Challenges in Applying for Residencies for Caribbean Medical Students

The following was an email from a blog reader.  I think the reply I gave should answer questions for some prospective students.

I just wanted to know if you could tell me the challenges applying for residency that come with being a caribbean student. I know the obvious issues but what can you do to get around it besides having a good score?


Unless you graduate from the offshore schools of Ross University, St. George University, or American University of the Caribbean, you may run into a good amount of obstacles to gain residency. Most Caribbean medical schools are not approved in all 50 states. My school Saint James School of Medicine, is about to reach 15 years in which the school will apply to big states like Texas and Florida for licensing. Usually it’s a case-by-case basis for license approval in those states. Luckily my school has not been disapproved in any states. A good number of states follow the California approval list and so some Caribbean medical schools may not be approved.

Another issue is if you are Canadian then some program will not accept you unless you are also a US citizen or a US green card holder. Some residency programs will not sponsor visas for foreign grads, that’s where US citizens who went to offshore schools have the advantage.

At the end of the day, the Step 1 and Step 2 CK scores matter. Some programs look at your Step 1 score and some programs look at your Step 2 CK score, and others may look at both. So it’s a good idea to score high in both tests with Step 2 CK score being higher than Step 1 score.

Another issue could be your letters of recommendation. Some schools have good rotation posts in which students get good LORs but others may not so it depends on the school and what rotation spots they have.

Also, with more American medical schools being built and more American medical grads are applying to primary care, IMGs will have high competition since residency spots have not increased significantly. Therefore, it’s better to go to a US med school, the second option would be to attend the top three Caribbean medical schools which I listed: Ross, AUC, and SGU.

USMLE Step 2 CS Hands-On Teaching From a Student

As you know the USMLE Step 2 CS has gotten harder.  Before the candidate just has to list 5 differential diagnosis and 5 diagnostic workup. Now with the new change, candidates must now list 3 differential diagnosis and give the reason of why those differential diagnosis were chosen.  Due to this change even American medical students are failing. 
Here is a Cheap Solution
One of the SJSM students, who is living in Hyde Park, is offereing hands on teaching for students who need help studying and practicing for the USMLE Step 2 CS. He said the first hour is free and it’s $20 per case to practice. He will be the SP and he will go through each case thoroughly with the students.

He passed USMLE Step 1, USMLE Step 2 CK, and USMLE Step 2 CS; therefore, he is fully ECFMG certified. He is finishing up his 4th year. Instead of paying $1000+ to Kaplan and other institutions, get hands on experience from a fellow student will help the teaching a lot better because he was in the same position as us. He did all his core rotations in Chicago and he is currently finishing up his electives. Remember this is open to ALL MEDICAL STUDENTS, regardless of which school you are from. He can also Skype with you if you are not living in Chicago.

If you are interested then please contact us, and you’ll get a reply back with his contact information.

Transferring Out or Sticking with Saint James School of Medicine

This relates to the recent events of Bonaire campus becoming the subcampus of Anguilla. Saint James School of Medicine Bonaire is scheduled to be completely closed in December 2014 and operations to be continued in Anguilla after December 2014. The question is, should I stick with SJSM or should I transfer out?
You have to consider several things and everyone’s situation is different. First think about how far you are in your MD. If you are in basic sciences on the island or in AICM and still haven’t registered with the ECFMG then you have the option of transferring out without any problems.
For those who are not familiar with the ECFMG, it is the US medical organization you need to register with in order to take your USMLE tests since you go to a non-US medical school. When you register with the ECFMG, you basically tell them who are and what school you started medical school with. After registering with the ECFMG, they will know everything after you make any changes you make afterwards.

Saint James School of Medicine

If you are in AICM 5th semester and you didn’t pay for the 6th semester or above, and you didn’t register with the ECFMG yet, then you have an option to transfer.

However, for us clinical clerkship students, we have to finish what we started because we already paid the majority of the tuition. Also we already took USMLE Step 1 and some of us are already registered for USMLE Step 2 CK or CS or both so, there’s no point in transferring. Transferring after all we did will only make things more complicated with the SJSM, ECFMG, and with residency.
Since our transcript will show that we transferred, it will have a minimal impact from what I was told. The reason is we are transferring from one campus to another, yet we are still with the same school. Therefore, we still have one transcript.
So that’s my two cents about transferring. So, if you transfer, make sure you look at all your options and angles before doing so.