Are there any significant disadvantages to going to medical school in the Caribbean?

July 30, 2008 4:17 PM

Are medical schools in the Caribbean a respectable alternative to the traditional route of going to school in the US?

I know a young person who recently got accepted to, and is now destined to goto, a Caribbean medical school in lieu of finishing a traditional undergraduate degree in the US and applying here. I have some major concerns because I'm more of a traditionalist in the academic sense, and I'm very afraid that their education will be subpar and would put them at a significant disadvantage to tradional medical school graduates.

Here's what I know: 1) They still need to apply to, and get accepted to, a residency program in the US following med school. 2) It's a tougher climb to get into residency. 3) They will not graduate with an undergraduate degree, and could put them in a disadvantage should they decide that being a doctor isn't for them anymore.

What I don't know: 1) Does the fact that the school is located in the Caribbean really matter (i.e. is the education actually subpar)? 2) Are there any professional disadvantages that doctors here can attest to? 3) If there's really no downside, why don't more people do this? (or do they, and I'm just unaware) 4) Is my concern justified, or am I simply being an overly traditional academic?

posted by SeizeTheDay to education (13 answers total)

IANAMSS, but I do know one person pretty well who went to a Caribbean medical school, and he fared just fine passing his boards, and getting residencies and internships in the US after his 2 years was over.

He did have a 4-year undergrad degree from a US university, however, so his experience is much different from your friends' in that respect.

Also keep in mind that in some countries (the UK I believe is like this), the medical degree IS your college degree; you don't do undergrad and then apply to a separate medical program. While I've no idea specifically how that would impact somebody's options trying to practice medicine in the US, it's par for the course elsewhere. And if your friend is planning on attending a medical program in a UK-territory, it's just how it's done there.
posted by brain cloud at 4:44 PM on July 30, 2008

My dad is a physician. When I asked him whether the Caribbean-trained physicians were viewed with less respect, he said, "Not really."

I would think that, if your only realistic way to become a physician is to go to a Caribbean school, do it. Physicians have such prestige, and make such jaw-droppingly huge salaries, that having a sub-par medical degree is manifestly a better option than not being a physician at all. Most of your patients will probably not care where you went to medical school.

Recently I walked past the medical school in Grand Cayman. It was right on the beach. It made me want to be in medical school.
posted by jayder at 4:44 PM on July 30, 2008

Yes, it is harder to get into residencies besides Family Practice, Internal Medicine, and Psych. I also got into a caribbean school, but decided to wait it out and try again (3rd time applying) for a school in the US. I read an analogy that went something like this "With the lower standards for admission to the schools, what kind of teachers would you expect to find there?" As in, all the best professors would not be attracted to it, but already be in some US medical school. Also, if they are unsure AT ALL, that they don't want to be a doctor, they should wait it out and get more clinical experience. I've met many med students and even physicians who have told me they dislike what they're doing. The 4th year med student I met recently said she would have never gone into medicine knowing what she knows now, and hates the fact that she's locked into medicine because of the tremendous debt she's in now.

Why is this person not graduating? This should be the first step, and entering med school after that. It works for pharmacy to skip the bachelors, but not so much with medicine.
posted by senseigmg at 4:49 PM on July 30, 2008

100% wait to graduate. Then apply to MD or DO medical schools. If this fails, consider Caribbean schools. Nothing wrong with them, but it's MUCH harder to get a desired residency in the US being a foreign medical graduate. Also people are going to ask why the person chose not to do finish their undergraduate education.
posted by ruwan at 4:54 PM on July 30, 2008

"Physicians have such prestige, and make such jaw-droppingly huge salaries, that having a sub-par medical degree is manifestly a better option than not being a physician at all." This is not entirely true anymore. Working in a public hospital, I've seen the difference in treatment by patients and salaries of physicians, vs. their counterparts in a private setting. You want jaw dropping, go into finance or dentistry.

Its true that you can go to the caribbean and do just fine. It is just much harder to do so. The fail rate for 1st years is much higher than it is in the US. Also, what if the student would like to do research? Those schools aren't exactly known for their research facilities. I'm not bashing it, I have a friend who's done 2 years there, and is now doing rotations in Miami. It should be a very careful decision that this student makes, not just the caribbean, but a career in medicine.
posted by senseigmg at 4:55 PM on July 30, 2008

"1) Does the fact that the school is located in the Caribbean really matter (i.e. is the education actually subpar)? "

There are some that are, but there are also fine schools. St. George in Grenada boasts very good match rates and USMLE pass rates. The data that I have for non-US allopathic shows a rougher time getting a residency, but they don't subset it by citizenship (US citizens are only about 20% of the non-US allopathic pool).


"2) Are there any professional disadvantages that doctors here can attest to? "

Doctors care where you did your post-graduate training. Plenty of people in my hospital graduated from foreign medical schools and trained in the US.


"3) If there's really no downside, why don't more people do this? (or do they, and I'm just unaware) "

{US citizens at non-US schools} is about 1/5 the size of the {US citizens at US allopathic schools} in the application pool, which isn't negligible. The disadvantage is the question of getting as good a residency as you possibly can. Some places you'll need to know Spanish. Some schools have kind of elaborate deals with their clinical training, which could be inconvenient. Med school is somewhat stressful and people want to be in a more familiar setting. Pride. Probably pride above all others.

