February 15, 2021

Should You Apply to Caribbean and International Medical Schools?

The Savvy Premed

By: Savvy Pre-Med Staff

When gaining admission into a US medical school feels impossible (or at least unlikely), less competitive applicants often turn to Caribbean or international medical schools to fulfill their dreams.

But what are the consequences of choosing this route? Is going to a foreign medical school a viable option?

We’re here to answer all your FAQs about Caribbean and international medical schools so that you can make a well-informed decision before pursuing this option!

Without further ado...

Should You Apply to Caribbean and International Medical Schools?

Is it easier to get accepted into a Caribbean or international medical school?

Statistically, it’s definitely easier.

The average GPA and MCAT for matriculants at Caribbean schools are much lower than US medical schools. These schools offer second chances to students with subpar GPAs and MCAT scores who have little to no shot at a US MD or DO school.


Is the curriculum and academic rigor easier at a Caribbean or international medical school?


No. In fact, if you attend a Caribbean or international school, you will have to score much higher on the USMLEs to make up for the fact that you went to a Caribbean school. And even then, you’ll likely still be limited in your residency options.

If you attend a US medical school, passing the USMLE Steps 1 and 2 is usually not a problem. Unfortunately, the same cannot be said about many international medical schools. Some of these schools have a hard enough time getting students to pass the exams, let alone preparing them to score well enough to obtain competitive residencies. Working hard to attend a US school, whether MD or DO, even if it takes much longer, will probably be worth it in the end.

However, for students who screwed up during college, feel motivated and are unwilling to wait, do not mind heavy competition, and are willing to do whatever it takes to be a doctor (regardless of specialty), these schools are a good last resort.


Should I only attend a Caribbean or international medical school if my GPA or MCAT is below average?


If your numbers are holding you back, then it may be worth considering Caribbean or international schools. It can take a lot of time and effort to raise your numbers, and you might be able to save that time by going to a Caribbean school.

However, if your extracurricular activities are lacking, it’d be wiser to take time and improve your resume rather than jumping into a Caribbean school. Where you go to medical school affects where you go to residency, which essentially affects the rest of your medical career.


Should I consider reapplying to MD programs or applying to DO programs instead of applying to Caribbean or international medical schools? 

Oftentimes, people who have unsuccessfully applied to American MD schools two or three times will start to consider Caribbean schools.

If you’re on your third or fourth application, it’s probably time to at least apply to Caribbean schools to have them as a back-up option.

DO schools are often recommended over Caribbean schools. You should either apply to DO schools first or at least apply to them simultaneously.


What criteria should I look for when considering a Caribbean or international medical school?


You should ask yourself these two important questions:

  • What percent of students successfully graduate from that medical school?
  • What percent of graduates are successful in obtaining residency in the US?

There are some Caribbean schools that have high graduation rates, but others are notorious for high drop-out rates. In general, Caribbean medical schools tend to have a much lower graduation rate than US medical schools.

Why? One possible explanation is the lack of support that Caribbean schools provide students. Another argument is that Caribbean medical students were not ready for medical school in the first place. It’s common for students to enter Caribbean medical schools only to find out they’re not academically ready. Either way, applicants can avoid wasting valuable time and finances by doing research.

In terms of residency, a few Caribbean medical schools are known to have strong residency connections within the US. In contrast, there are Caribbean schools that have little to no connection to US residencies. It can be tempting to enroll in a Caribbean medical school if it’s the only option available. However, one must carefully assess the likelihood of becoming a doctor at that school. Enrolling does not mean anything if you don’t end up a doctor.


Is there a benefit to the “rolling admissions” at Caribbean and international medical schools?

Unlike US schools, many Caribbean schools allow you to apply throughout the year and matriculate soon after. This process allows you to start medical school right away and is especially helpful if you’re waiting to hear back from US medical schools.

What are my chances of matching into a US residency program if I attend a Caribbean or international medical school?

According to the National Resident Matching Program (NRMP), ~50% of foreign medical school graduates match into US residencies.

The “best” Caribbean schools boast a match rate of ~70%. In comparison, 94% of US MD graduates matched, while 79% of US DO graduates matched. When considering these numbers and the hefty price tag of foreign schools, you might be paying a lot for something that’s far from a guarantee.


Are there certain Caribbean and international medical schools that are better to attend?

If you’re looking for a cheat sheet of sorts, we would recommend the following 11 schools. Why? Mainly because they either participate in the AMCAS or because they have a solid reputation and track record of success with residency match rates: 

University of Puerto Rico

San Juan Bautista School of Medicine 

Ponce Health Sciences University

Universidad Central del Caribe 

St. George’s University - School of Medicine

Saba University School of Medicine

Ross University School of Medicine 

American University of the Caribbean School of Medicine (AUC)

UAG School of Medicine

Tel Aviv University Sackler School of Medicine

Ochsner MD Program - University of Queensland

In particular, you may want to focus on the “Big Four” Caribbean schools.

There are many Caribbean and international schools that offer a “US medical education,” but only a handful are actually equipped to send you to a US residency.

If you want to practice medicine in the US, you should mainly consider St. George’s, Ross, American University, and Saba.

How do the “Big Four” Caribbean medical schools compare with US medical schools?

