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.

Accreditation Status of St. James of Medicine Bonaire Campus

There has been a lot of talk about the status of the St. James School of Medicine’s survival. Let me make it clear to you that the school is not shutting down, nor is it in the process of shutting down.  Readers of this site questioned what was happening and I had no answer to give them because I didn’t know anything.  But now I do know what’s happening and I will lay it out.
Right now, the accreditation of the Bonaire campus is extended for another 5 years supposedly. Apparently, the Bonaire campus education quality must be in parallel with Dutch education standards and that’s where the problem started.  So, SJSM has to improve the quality of education.
I’m not going to sugarcoat anything, the ground reality is if Bonaire ever lost the Dutch accreditation then Bonaire campus will close and the SJSM accreditation will be dependent on the Anguilla campus. Unfortunately, for the Bonaire students who already registered with the ECFMG for USMLE Step 1, SJSM will mostly likely transfer everything from the Anguilla campus and it will show “transfer” on your transcript. If you didn’t register yet with the ECFMG then you should be good, but don’t take my word for it.
Currently, SJSM have cleared anything and everything that stood in the way of the Bonaire campus’s accreditation so you don’t need to worry.  The best thing is to call SJSM’s main office and ask them what happened in detail.
Bottom like is, SJSM Bonaire still has IMED accreditation and it will continue to run.
Here is the letter the students received from the main office:
We are pleased to announce our IMED listing issue has been RESOLVED
Over the past months we have been working closely with the Dutch Government regarding the school’s accreditation.
We have been advised that these discussions have been successful and ourIMED listing is secure. We are now waiting for the official extension notification documentation which is due shortly.
The extension means SJSM Bonaire will continue to operate as normal with the support of the Dutch government and local Bonaire administration. Our students can therefore focus on their medical studies with certainty.
Saint James School of Medicine – Bonaire