"4) Is my concern justified, or am I simply being an overly traditional academic?"

It's a little risky jumping in and not finishing a degree (this is part of why they're not getting in elsewhere). I'd demand an extremely high level of awareness with the medical system, what being a physician is like, experience in related fields, etc. This is a lot of commitment; she'll have to work extra hard to distinguish herself to jump out a residency director. If what she wants is to be a normal MD in the community, that's achievable. If she wants to do Rad-Onc, Plastics, Orthopedics, etc., or to go to a really top rated Medicine program, or to be able to pick where in the country she ends up on a Family or Medicine program then it's probably worthwhile to invest the extra year or two and apply in the US. Really, what's the rush? It takes a long time anyway, and by finishing she'll have the opportunity to apply to her in-state school(s) and save a boatload of money.
posted by a robot made out of meat at 5:52 PM on July 30, 2008

Oh, disclosure. IAAMS, my advisor is involved in the medicine residency program here, and a secondary advisor is director of the EM residency program and blabs on and on and on about it. For motivation of US vs non-US go here (pdf) and jump to pdf page 9, numbered page 4.
posted by a robot made out of meat at 6:05 PM on July 30, 2008

My GP in college went to med school in Grenada. So yes, they do get jobs.
posted by HotPatatta at 7:13 PM on July 30, 2008

I've talked to my school's med advisor on this and she does recommend it for certain students. From what I've heard some of the schools have pretty good numbers as far as how many students pass their boards and they have about average residency placements. So as far as getting a job it sounds like they're not that bad. But you also have to consider the fact that in the eyes of your peers there may be some disadvantages, I've brought this up with my sister and cousin, both of whom are doctors, and they have a very snobbish attitude towards people who went to the carribean or went to a D.O. medical school (my sister refer's to D.O. doctors as "crazy" doctors). My cousin straight up said don't even think about going to the carribian but he's also an asshole. The acceptance standards are lower for the Carribian (avg mcats in the low 20's compared to low 30's) and that's always going to be in the mind of other doctors but in the end who really cares, if you pass the boards than you've proven you are capable of being a doctor. And do well enough on those and you'll get a good placement, which is way more important for your career.
posted by BrnP84 at 3:21 AM on July 31, 2008

It is definitely a disadvantage when applying to residency as stated above. An additional hurdle is that all foreign medical graduates have to pass the ECFMG exam, which can be difficult. After that, though, most people who care at all are more concerned with your post-MD training rather than where you got your MD.

There was a student in the class ahead of me in med school that did two years at an offshore school (Grenada, if I recall correctly) and then transferred to a stateside school for his last two years. Since his degree was from a U.S. school that helped him avoid some of those hurdles.
posted by TedW at 6:38 AM on July 31, 2008

I'm in a relatively pertinent situation: I am a USIAN, currently in second year at a medical school in Australia. I didn't get in the 1st round and applied to school here on a whim (did a semester abroad here and liked it) and decided to go for it. For me it was a toss up between waiting 1 1/2yrs and having an easier time getting into residency or start right away and be less in debt. It's pretty cheap, even for an international student, compared to US schools (without scholarship) and has a good reputation as a school. I am happy I'm here and don't regret it (especially considering staying here afterwards is an option).
This being said, I do worry about the hassles ahead of me. To be allowed to get into residency back in the States, I must take several (expensive) tests; as well, I will be considered 2nd tier in terms of the program I want to get into. Applying for residency in Family Practice or some such less-competitive field and, while working in that, re-apply for a different specialty that catches my eye more is definitely an option.
In terms of transferring, it's actually pretty difficult to do from what I've read about it and is very last minute and so may be difficult in leaving school/moving back to the US.
I cannot tell you about how Caribbean school graduates will be treated but from what I've asked of doctors that I've met (and seen from how many people working in health care are foreign anyway) it doesn't matter that much. Sure, there might be some snobbery but then your "young person" can just show a picture of their school on the beach and stuff it back in their faces! I think the reason a lot of people don't do this is because of pride, worry, and anxiety of being away from their families and friends.
With regards to finishing undergraduate I agree with everyone above that finishing a degree would be good. It would most likely not make a difference in terms of getting a residency; however, it would provide good background and introduction into the medical field and give this person time to chew over their situation. Also would give him/her an opportunity to apply to a US school and see how the cards fall.
Good luck!
posted by shokod at 2:15 AM on August 1, 2008

(1) Education quality: there are variations within the Caribbean schools. Some, like SGU, are actually better than your average domestic school.

(2) Can be harder to get highly selective residencies. However, (a) I've seen it done, (b) those are hard for everyone, and (c) most people aren't going for those anyways.

(3) (a) More than a few do. (b) They're private, so they cost more than State U. Med School. (c) Obsession with status. (d) There is an extra layer of bureaucracy, mentioned above, if they're coming back the US.

(4) I'm not sure how not finishing undergrad plays into all this. Also, which school is it? Some seem sketchy; others are well-established and reputable.

Those would be my quick answers. My information is a few years old, now.
posted by coffeefilter at 12:59 PM on August 1, 2008

Thanks for the info. folks. I wish I could go into more detail about the candidate, but suffice it to say, this was probably the best decision for them, considering their expectations and goals.
posted by SeizeTheDay at 5:37 PM on August 4, 2008