bad. They don't want to believe that (confirmation bias). Furthermore, while it's true that people have become attendings after attending carib schools, that was then and this is now. The reality is that enough new med schools have opened up in the US such that in four years' time there will be enough US med grads to take up all the residency slots. Since Carib students have always been viewed as bottom-of-the-barrel candidates, they're going to be the first ones to get knocked out of any match list. As a result, while a few Carib students can currently obtain residency spots right now, in four years that will no longer be the case. Instead, all the residency slots will go to US medical graduates, and Carib students will be $200k in debt with nothing to show for it beyond an MD which is useless without a residency.

So go Carib if you want, but don't ever say that no one warned you when you find out your life is ruined because you have a mountain of debt and no way to ever pay it off.
 
Medstart108 said:
Can't this mostly be chalked up to be due to the fact that US MD students are smarter and or harder working than Caribbean medical students and as a result get better specialties and the disadvantage of going to a non-ranked medical school aka the Carib?
Click to expand...

No way, Id venture to say most any current US med student would have just as difficult of time matching if they were instead enrolled in the Carib.

While we were all differently qualified getting into medical school and, therefore, ended up where we did, the stigma is against FMG/IMG's in general and not the individual students.

tl;dr Rockstars at Carib. Schools are still at a major disadvantage
 
First of all, a high pass rate is not necessarily a good thing. From what I hear, most medical students can pass step 1 without studying, but a low pass will get you nowhere in terms of residencies.
Secondly, many Carribean schools have high attrition rates (like in the 50s and 60 percents), so just starting there it is more likely than not that you will drop out. Secondly, their match rates are around 50%. Right off the bat, that's a 1 in 4 chance of getting residency if you're an M1.
Be careful about them saying they match into competitive residencies - most students who do have connections or some other "in", while the overwhelming majority of grads who do match (regardless of board scores) end up at the lowest tier community family practice residencies and the like.
Also - DEBT. These are for profit schools that give you bad odds at being able to pay back your loans.

There are other reasons in terms of quality of life you experience in the Carribean, as well.
 
whatever5 said:
First of all, a high pass rate is not necessarily a good thing. From what I hear, most medical students can pass step 1 without studying, but a low pass will get you nowhere in terms of residencies.
Secondly, many Carribean schools have high attrition rates (like in the 50s and 60 percents), so just starting there it is more likely than not that you will drop out. Secondly, their match rates are around 50%. Right off the bat, that's a 1 in 4 chance of getting residency if you're an M1.
Be careful about them saying they match into competitive residencies - most students who do have connections or some other "in", while the overwhelming majority of grads who do match (regardless of board scores) end up at the lowest tier community family practice residencies and the like.
Also - DEBT. These are for profit schools that give you bad odds at being able to pay back your loans.

There are other reasons in terms of quality of life you experience in the Carribean, as well.
Click to expand...

I don't think people are passing usmle without studying, sorry. Secondly I'm not sure why your entire first paragraph is a good thing....
 
KnuxNole said:
Board scores aren't the end all be all for residency. Clinicals are the HUGE disparity. Clinicals at most hospitals for US-IMGs are piss poor and not regulated at all. With a US school, you KNOW you are getting a strong clinical training, which is the most important thing. Clinicals are vitally important to function well as a resident. Just because you return to the states after Step 1 & went to NYC or NJ or wherever, doesn't mean you are getting even close to a good education. Also, for IMGs, applying to hospitals which takes IMGs are preferred. There are bias to take students that they know performed well. I.e. if they taken SGU students who are lazy and horrendous, they might be hesitant to take more. Even though it's a selection bias, it can occur.
Click to expand...

Quoted for truth. The quality of IMG clinical training, even if done in the US, is extremely variable and programs know it. US grads are more reliably ready for residency because their programs have stricter accreditation standards. This is far and away the reason why even IMGs with good board scores tend not to fare as well in the match as their AMG counterparts.

whatever5 said:
First of all, a high pass rate is not necessarily a good thing. From what I hear, most medical students can pass step 1 without studying, but a low pass will get you nowhere in terms of residencies.
Secondly, many Carribean schools have high attrition rates (like in the 50s and 60 percents), so just starting there it is more likely than not that you will drop out. Secondly, their match rates are around 50%. Right off the bat, that's a 1 in 4 chance of getting residency if you're an M1.
Be careful about them saying they match into competitive residencies - most students who do have connections or some other "in", while the overwhelming majority of grads who do match (regardless of board scores) end up at the lowest tier community family practice residencies and the like.
Also - DEBT. These are for profit schools that give you bad odds at being able to pay back your loans.

There are other reasons in terms of quality of life you experience in the Carribean, as well.
Click to expand...

You heard wrong. Most US students would not pass Step 1 without some period of review study.
 
premedsc19 said:
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!
Click to expand...

Going the D.O. or Foreign route = automatically making your life harder if you later on decide that you would rather do a competitive specialty

If primary care is your main objective, then ignore my statement.
If you are unsure, then why limit your doors of opportunity?

Reality is Reality - and the current system favors US MD's for competitive specialties.
 
Ever heard of a concept called "search"?
 
Financing is mostly dependent on independent wealth and private loans.
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pbdk2w
 
ChemEngMD said:
Verbal is actually said to be the best predictor of STEP 1 scores.....
Click to expand...

Not an accurate statement, because I think people in pre-allo (not jyst you) don't appreciate the huge difference between "predictor" and "correlation". Yes, There is a modest correlation between the verbal score and STEP 1. That means in, say, 1000 people who take each test, a few more than would be randomly expected who did well on verbal will do well on step 1 (let's say eg 3 more). However how you do is in no way a "predictor" -- most with high verbal will still be within the same spread as those who did average on verbal. So there's some correlation, but it not a predictor.
 
gravitywave said:
Quoted for truth. The quality of IMG clinical training, even if done in the US, is extremely variable and programs know it. US grads are more reliably ready for residency because their programs have stricter accreditation standards. This is far and away the reason why even IMGs with good board scores tend not to fare as well in the match as their AMG counterparts....
Click to expand...

I think it isn't so much about "strictness" of accreditation as it is the fact that residencies know exactly what they are getting when someone exits a program with LCME oversight. It's not a better-worse analysis so much as it is a comfort level. there is standardization thanks to the LCME such that a program can throw someone onto the wards and not have to worry that they don't know what they are supposed to do, how to behave, how to interact with attendings, patients, nurses. Board scores are pretty meaningless for this -- they are useful in gauging how someone will do on the inservice exams, but most of the people who wash out of residency did adequate on tests -- that's never what gives a PD headaches or wakes him up in the middle of the night.

It's very much like buying a TV set. Say you narrowed it down to two equally priced choices, a Sony or some Yugoslavian brand you know very little about. The latter may look better in the store and have lots of nice features but you are still usually going to buy the Sony because of the comfort level you have in terms of the brand and of what you are getting. You are familiar with that company and their products. It's just not worth it to you to gamble. And so that is the hurdle offshore grad face -- they are competing against LCME accreditation, the Sony of accrediditions.
 
I wouldn't go to a doctor that got his education in the Caribbean. If someone's going to have my life in their hands I want to make sure they're the best of the best, not a slacker. Just my 2 cents.
 
IL Pre Med said:
I wouldn't go to a doctor that got his education in the Caribbean. If someone's going to have my life in their hands I want to make sure they're the best of the best, not a slacker. Just my 2 cents.
Click to expand...

Same. Going to the Caribbean is taking the easy way out, and medicine is a profession that shouldn't have an easy way out. If you really want to be a doctor and right now the Caribbean is your only option, work harder.
 
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