RogueUnicorn

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Having some downtime tonight I figured I'd take a look at some match data from my year (2015). The whole document's pretty interesting and IMO a very worthwhile document to peruse for anyone going into the field. But what I really want to draw attention to is this, well known bit about the allo Match-

US allo grads: 94% match out of a pool of ~18k
US osteo grads: ~80% match out of a pool of ~3k
Foreign grads, US citizens: 53% match out of a pool of ~5k.

In this new application season, with all its fresh hopes and neuroses, I very very strongly encourage you to consider the implications of going carib/IMG. Consider the prospect of being 300-500k in debt (of principal only) with only a coin flip's chance of matching.

Don't let your pride get in the way. Give DO a strong consideration.
 

Goro

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Cue Argus to come in sputtering "but, but NRMP!"

Something else to look at:
For U.S. citizen students and graduates of international medical schools (“U.S. IMG”), the top five specialties were:
 Internal Medicine (categorical) (894)
 Family Medicine (680)
 Psychiatry (categorical) (178)
 Pediatrics (categorical) (174)
 Medicine-Preliminary (PGY-1 Only) (125)

In EVERY category except IM, more DOs matched.
 
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Having some downtime tonight I figured I'd take a look at some match data from my year (2015). The whole document's pretty interesting and IMO a very worthwhile document to peruse for anyone going into the field. But what I really want to draw attention to is this, well known bit about the allo Match-

US allo grads: 94% match out of a pool of ~18k
US osteo grads: ~80% match out of a pool of ~3k
Foreign grads, US citizens: 53% match out of a pool of ~5k.

In this new application season, with all its fresh hopes and neuroses, I very very strongly encourage you to consider the implications of going carib/IMG. Consider the prospect of being 300-500k in debt (of principal only) with only a coin flip's chance of matching.

Don't let your pride get in the way. Give DO a strong consideration.
I agree that Carib is NOT the way to go, but I'm a bit confused on the bolded. Isn't that a pretty good percentage for foreign grads? More than half of them match! And the pool is so small too, so it would be easier for FMG's/IMG's right?
 
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RogueUnicorn

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I agree that Carib is NOT the way to go, but I'm a bit confused on the bolded. Isn't that a pretty good percentage for foreign grads? More than half of them match! And the pool is so small too, so it would be easier for FMG's/IMG's right?
A 50-50 of having a career after investing half a mil of non-dischargeable debt seems like a big deal to me on its own, but if you factor in attrition, where a large percentage (some say even a majority) of the class doesn't even get to putting their names into the pot, I'd say it's better to take the half mil and put it all on black.
 
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A 50-50 of having a career after investing half a mil of non-dischargeable debt seems like a big deal to me on its own, but if you factor in attrition, where a large percentage (some say even a majority) of the class doesn't even get to putting their names into the pot, I'd say it's better to take the half mil and put it all on black.
True for schools like the Carib, but what about schools in India/UK/Israel/Australia where you don't need to pay so much for medical school (hardly any in some countries). Would it be worth it to do medicine there then? Since residency chances are 50-50?
 
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True for schools like the Carib, but what about schools in India/UK/Israel/Australia where you don't need to pay so much for medical school (hardly any in some countries). Would it be worth it to do medicine there then? Since residency chances are 50-50?
Let me put it this way. Let's look at a path that leads one to, say Israel (I've chosen this country for its pseudo-carib situation with several schools like Ben Gurion, Sackler, etc; also, honestly if you can get into a med school in India you almost certainly can get into one here). You failed to get into an MD school here, possibly multiple cycles, and this is your last resort. I mean, there are always exceptions, but 40-50 schools have told you, possibly more than once, you probably don't have what it takes to be a doc. Are you willing to spend tons of money and half a decade of your literally priceless life just to find out if they were wrong?

If it were me I'd just find another career, but hey that's just me; I've never been one of those "medicine or NOTHINGGGG" kind of people. Hell you could get an MBA and be my boss and make 10x my salary in the time I go from MS1 to attending.
"But I want to study A&P flashcards while on the beach in my bikini!"

