Over the years we have recorded a large number of
students from African countries (e.g Nigeria, Ghana, Kenya and South Africa)
and even the United States of America, coming to us to work their way to the
Caribbean to study. Over 98% of these
students want to study medicine in the Caribbean. This led us to focus on
medical students and medical schools respectively as far as study in the
Caribbean is concerned. We then focused majorly on four of the best major
Medical Universities which we partner with today. They are:
All Saints University School of Medicine
Windsor University School of Medicine
Ross University
St. George’s University
Because the competition for admission to medical
schools in the United States is extremely strong, many applicants consider
attending medical school in the Caribbean. In fact, a great many bright and
talented applicants are now opting to obtain their medical education in the
Caribbean.
How can you decide what is the best choice for you?
What must you consider in evaluating these schools? And will you be able to
obtain a residency in the United States after you graduate? To help you decide
if attending a Caribbean medical school is a good choice, we put this piece for
you.
A Little Background
In the last four decades, the Caribbean has seen a
steady increase in the number of medical schools on the islands as well as the
size of their student bodies. In the late 1970′s three Caribbean medical
schools were established: American University of the Caribbean, originally
located on the Island of Montserrat, Ross University on the Commonwealth of
Dominica, and St. George’s University in Grenada. Since their
inception, these schools have educated many US citizens seeking a medical
education outside the US, and now about 60 medical schools in the
Caribbean are listed in the Foundation for Advancement of International Medical Education Directory (IMED).
The physicians who graduate from Caribbean medical
schools play an increasingly important role in the US health care system by
supplying residency programs with qualified applicants and helping to meet a
well documented physician shortage, particularly in primary care
medicine. While accreditation, didactic studies (first and second years
of medical school), and clinical rotations (third and fourth years of medical
school) differ among institutions, requirements for graduate certification in the
United States, as outlined by the Philadelphia based Educational Committee on Foreign medical graduatess, are the same for
all students graduating from all international schools, including the
Caribbean.
Caribbean Medical School
Accreditation
Accreditation
for Caribbean medical schools is on several levels, including local Ministry of
Health accreditation by some individual Caribbean country’s government,
regional accreditation by organizations such as The Caribbean Accreditation
Authority for Education in Medicine and Other Health Professions (CAAM-HP). The
World Health Organization (WHO) does not accredit medical schools but maintains
a list of schools that are recognized by local governments. In the United
States, The National Committee on Foreign Medical Education and Acrreditation of the US Department of Education (NCFMEA) of the
United States Department of Education determines whether the process conducted
by an accrediting organization is comparable to the Liaison Committee on Medical Education (LCME) process of accreditation. This is a voluntary process so not all
schools undergo this evaluation. If a school’s accreditation is deemed
comparable to the LCME process, then that country can apply for US federal
loans for those students. Currently, only 3 schools in the Caribbean are
eligible for these loans.
It is important to know which organizations have
accredited any school you consider attending. Knowing if the state in
which you intend to practice recognizes your school is also important.
Caribbean medical schools proudly display these accreditations on their
websites so if an accreditation is missing, be wary.
Quality of Medical Education
in the Caribbean
The only way to
evaluate the education Caribbean medical students received was to examine students’
scores on the United States Licensing Exam (USMLE) Step 1, which is taken after
the second year of medical school. Investigators calculated the average USMLE
Step 1 first time pass rate for each country in the Caribbean. In evaluating
this data they also took into account that some islands have more than one
medical school. The countries with the highest percentage of students
passing the (USMLE) Step 1 on the first attempt were Grenada (84.4 %) and
Dominica (69.7%). Countries with the lowest pass rates were Saint Lucia (19.4%)
and Antigua/Barbuda (22.9%).
Preclinical Years
Students
typically spend the first four to five semesters of medical school in the
Caribbean completing basic science courses before taking USMLE Step I.
Basic science curriculums in the Caribbean are similar to US curriculums.
