Caribbean Medical Schools: Second-Chance or Second-Rate?

It's no surprise that medical school is getting more competitive. As far as aspiring doctors go, undergraduates today must struggle through a completely different experience than their parents and grandparents did. In 1999, a "record" number of students – 1,049 – applied to U.S. medical schools. By 2013, that number had grown to nearly 50,000 a year.

The Association of American Medical Colleges reports that this jump is partially attributable to the increasing number of women and minorities who are seeking positions in healthcare. To their credit, American universities have done their best to keep up with demand; more than a dozen schools have increased their class sizes, and a few new medical colleges have established themselves throughout the country.

Unfortunately, this growth hasn't done nearly enough to absorb the influx of medical hopefuls. And the "tips and tricks" for applying to school increasingly reads like a set of riddles. For example, a guide on U.S. News suggests that yes, GPA and MCAT scores are still very important, but so are life experiences, diversity, gender orientation, and problem-solving abilities. Students should present themselves as thoughtful and service-oriented. They need to be unique, but should also demonstrate that they will work well in a cohort of other students.

In some ways, the request that medical applicants practically be "all things to all people" ensures that only the very best gain the privilege – and responsibility – of becoming healthcare practitioners. But it also marginalizes many hardworking students who can't figure out the cryptic magic formula.

More and more often, students who are denied from American medical colleges are turning to alternatives in the Caribbean, where 30-40 schools are ready and willing to take on the American "rejects." These universities are both painfully expensive and attractively unselective. They admit roughly 1 in 4 applicants, advertising themselves as a "second chance" to curious and passionate students who simply don't have the chops for American education.

The students who attend these foreign schools offer myriad explanations for their rejections – their age, their major, the fact that they went to a selective undergraduate school, their test scores…the list goes on. But the question remains: are these Caribbean alternatives simply helping determined students get back on their feet, or are they injecting the healthcare system with subpar doctors?

The schools differ wildly in their performance; first-time pass rates on the Medical Licensing Exam Step I range from 19-84%. Plus, most of the universities pay U.S. hospitals to take students for rotations, asking them to ignore the students' potentially underwhelming abilities. And without an accrediting body or any objective ranking system, it's nearly impossible to tell if students at Caribbean schools are getting an education that can even compare to the U.S.'s second-rate programs.

Fortunately, there is one clear take-away that may shed light on the issue for administrators involved in the hiring process. These students understand that the most advanced specialties are out of reach for them. Many of them also understand that they won't make as much as their American-educated counterparts, and their student debt will be much higher. As such, administrators can count on the fact that compared to their colleagues with a glitzy U.S. diploma, these would-be doctors aren't in it for the money. Add to this the unique education they receive on Caribbean islands – where clinics are shockingly primitive, resources woefully scarce, and patients sickeningly poor – and you have a perfect formula for compassion, service, and patient-centric care.

Hospital administrators who see a résumé adorned with Grenada or Dominica under the "Education" heading might be quick to throw it straight in the trash. If they're hiring a neurosurgeon, that might be the right call. But administrators who need someone with experience in infectious disease, with the heart to travel to third-world countries (such as through Doctors without Borders), or who can make a respiratory diagnosis without a chest x-ray might due well to put aside the question of whether or not they're second-rate or second-chance, and take a second look.

Association of American Medical Colleges
U.S. News: Medical School Admissions
The New York Times: Second-Chance Med School

About the Author:
Iris Stone is a freelance writer, editor, and business owner who has written on a range of topics. She has experience covering content on medicine, healthcare, and career training, as well as education. Iris is also interested in science and mathematics and is currently studying to be a physicist. Check out her Google+ Profile.

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