-Most every freshman (female) premed I've ever met.
Ironically, a proper school in the US with P/F grading offers this very opportunity in spades, but you already knew that
 

Dr.Sticks

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I have question for the doctors/adcoms here;
Do you think a doctor with a Caribbean degree is not as good as those with U.S degrees?
Also, is a Caribbean degree an eye sour even beyond residency?
It seems that if they can barely get a residency spot, they might have trouble even getting a really good spot as an attending at a decent hospital.. Also it looks like they'd be pretty much shunned from academic medicine.
 
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Hmmm, I would expect the DO percentage to be higher to be honest. The 20% of DOs that dont match, is it mostly because of unrealistic expectations?
 
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Interpreting the DO data is hard because they have two separate matches (the AOA match and those who choose to go for the ACGME match) that occur at two different times.

The overall placement rate (combining the two matches and the post match scrambles) for DOs is extremely high - >95%
But the DO match happens first. So its not like the people who didnt match ACGME have another match they go into. 20% seems like a significant risk if you have your heart set on ACGME for whatever reason.
 
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But you have to consider that the pool in the ACGME match also includes those who didn't match in the DO match. Which skews the numbers significantly (since they already failed in one match, their a priori odds in the second match are lower). There are also still a lot of open DO positions available in the scramble AFTER the ACGME match.

Again the important thing to focus on is the overall placement rate
Fair enough, that makes me feel a bit better(Im applying mostly DO)
 

nolookpass

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I have a question about the Carribean. I'm not considering it, but the info is for a friend who just started.

The match rate is 53%. What did those 53% do to match compared to the others? Does your Step scores have to be higher than the average US Step scores. Also if you don't match, what happens next/what can you do next?
 

IlDestriero

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...for a friend...

The match rate is 53%. What did those 53% do to match compared to the others? Does your Step scores have to be higher than the average US Step scores. Also if you don't match, what happens next/what can you do next?
You have to score higher than US grads and you have to work harder on your often shady clinical rotations to try to get good LORs. You will have higher success in primary care, often in undesirable locations. But you have to survive the high attrition to even make it that far. Many also only match into preliminary spots and may still not match into a residency. Your friend's school won't be helping you with any of that.
Once you don't match, plan on moving into your parent's basement while you try to find a low paying research job at an academic canter to buff your resume and try again next year.
When that fails, you're sitting on 5 wasted years and at least a quarter of a million dollars in debt. Hopefully you have an engineering degree and can get a good job. FYI, Starbucks baristas get a nice benefit package, you know, for your friend.
 

Dr. Death

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There is a new adjunct professor at my UG who finished med school in the carribean (not sure if she graduated this year or last). She is teaching senior seminar (a one credit class) at my school because she was unable to match. Now she has 400k in debt and is getting paid peanuts and will likely never be a doctor. Still got that MD tho
 

Doudline

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I preface this post by saying that anyone should go DO over caribbean.

However, you don't have to be smack in the average of statistics. I'd wager that many -most- caribbean attendees were college students with poor work habits, tendency to procrastination, little ECs, etc, who chose the easy way out instead of fixing their problems and applying later. It's likely that these students have the same issues in med school now, therefore it's not surprising that so few of them match.

But for a motivated student who knows what to do to improve and acts on it, and makes every effort to beast step 1, get good LoRs, etc, I bet that the odds to get a residency spot are much higher than the average.

It's like medical school admissions, where 40% match, but multiple adcoms have stated that sometimes up to 50% of the applicants pool has absolutely no business applying (terrible stats, virtually no clinical exposure, etc). Therefore most people who took the time to check the boxes and have realistic stats for where they apply do get in.

(Of course, there is still a stigma attached to caribbean which is real and separate from one's performance. Again, one should always choose DO over caribbean. But it's not always the death sentence people make it to be.)
 

NotASerialKiller

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I preface this post by saying that anyone should go DO over caribbean.

However, you don't have to be smack in the average of statistics. I'd wager that many -most- caribbean attendees were college students with poor work habits, tendency to procrastination, little ECs, etc, who chose the easy way out instead of fixing their problems and applying later. It's likely that these students have the same issues in med school now, therefore it's not surprising that so few of them match.