Some schools offer a fifth semester, either in the Caribbean or in the US, to
help students prepare for the USMLE Step 1 and transition to their clinical
semesters.
On the plus
side, many students form strong relationships with classmates and also enjoy
learning about the history and culture of the local West Indian population.
Former students also have fond memories of celebrating yearly holidays such as
Carnival, the colourful, festive, and historical event celebrated annually
throughout the Caribbean. After successfully passing the USMLE Step 1, students
proceed to their clinical rotations, which usually are outside of the
Caribbean. When evaluating schools, it is important to ask what percentages
of students who initially enrol in each class actually take and pass the USMLE
Step 1 and successfully proceed to clinical rotations.
Clinical Years
Core clinical
rotations and third and fourth year curriculum in Caribbean schools resemble
those of US medical schools. Caribbean schools that offer clinical training in
the US have strict guidelines about the location and quality of students’
clinical training. All core rotations and subinternships must be
completed in hospitals with which the Caribbean medical school has an active,
written affiliation agreement and which have appropriate clinical faculty
members. Rotations must be approved by the Accreditation Council for Graduate
Medical Education (ACGME). In addition, it is preferable that hospitals have
approved residency training programs (or their British equivalents) in the
specialties through which students rotate. Students also take both parts
of USMLE Step 2 (clinical knowledge and clinical skills) after the third year.
Hospitals in which electives are taken should also
have approved postgraduate programs in those specialties. For example, it
is best to do an anesthesia elective at a hospital that has an anesthesiology
residency. Regardless of school affiliation, however, individual hospitals still
reserve the right to screen individual students for elective clerkship
acceptance. Some individual hospitals and departments do not accept
international rotating students, which can limit the away electives in which
students can participate. From a competitive perspective, it is always
preferable to participate in clinical rotations located in hospitals that not
only have ACGME accredited residency programs but are academic teaching
hospitals rather than community hospitals.
If I Go To a Caribbean Medical
School, Can I Get a Residency?
Graduates of
Caribbean medical schools have tremendous success in obtaining residency
positions, even in competitive specialties. It helps to attend a
well-established Caribbean school, perform well on the USMLE Steps 1 and 2, and
obtain strong letters of recommendations. Before applying for the residency
match and early in medical school, students should strategically plan their
clinical clerkships in the US, ideally arranging rotations in the settings
where they prefer to match. In recent years, Caribbean students with
strong academic and clinical performances have been able to obtain competitive
residency positions at an increasing rate. However, the largest number of
students pursue less competitive specialties, such as internal medicine or
family practice. Some students are also able to “prematch” into residency
positions outside of the National Resident Matching Program (NRMP).
When evaluating the success of a Caribbean medical
school’s graduates, it is important to find out specifically where and in what
specialties students match. Also determine what percentage of fourth year
students match into categorical programs. This information may not be easy to
obtain. While schools typically publish their match results, it is unclear if
these lists are truly comprehensive.
After residency, Caribbean medical students, along
with their domestic colleagues, will obtain board certification and must meet
specific requirements for state licensure. The quality of one’s residency
training usually carries more weight than the medical school attended, so
obtaining the best possible residency and even fellowship can help Caribbean
students overcome some of the bias foreign students face when competing for
competitive attending positions.
Educational Commission for
Foreign Medical Graduate (ECFMG) Certification and Graduate Medical Education
Programs
To be eligible
for ACGME accredited residency programs in the United States, and for licensure
in many states, students who graduate from a Caribbean medical school must
obtain an ECFMG certificate. Eligibility for this certificate includes
graduating from a medical school listed in FAIMER’s online International
Medical Education Directory (IMED) and passing the USMLE Steps 1 and 2
(both clinical knowledge and clinical skills).
Studying in the Caribbean Medical Universities
could be the ideal place for you. Let’s work your way to one of our partnering
Universities.
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