For starters, the Big Four tend to have a lower attrition rate than other Caribbean schools, but it’s often still higher than US medical schools.

Matching into residency is one of the biggest hurdles for medical students, and it will dictate what type of specialty they will pursue. In 2019, the Match Day—when the NRMP releases decisions—was the biggest ever. More than 38,373 applicants applied for 35,185 positions. For students who don’t match, they must try to match again after the initial process has ended. If they are unable to secure a spot, they will have to wait and reapply the following year. 

For US MD school graduates, 93.9% matched into a program. This number has been relatively consistent in recent years. The NRMP doesn’t break the data down by specific country, but for all international medical school graduates, 59% matched into first-year positions (PGY-1).

According to SGU—the second largest source of physicians in the US—93% of their eligible US graduates obtained a PGY-1 position. AUC had a similar match at 91% in 2019. From 2013 to 2018, 94% of Saba University’s graduates attained a residency.

While students from the Big Four match into US residency programs, it is important to look at what type of programs they match into. For Caribbean medical school graduates, it can be challenging to match into the most competitive specialties.

According to NRMP, in 2019 US allopathic graduates filled more than 90% of the spots in the following specialties: 

  • Integrated Plastic Surgery (91.9%)
  • Neurological Surgery (91.8%)
  • Orthopedic Surgery (91.8%)
  • Otolaryngology (93.9%) 
  • Thoracic Surgery (91.9%)

However, for students who want to pursue a different specialty, like internal or family medicine, a Caribbean medical school might be a good option. In 2020, the majority of graduates from SGU, AUC, Saba University, and Ross University matched with an internal medicine or family medicine residency program. 

According to NRMP, US allopathic graduates filled less than 45% of the spots in the following specialties:

  • Family Medicine (39.0%)
  • Internal Medicine (41.5%)
  • Pathology (33.4%)
  • Pediatrics - Primary (40.0%)
  • Surgery - Preliminary (23.9%)

Will attending a Caribbean or international medical school affect my chances to enter competitive specialties?

The most competitive specialties to obtain residency spots are Surgical subspecialties (Head and Neck Surgery, Neurosurgery, Urology, Dermatology, etc), Radiology, and Interventional Radiology.

One Caribbean school graduate wrote a blog post that detailed his journey of trying to match into Orthopedic Surgery. He had an amazing CV and board scores, but still failed to match.

Many of these schools hide their match lists, which is a big red flag. If you desire to enter a competitive specialty, think twice before attending a Caribbean school because it will be nearly impossible to obtain a residency spot as a foreign graduate.

Do your research on each foreign medical school. You will have to call admissions offices and speak with them directly because most schools don’t post match results online. Even if schools post match results online, you must interpret them carefully.

You want to see what percentage of students matched successfully to categorical positions, which are specialty matches, and which guarantee board eligibility. If you want to work as a US MD, make sure you attend a school with a strong tradition of matching well.


What kind of academic environment and support can I expect if I attend a Caribbean or international medical school?

Although Caribbean schools care about their reputation and want their students to do well, they don’t have the same supportive environment as US schools.

You often have to coordinate your own clinical rotations. Mentorship and career guidance is lacking. You’re directly competing with your classmates because residency spots are limited.

Attending a Caribbean school is much more academically, socially, logistically, and emotionally challenging than a US MD or DO school. You should be prepared to work at least twice as hard as a US medical student.


Will I be able to do US clinical rotations at a Caribbean or international medical school?


A few Caribbean schools offer clinical rotations in the US for the third and fourth years. Essentially, schools that don’t offer this option are almost worthless (if you’re trying to practice medicine in the US). Doing a clinical rotation in the US is a huge pro when trying to apply to US residency.

Since rotating is an important time to build contacts for future residency placement, it’s key to attend a school with a network of affiliated US hospitals. You want rotations that are accredited by the Accreditation Council for Graduate Medical Education (ACGME). There is a huge difference between a school that has established connections with US hospitals and a school that simply allows its students to rotate in the US (since students arrange the rotations themselves!).


What do I need to know about accreditation for Caribbean and international medical schools?


The National Committee on Foreign Medical Education and Accreditation of the US Department of Education (NCFMEA) determines whether a school is comparable to that of the Liaison Committee on Medical Education (LCME), the US’s accrediting organization. If a school’s accreditation is comparable to the LCME process, then the country where the school is located can apply for federal loans for its students.

For students considering Caribbean schools, the accreditation of the institution is essential to consider if they’re planning on practicing medicine in the US. You should only consider top-tier Caribbean medical schools that have an accreditation recognized by the World Federation for Medical Education/Foundation for Advancement of International Medical Education and Research (WFME/FAIMER). 

Some states, like California, Florida, New Jersey, and New York, have stricter guidelines, and even if the school has an accreditation recognized by WFME/FAIMER, it might not be enough to practice in that state. For example, California keeps a list of foreign medical schools that have been approved by the Medical Board of California. The Big Four and a few other Caribbean medical schools are approved to practice in California, but the list is limited. 

Lastly, not many international medical schools have accreditation and connections to offer US federal financial aid. Therefore, you will need to figure out how you will finance your education. Typically, schools that have their students rotate in the US also have financial aid connections.

Have any questions about Caribbean or international medical schools? Let us know in the comments below, and we’ll respond to you personally. 

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