But for a motivated student who knows what to do to improve and acts on it, and makes every effort to beast step 1, get good LoRs, etc, I bet that the odds to get a residency spot are much higher than the average.

It's like medical school admissions, where 40% match, but multiple adcoms have stated that sometimes up to 50% of the applicants pool has absolutely no business applying (terrible stats, virtually no clinical exposure, etc). Therefore most people who took the time to check the boxes and have realistic stats for where they apply do get in.

(Of course, there is still a stigma attached to caribbean which is real and separate from one's performance. Again, one should always choose DO over caribbean. But it's not always the death sentence people make it to be.)
Yes, if you know yourself VERY well or can somehow turn around your academic trajectory with ease then it's not quite as risky. But most people who decide to apply there are doing it because they just don't have the stats to stay in the US, and for most of those people there's no reason to think they won't end up part of the tragic 75%. That's why it's still good advice to tell people not to go to the Caribbean, and going there instead of applying to DO schools is insane.
 

gonnif

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Counting NRMP, AOA match, Military match, SOAP , and final opportunity, DOs match 99.45% . With 5% or less overall attrition rate, that means if uou start DO school you have over a 95% chance of earning your degree and getting a residency. Graphic across match types below


DO 2015 Match.jpg
 

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That's not a coin flip, it's getting tails twice in a row. That match rate is after 50% of the class has been booted out with a life cripplingly large amount of debt.
Yes, you can't look at the match rate without looking at attrition. US allo attrition is nominal -- maybe a couple of percent. At some offshore schools attrition is as high as 50% (and necessarily needs to be because they don't have enough clinical rotation sites). So we are talking 53% after a 50% cut, or essentially a 26% chance. And its probably even lower than this because a good portion of the "matches" are into "dead end" preliminary spots that dont lead to anything and just put applicants back into the match again a year later. So its probably really closer to a 20% chance of becoming a doctor. That's pretty awful odds actually -- much worse than at any casino.
And that's TODAY'S odds. As the number of US grad increases faster than residency spots, this is projected only to get worse. Kudos for those who make it, but the wise move is probably to put your money back into your pocket or use it for something with a better return.
 

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Caribbean grads have a figurative 'cloud' hanging over their heads when it comes to residency placements. WHY did they go Caribbean? As @Doudline mentions, it may have been primarily a case of poor work habits and immaturity, and those who make it through a Caribbean school and have decent STEP scores have some evidence that they have overcome this problem.

But for many others, it was personality or character problems (as evidenced by legal records or IAs) that kept them out of US schools, and those 'clouds' are considerably more difficult to discharge.
 

Gandyy

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Caribbean grads have a figurative 'cloud' hanging over their heads when it comes to residency placements. WHY did they go Caribbean? As @Doudline mentions, it may have been primarily a case of poor work habits and immaturity, and those who make it through a Caribbean school and have decent STEP scores have some evidence that they have overcome this problem.

But for many others, it was personality or character problems (as evidenced by legal records or IAs) that kept them out of US schools, and those 'clouds' are considerably more difficult to discharge.
I think some people are just so shallow that they do not want the D.O. title after their name. I think its as simple as that for some Caribbean grads.
 
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gonnif

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Without beating this dead horse anymore than it has to be:

US MD-DO have a 97% graduation rate after 8 years (counting dual degrees, etc) and have a match rate of about 95% (with final placement in excess of 99%).
So you have about a 92%-93% chance of starting medical school and matching into residency

At the better off shore schools (from reporting to HHS and congress), 25% students drop out before clinical and another 25% do not graduate. Additionally at best 85% match. So you have about a 42% chance of starting medical school and matching into a residency with hundred of thousands of dollars due in loans with no prospect of a job or at least in clinical medicine.

Taking into account admissions, you can say both US schools and off shore have the same percentage of success.
US schools cut them before they get accepted via the admissions process
Off shore cut them after they start paying .

While these used to be a reasonable path to medicine, the residency squeeze makes it very difficult to recommend. Students should not consider off shore until they have done at least 2 US application cycles for both MD and DO with break in between for repair. With all the post bacc, SMP, MCAT prep, and professional advising, there is no reason for any applicant to try this approach. Those who say they dont want to wait or dont want to consider DO get no sympathy from me on it.

