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Caribbean Medical Schools and U.S. Residency Options

According to the Association of American Medical Colleges, only about one-half of all applicants to U.S. medical schools eventually receive an admissions offer. Given this statistic, many American applicants consider applying to Caribbean medical schools in hopes of increasing their admissions chances. These applicants should understand, however, that any advantage they receive in admissions may be more than offset by the disadvantages they will later face in their careers.

Former AAMC President Jordan J. Cohen noted that an ongoing lack of information about Caribbean schools leaves American employers with questions about their graduates' quality. "Unfortunately, we just don't know as much as we'd like about medical education in offshore schools or about the relative performance of their graduates during their careers as practitioners," Cohen wrote in an open letter on the subject. He called for more dialogue so that the American medical community could better assess the Caribbean schools' educational value. Until that happens, U.S. graduates of Caribbean schools will continue to encounter doubts from potential employers about their qualifications.

We asked one of our consultants, Dr. Gregory Goldmacher, to explain the concerns that U.S. medical professionals have about graduates of Caribbean medical schools.

"Applicants considering schools in the Caribbean should realize that there are serious challenges to overcome for anyone who receives their medical education from a foreign medical school," says Greg.

One of these challenges lies in securing admission to a residency program.

"Each year, about 16,000 residency positions become available nationwide," says Greg. "Approximately 12,000 of those are filled by graduates of U.S. medical schools. That leaves 4,000 available positions for other graduates – and there are usually over 30,000 foreign-trained doctors competing for them.

"Some of these candidates were highly skilled physicians in their countries of origin – cardiologists, orthopedic surgeons, and the like. Given that kind of competition, getting into a residency program with a foreign medical education from a school in the Caribbean is not easy.

"However, there are a few well-established Caribbean schools that can serve as a launching point for a medical career in the U.S.

"Ross University, for example, has made great efforts to establish connections with U.S. medical schools. Students from Ross and its peers generally do their third and fourth year clinical rotations in U.S. hospitals. These rotations allow the students to become known as individuals in the hospitals and departments where they work. They have the opportunities to show their skills and dedication and to develop personal relationships with the physicians and administrative staff who ultimately make the decisions about residency program admissions. These opportunities and relationships can be enough to compensate for the inherent disadvantages that graduates from foreign schools face in the residency admissions process."

We asked Greg how a prospective applicant could tell which Caribbean medical schools might be worth considering. He said that applicants should ask themselves these questions:

"One - What are the USMLE scores of students who attend the school? Although residencies are technically not supposed to use Step 1 scores to select their residents, all of them do. Find out if there are in-house preparation programs offered at the school you are considering. Also find out what students' average scores have been in the past few years, and what percentage of students pass the Step 1 on their first try.

"Two - At what U.S. hospitals do the students at the school you are considering do their clinical rotations?

"Three - Where have recent graduates matched for residency?"

Greg encourages applicants looking at Caribbean schools to keep an open mind about other options as well. "If you're interested in a career in primary care, but your GPA and MCAT scores are such that you are concerned about being able to get into a regular U.S. medical school, you could consider a school of osteopathic medicine – that is to say, a D.O. program – in the U.S."

– Dr. Gregory Goldmacher has an M.D. and a Ph.D. from the University of Texas Southwestern in Dallas.


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