- Today I'm going to answer the question: "Should you attend a
Caribbean medical school?" Let's face it--there are
lots of negative stereotypes with Caribbean medical schools. And if you have less than stellar stats and are considering attending
one of these schools, you probably don't hear the
most encouraging information online or from your peers. My name is Dr. Shirag Shemmassian, and I'm a medical school admissions expert and founder of Shemmassian
Academic Consulting. My goal for this video
is not to discourage you from applying to
Caribbean medical schools. Instead, I'll discuss several key facts which highlight the major differences between Caribbean medical schools and American medical schools so you can make the most informed decision about whether to apply. Alright, let's get into it. On premed forums like Student
Doctor Network and Reddit, there's no shortage of folks
sharing strong opinions about Caribbean medical schools. Those in support of Caribbean
medical schools argue that these institutions
provide a second chance to students who would have
otherwise abandoned their dreams of becoming a doctor, and say that once you match
into residency programs, where you received your
degree becomes less important. On the other hand, naysayers
cite the high attrition rates, whopping tuition costs,
and lingering stigma as clear reasons not to attend. In speaking with students
for over 15 years, many students have asked me
some form of the question, "Should I attend a
Caribbean medical school?" However, I have learned that what students really want to know is: Is it possible to become
a successful physician by attending a Caribbean medical school? And most importantly: What sort of impact will attending a Caribbean
medical school have on my career? To answer the first question, yes, it is certainly possible to
become a successful physician if you attend a Caribbean medical school. According to the AAMC, nearly a quarter of all U.S. physicians are IMGs or international medical graduates. And this percentage is only
continuing to grow each year. While this percentage
does include a number of non-Caribbean foreign
medical school graduates, it's safe to assume that many IMGs are in fact Caribbean
medical school graduates. The second question is
a bit more complicated. Let's look at the facts. Fact #1: the USMLE Step
1 pass rate for IMGs is much lower than the pass rates for U.S. allopathic and
osteopathic medical schools. Your score for the USMLE Step 1 exam which most students
take after their M2 year is the most important factor
in your residency application. The higher your Step 1 score,
the better your odds are of not only matching, but
into your desired specialty. According to the USMLE in 2018, the pass rate for first time test-takers from allopathic medical schools was 96%. Test-takers from
osteopathic medical schools had the exact same pass rate. However, the pass rate
was significantly lower for international medical
school graduates at 80%. Now let's look at average score data. Remember, a passing score is important but the higher your score, the better. According to the National
Resident Matching Program or NRMP, we can also see that average Step 1 scores for U.S. allopathic seniors who match are significantly higher than
scores for U.S. citizen IMGs. A common misconception
that many students have about Caribbean medical schools
is that the lower pass rates and average scores are due
to the quality of instruction offered by these schools. While this may be a contributing factor, it's also important to note
that Caribbean medical schools have much lower standards for admission. This means Caribbean medical
schools tend to admit students with weaker academic profiles than their U.S. MD and DO counterparts, so it makes sense that students who are already struggling
academically to begin with would also be less successful
on the Step 1 exam. This leads to our second fact, Fact #2: Residency match rates are
significantly lower for U.S. IMGs. Your residency training is one
of the most important phases of your medical career. Residency training is a
requirement to practice as a physician in the United States. A school's residency match rate tells you what percentage of graduates are accepted to residency programs. In 2019, graduates of U.S.
allopathic medical schools matched at 93.9%, so nearly all students who
applied for residency programs matched into one. The match rate for osteopathic students was slightly lower at 84.6%. In stark contrast, however, the
match rate for IMGs was 59%. That means about 40% of IMG applicants who applied for residency
programs did not match. Those who don't match may be able to find an unfilled position through the Supplemental
Offer and Acceptance Program known as SOAP, but it's not
the position you want to be in after you've invested four
years in medical school. In 2019, only 200 IMGs obtained their residency
position through SOAP. Of 60 medical schools in the Caribbean, there are four schools collectively
known as the "Big Four" that have high Step 1 pass rates, high residency match rates, and give you eligibility to
practice in all 50 states. These schools are: Saba
University, Ross University, St. George's University, and Medical University of the Americas. Fact #3: IMGs tend to become
primary care physicians. Approximately 65% of Caribbean
medical school graduates go on to match into internal medicine or family medicine residency programs. There are a couple reasons why. One, these specialties
offer more positions than any other specialty, and two, the average Step 1
scores for these specialties tend to be lower. As a premed, it's impossible to predict what specialty you'll want to
pursue after medical school. When we compare the two
tables from the NRMP listing the total number of positions offered for each specialty,
it's pretty clear that U.S. medical students
are successful at matching into a much wider range
of specialties than IMGs. If your goal is to become
a primary care physician, you can rest assured that if you match as a Caribbean medical school graduate, your odds of landing a position in primary care specialties
are fairly high. However, if your goal is to match into competitive specialties such as orthopedic surgery,
anesthesiology, or dermatology, you'll need to be an
exceptional candidate to match. Even for U.S. graduates,
positions in these specialties can be tough to obtain. You'll need to achieve
a high Step 1 store, secure prestigious rotations
during your M3 and M4 years, and receive strong letters of rec from clinical supervisors to
give yourself the best odds. Fact #4: Tuition at
Caribbean medical schools is significantly higher. Medical school tuition is high no matter which school you attend. According to MSAR, average
annual tuition costs were $37,556 for in-state
students at public medical schools and $60,665 for in-state students at private medical schools. Over four years, this adds up to $148,000 for public medical schools and $240,000 for private medical schools. Tuition rates at Caribbean
medical schools are even higher. For example, St. George's
tuition is about $280,000 for over four years, and these
costs don't factor housing food and other living
expenses or interest. Where you attend medical shool will not only have a significant impact on your career trajectory
but also on your finances. So, the big question: Should you attend a Caribbean medical school? Many good doctors have graduated from Caribbean medical schools, but know that you will face
significantly more hurdles than your U.S. counterparts when it comes time to match
into residency programs. If you're deciding whether to attend a Caribbean medical school, or
delay applying for one year, I strongly encourage you
to do all that you can to strengthen your application for DO or MD programs
in the United States. The truth is that U.S.
medical program graduates simply have significantly better odds of matching into choice programs
and desired specialties, which will in turn have
a significant impact on your career as a physician. Depending on your unique situation, you may benefit from retaking the MCAT, enrolling in a post-bac or
special master's program, or gaining more research
or clinical experience. However, if you've done
everything in your power to improve your candidacy and your stats still fall short of U.S.
med school expectations, you can still become a great doctor by attending a Caribbean medical school and putting in the work. If you found this video helpful, give it a thumbs up and subscribe so you don't miss out on new videos. And if you'd like to learn more about the med school admissions process, including a whole section on
how to develop a school list that maximizes your admissions odds, click the link in the description to get my free comprehensive guide "How to Get Into Medical School". The strategies in the guide
are the same ones we use to routinely help
students get into schools like Johns Hopkins, Mayo, and UCSF. Alright, thanks again for watching! See you next time.