Below are several lengthy threads that discuss all the factors in detail

forums.studentdoctor.net/threads/us-md-for-320k-or-img-for-100k.1130221/
http://forums.studentdoctor.net/threads/caribbean-now-or-us-later.1139241/
forums.studentdoctor.net/threads/saint-james-school-of-medicine.102770/
 

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Also worth noting the 42% chance of matching is a rather optimistic estimate. Certainly not even close to all Caribbean programs match 85% of their graduates. And there are many where well more than half their class drop. Realistically if you consider all Caribbean programs and not the very top where the match rate is around 42%, its probably lower. From the few successful Caribbean grads I know and have talked to recently, they estimated at their school it was closer to 30% of people who started ended up matching. And this says NOTHING about where Caribbeans are matching; compare their match list to DO's and its no comparison which ones are matching into far more diverse and the competitive residencies and often in more desirable locations/hospital systems.
 
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gonnif

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Also worth noting the 42% chance of matching is a rather optimistic estimate. Certainly not even close to all Caribbean programs match 85% of their graduates. And there are many where well more than half their class drop. Realistically if you consider all Caribbean programs and not the very top where the match rate is around 42%, its probably lower. From the few successful Caribbean grads I know and have talked to recently, they estimated at their school it was closer to 30% of people who started ended up matching. And this says NOTHING about where Caribbeans are matching; compare their match list to DO's and its no comparison which ones are matching into far more diverse and the competitive residencies and often in more desirable locations/hospital systems.

42% is the highest estimate
****************************
 

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Why is it that whenever a thread pops up with a hackneyed topic, everyone is so eager to bash it and to scream "USE THE SEARCH [email protected]!!", but this thread about how bad the Caribbean is (which has been WELL established) is perfectly fine?

Seems a bit strange and biased.
 

username456789

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Why is it that whenever a thread pops up with a hackneyed topic, everyone is so eager to bash it and to scream "USE THE SEARCH [email protected]!!", but this thread about how bad the Caribbean is (which has been WELL established) is perfectly fine?

Seems a bit strange and biased.
Because it can't be overstated how poor a decision the Caribbean is.
 

NotASerialKiller

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Why is it that whenever a thread pops up with a hackneyed topic, everyone is so eager to bash it and to scream "USE THE SEARCH [email protected]!!", but this thread about how bad the Caribbean is (which has been WELL established) is perfectly fine?

Seems a bit strange and biased.
Well this isn't just a rehashing, the OP linked current stats to confirm that this reasoning is still up to date. Also you constantly see people saying "Well if I don't get into MD I'll apply to the Caribbean" so it's an extremely pervasive issue, not just a stupid question that one lazy person is asking (and then getting scolded for asking).
 
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I preface this post by saying that anyone should go DO over caribbean.

However, you don't have to be smack in the average of statistics. I'd wager that many -most- caribbean attendees were college students with poor work habits, tendency to procrastination, little ECs, etc, who chose the easy way out instead of fixing their problems and applying later. It's likely that these students have the same issues in med school now, therefore it's not surprising that so few of them match.

But for a motivated student who knows what to do to improve and acts on it, and makes every effort to beast step 1, get good LoRs, etc, I bet that the odds to get a residency spot are much higher than the average.

It's like medical school admissions, where 40% match, but multiple adcoms have stated that sometimes up to 50% of the applicants pool has absolutely no business applying (terrible stats, virtually no clinical exposure, etc). Therefore most people who took the time to check the boxes and have realistic stats for where they apply do get in.

(Of course, there is still a stigma attached to caribbean which is real and separate from one's performance. Again, one should always choose DO over caribbean. But it's not always the death sentence people make it to be.)
Everybody wants to believe they're the special one who is going to excel because gosh darnit they're a hard worker and they're smart. Fact of the matter is, until you do med school, you don't know what it's like, you don't know that you can excel, and by doing something like going to a carib (or going to any med school with the sole desire to do something like become a dermatologist, radiation oncologist, etc.), you're putting yourself in a really risky position
 

NotASerialKiller

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Everybody wants to believe they're the special one who is going to excel because gosh darnit they're a hard worker and they're smart. Fact of the matter is, until you do med school, you don't know what it's like, you don't know that you can excel, and by doing something like going to a carib (or going to any med school with the sole desire to do something like become a dermatologist, radiation oncologist, etc.), you're putting yourself in a really risky position
I think it's highly unlikely that BOTH my mother and I are wrong about my potential...
 

