If the application season isn’t going as you’d hoped, your thoughts might be turning to alternative ways of advancing your medical education. Perhaps you’re thinking about retaking the MCAT, boosting your GPA with postbaccalaureate coursework, or spending a year in a clinical or research environment.
Or you might be thinking about warm tropical breezes and the island life that awaits you at a Caribbean medical school.
This is not a decision to take lightly. As an international medical student, you will have to contend with many different challenges – from language barriers to culture shock – that could affect your studies. Classes are large and can feel impersonal, and attrition rates are high. You might not have as many choices for clinical rotations, and you might even need to arrange your own elective rotations.
By far the biggest concern for U.S. citizen graduates of international medical schools (also known as U.S. International Medical Graduates, or USIMGs) is matching with a residency program after completing medical school. Some international schools have very poor records of residency placement. Attending the “wrong” medical school could mean you incur thousands of dollars in debt and struggle to practice medicine once you’re finished.
Despite these issues, an international program can be a feasible option for some people. The required GPA is often lower than the U.S. average, and some programs do not require the MCAT. You will interact with peers, professors, and patients from around the world, who offer a wealth of different perspectives. And even though securing a residency can be challenging, it’s certainly not an insurmountable obstacle. In the 2023 Residency Match, there were 4,963 USIMGs (representing approximately 11% of the applicant pool), and nearly 68% of them matched in PGY-1 positions.
If you’re wondering whether a Caribbean medical school is right for you, ask yourself four key questions.
1. Can I improve my profile and reapply successfully in the next cycle?
Identifying where you might have gone wrong in your application is an essential part of your decision-making process if you’re contemplating Caribbean med schools. Carefully consider whether retaking the MCAT, completing more clinical or research hours, or raising your GPA might make a difference in your future application. Also consider timing. If this is your first cycle, it’s probably not wise to give up on American medical schools just yet. Graduating from a U.S. allopathic (MD) or osteopathic (DO) program will still make you more competitive, with 93.1% of U.S. graduates matching to PGY-1 positions in 2023, compared with 67.6% of USIMGs.
But what if you’ve already applied multiple times to both DO and MD programs? What if you have taken and retaken (and retaken) the MCAT but haven’t been able to improve your score? If you’re positive you still want to become a doctor at this point, keep reading to determine whether looking outside the United States for medical school is the right decision.
2. Am I interested in a primary care specialty?
The match rate for USIMGs varies by specialty, and applicants in the primary care fields fare the best. In 2023, the top five specialties for USIMGs were Internal Medicine, Family Medicine, Emergency Medicine, Pediatrics, and Psychiatry.
There are a lot of reasons for this, but probably the most critical one is lack of access to other specialties for rotations and research experiences. Medical students at Caribbean programs can and do arrange rotations in surgical specialties, neurology, anesthesiology, and others, but this is not always easy and usually takes personal initiative (more on this later). Research opportunities might be less available as well, which is not ideal for some specialties.
The bottom line is that if you’re resolute about becoming a diagnostic radiologist, being a plastic surgeon, or entering another highly specialized field, your chances of matching as a graduate of a U.S. medical school, whether allopathic or osteopathic, will probably be higher.
If you are interested in a primary care specialty, you will still have a harder time in the residency match than a U.S. graduate.
3. Am I resilient and flexible enough to live on a remote island?
Let’s not beat around the bush – a Caribbean medical education isn’t about studying under palm trees while sipping pina coladas. Instead, you’re likely to have lab facilities that are older or less well equipped, or that lose power regularly. The study materials you need might not be as widely available as you’d like. Many of your classes will be too large, with less faculty attention than is ideal. Studying at a Caribbean medical school can be tough.
Life outside medical school can be challenging as well. It can be difficult to live without all the little luxuries you’re used to in the States. Those you can get will be more expensive. You’re likely to be evacuated at least once during hurricane season. You’re definitely going to lose power more than once. And you’re going to be an ocean away from your friends and family for at least two solid years, possibly in a country where English is not the primary language. All of this can be very isolating.