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More interesting pieces of info -

Specialties you can probably wave goodbye to if going abroad (my interpretation), as well as unlikely to snag as a DO outside the AOA match:

Specialties with at least 10 positions in the Match and filled more than 90 percent by U.S. seniors:
Psychiatry-Family Medicine: 100 percent
PPediatrics/Psychiatry/Child Psychiatry: 94.7 percent
Otolaryngology: 94.6 percent
Orthopedic Surgery: 94.3 percent
Radiation Oncology (advanced): 93.8 percent
Plastic Surgery (Integrated): 91.9 percent
Dermatology (categorical): 90.9 percent
Out of ~6300 matched foreign applicants (counting both US-citizen IMGs and foreigner IMGs), ~570 spots were sh!t prelim spots. This is much lower than I expected, so if you actually end up matching the chances are good that it'll be a real spot
 
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Lucca

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Why is it that whenever a thread pops up with a hackneyed topic, everyone is so eager to bash it and to scream "USE THE SEARCH [email protected]!!", but this thread about how bad the Caribbean is (which has been WELL established) is perfectly fine?

Seems a bit strange and biased.
The more hits people get when they search "Carib med school good idea?" that establishes that it is, in fact, not a good idea the better. My favorite ones are the ones made by Carib students themselves, successful or otherwise. When Carib schools stop filling their classes then we can all stop talking about it when it comes up.
 
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gyngyn

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Seeing that SGU has a total enrollment of 5300, and this report shows 534 + 155 matched from Grenada (chart 15), this leads one to the very solid conclusion that you can expect SGU's match rate to be a max of 689/5300/4 = 52%. This does not factor in attrition.
The math only works if you believe the stats from the school, though!
They don't answer to any actual accreditation authority.
 

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Why is it that whenever a thread pops up with a hackneyed topic, everyone is so eager to bash it and to scream "USE THE SEARCH [email protected]!!", but this thread about how bad the Caribbean is (which has been WELL established) is perfectly fine?

Seems a bit strange and biased.
Because we like rogueunicorn and he is presenting data that we didn't know about. It's different from the hay guys do is so holistic plus they learn omm so cool why less hard than md threads
 
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jl lin

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Without beating this dead horse anymore than it has to be:

US MD-DO have a 97% graduation rate after 8 years (counting dual degrees, etc) and have a match rate of about 95% (with final placement in excess of 99%).
So you have about a 92%-93% chance of starting medical school and matching into residency

At the better off shore schools (from reporting to HHS and congress), 25% students drop out before clinical and another 25% do not graduate. Additionally at best 85% match. So you have about a 42% chance of starting medical school and matching into a residency with hundred of thousands of dollars due in loans with no prospect of a job or at least in clinical medicine.

Taking into account admissions, you can say both US schools and off shore have the same percentage of success.
US schools cut them before they get accepted via the admissions process
Off shore cut them after they start paying .

While these used to be a reasonable path to medicine, the residency squeeze makes it very difficult to recommend. Students should not consider off shore until they have done at least 2 US application cycles for both MD and DO with break in between for repair. With all the post bacc, SMP, MCAT prep, and professional advising, there is no reason for any applicant to try this approach. Those who say they dont want to wait or dont want to consider DO get no sympathy from me on it.

Below are several lengthy threads that discuss all the factors in detail

forums.studentdoctor.net/threads/us-md-for-320k-or-img-for-100k.1130221/
http://forums.studentdoctor.net/threads/caribbean-now-or-us-later.1139241/
forums.studentdoctor.net/threads/saint-james-school-of-medicine.102770/

I know of bright students that went the route of SG's, and they ended up in residencies and thereafter in good positions in primary care; HOWEVER, that was>15 years ago. Things have changed, and the people to which I am referring were very determined, fastidious students with the support of their families in their endeavors.
 
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Not trying to derail the thread here- not interested in Carribean school at all.

I'm curious though- why are so many "averse" to going DO route?
One of my primary care docs is a DO and I would argue is the best of those that I have.

Is it because they're newer? I don't think they're any less competitive to get in?
 

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Another fact from the data that I didn't post is that the odds of NOT matching into a categorical residency (meaning a 3-5 year position that will lead to full and gainful employment) is ~67%.

So you only have a 50-50 chance of matching, period, and then a ~33% that it will be a 1 year, near dead end position, like being a permanent post-doc.

A 50-50 of having a career after investing half a mil of non-dischargeable debt seems like a big deal to me on its own, but if you factor in attrition, where a large percentage (some say even a majority) of the class doesn't even get to putting their names into the pot, I'd say it's better to take the half mil and put it all on black.
Either pure ignorance, or else everyone thinks that they're magically the one who will end up in the super competitive residencies. A lot of pre-meds also seem to think that Primary Care is akin to the 7th circle of hell.

I'm curious though- why are so many "averse" to going DO route?
One of my primary care docs is a DO and I would argue is the best of those that I have.

And a lot of other problems as well, as PDs already know of. These include parental pressure, inability to delay gratification, poor research skills, and an inability to look before leaping, among others.


However, you don't have to be smack in the average of statistics. I'd wager that many -most- caribbean attendees were college students with poor work habits, tendency to procrastination, little ECs, etc, who chose the easy way out instead of fixing their problems and applying later. It's likely that these students have the same issues in med school now, therefore it's not surprising that so few of them match.

No. Residency is where you really learn to be a doctor, as Law2Doc and Mimelim and others have eloquently pointed out.
Do you think a doctor with a Caribbean degree is not as good as those with U.S degrees?

That I doubt.
Also, is a Caribbean degree an eye sour even beyond residency?

Don't have enough data on this one! Perhaps out clinical colleagues can chime in?
It seems that if they can barely get a residency spot, they might have trouble even getting a really good spot as an attending at a decent hospital..

In over 30 years in academia, I've never met a Carib post-doc, fellow or PI.
Also it looks like they'd be pretty much shunned from academic medicine.
 
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Law2Doc

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Seeing that SGU has a total enrollment of 5300, and this report shows 534 + 155 matched from Grenada (chart 15), this leads one to the very solid conclusion that you can expect SGU's match rate to be a max of 689/5300/4 = 52%. This does not factor in attrition.

As you mentioned it doesn't factor in attrition which is huge but it also doesn't factor in those matching into dead end prelims.
 
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NotASerialKiller

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Not trying to derail the thread here- not interested in Carribean school at all.

I'm curious though- why are so many "averse" to going DO route?
One of my primary care docs is a DO and I would argue is the best of those that I have.

Is it because they're newer? I don't think they're any less competitive to get in?
It's about how people view DO outside of medicine (iz not MD u still doctorr???) and silly pre-meds or their parents being worried about status. An MD is well known and what the top ranked schools in the country give out, so for a lot of people that means that it's inherently better, never mind the fact that the education, opportunities and scope of practice are the same.

Unfortunately matching in Canada is also harder as a US DO than US MD, which is why I'm not applying to DO schools this cycle. Not sure what their reasoning is.
 
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Either pure ignorance, or else everyone thinks that they're magically the one who will end up in the super competitive residencies. A lot of pre-meds also seem to think that Primary Care is akin to the 7th circle of hell.
I suppose you mean DOs are expected to have an even harder time getting into the more competitive residencies?

As far as how PC is looked at- That's too bad. I mean, I understand keeping your options open, but...well if be preaching to the choir I suppose, to extol the virtues of primary care.
 

zero0

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Fun thing about statistics: you can get them to say whatever you want if you manipulate the numbers right.
 
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Fun thing about statistics: you can get them to say whatever you want if you manipulate the numbers right.
Another fun fact about statistics - if you understand how they work and look at the data a bit yourself, you can obtain a lot of meaningful information from them. You know, if you want to put some legwork in instead of dismissing them with trite expressions ;)