This life isn’t for everyone, which is one of the reasons for the high attrition rate at Caribbean medical schools. But some people manage to not just survive but even thrive. They’re the ones who embrace these challenges while keeping their eyes on the prize, making the most of what this environment has to offer.
4. Do I enjoy taking initiative, and can I make opportunities for myself where they don’t exist?
I’ve worked with many successful USIMGs over the years, and what consistently sets them apart is that they make up for any lack in their initial qualifications by working harder than the average medical student. They’re heavily involved in university activities, community healthcare initiatives, international case competitions, and so on. They lift up their classmates by sharing study resources and mentoring newcomers on the island. And they go above and beyond in every single one of their clinical rotations, demonstrating their cultural competence by adapting seamlessly in varied environments and contributing on different teams.
And significantly, they can express the advantages of their non-U.S. medical education in their applications and interviews. They can talk about the deep grounding in diagnoses that comes from doing without modern diagnostic equipment while volunteering in their local community clinics, or the resourcefulness that grew out of necessity while supporting local hurricane relief efforts. These are invaluable skills that can set USIMGs apart, making them very appealing to primary care residency programs, especially in rural areas.
That said, I do have a very important caveat for anyone considering a Caribbean program:
Do your research
If studying medical school in another country appeals to you, you need to do your research. There are roughly 60 Caribbean programs of varying quality. Of these, Ross University, St. George’s University, Saba University, and the American University of the Caribbean have the most consistently high placement rates. Courses are taught by U.S. academic physicians, and the programs have well-established clinical rotations in the United States.
Other programs might work well for you, but be sure to pay attention to their students’ performance on the USMLE Step exams. For Step 1, the first-time pass rate for non-U.S./Canadian medical students was only 74%, compared with 90.6% for students at U.S. MD and DO programs. (Note that this includes all international medical schools and students.) If a medical school does not freely share information on its pass rates and residency match success rate, this is cause for concern.
It can also be more difficult to secure funding at international med schools, so when you’re doing your research, insist on a realistic estimate of the cost of your studies and living expenses. Talk to students as well as admissions personnel to confirm everything you hear.
Finally, as you consider Caribbean medical schools, also look to other countries. I highly recommend Ireland’s Atlantic Bridge program. Although quite competitive, Irish medical schools are flexible with regard to the GPAs and MCAT scores of otherwise qualified American and Canadian students and offer a diverse, world-class medical education (including U.S. and Canadian rotations). With a single application, you can apply to the six Irish medical schools, plus the Royal College of Surgeons in Ireland-Bahrain. Irish medical schools are highly regarded in the States and Canada, and many graduates secure residency spots every year.
The other program I recommend is the UQ-Ochsner MD Program. This is a partnership between the University of Queensland in Australia and Louisiana’s Ochsner Health System. The program offers U.S. students the chance to do their clinical years in Brisbane and complete clinical rotations in New Orleans. In 2023, it matched 96% of its graduates.
Being a USIMG is not for the faint of heart, but if you’ve tried everything else and still have your heart set on medicine, it is something to consider. Your road might not be as easy as that of other medical students, but it’s likely to be more interesting. Personally, I love working with USIMGs, hearing about their unique experiences, and helping them see the value they can bring to a university program. If you would like to discuss whether an international medical school is right for you, schedule a complimentary call with one of our expert consultants today.
Since 2001, Cydney Foote has advised hundreds of successful applicants for medical and dental education, residency and fellowship training, and other health-related degrees. Admissions consulting combines her many years of creating marketing content with five years on fellowship and research selection committees at the University of Washington School of Medicine. She’s also shared her strategy for impressing interviewers in a popular webinar and written three books and numerous articles on the admissions process. Want Cydney to help you get Accepted? Click here to get in touch!
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