For years, less competitive medical school applicants have been attracted to the more liberal admissions policies of medical schools in the Caribbean. Other applicants have been attracted to medical schools overseas for personal reasons, including simply wanting to explore a new culture. However, with a myriad of languages, laws, and curricula, it's hard to know what you're getting—especially if you plan on returning to the U.S. for residency.
What is the truth about applying to foreign medical schools? Consider both the pros and cons.
Pros: There are some distinct advantages to applying to foreign medical schools, particularly in the Caribbean.
1. Acceptance rates are higher than average. Many medical schools in the Caribbean accept a much higher percentage of applicants than schools in the U.S. As an example, the George Washington University School of Medicine (ranked 60th in the research field by U.S. News) accepted just 3.6 percent of all applicants in 2010, while the Ross University School of Medicine, on the Caribbean island of Dominica, accepted 38 percent of applicants that same year. For schools outside the Caribbean, acceptance rates vary considerably, as these typically taxpayer-funded schools tend to prefer their own nationals.
[See the rankings of the U.S. News Best Medical Schools.]
2. GPAs and MCAT scores are lower than average. For applicants with a blemish on their record, schools in the Caribbean can seem fairly enticing. Successful applicants to Wake Forest University in North Carolina, for example, had a mean GPA of 3.8 and a mean MCAT of 32 in the last admissions cycle, while those to St. George University in Grenada had an average GPA of 3.4 and MCAT of 27. As such, these schools can be a realistic option to consider for applicants with lower scores.
3. There are clinical rotation opportunities in the U.S. In many of the Caribbean schools, the first two years of basic science is done on their campuses overseas, while clinical rotations are done in U.S. hospitals, most commonly in the New York area. Though your home school is still overseas, you have the advantage of the same clinical exposure and opportunities as the hospitals' home medical students. Many past students cite this as an advantage in applying to U.S. residencies. Other overseas medical schools allow students U.S. clinical rotation opportunities, though usually on a more case-by-case basis.
[See the 10 most popular U.S. medical schools.]
Cons: There are some things you should be aware of when considering overseas schools.
1. Applying and matching to a U.S. residency can be more challenging. Though many international medical graduates successfully match into residency programs across the U.S., they do so at significantly lower rates than their U.S. graduate counterparts. In the 2011 match, 94.1 percent of U.S. senior medical students matched into a residency program, compared to 50 percent of U.S. graduates of foreign medical schools. Many schools in the Caribbean, however, state that a significant percentage of their graduates find positions outside the match.
On top of all that, there are additional paperwork requirements in order to apply. The Educational Commission for Foreign Medical Graduates (ECFMG) has details on its website. Before applying, it would be wise to research each individual school's match success rate, as they may vary.
2. Grading systems can vary. While many U.S. medical schools have trended toward a variant of an Honors/Pass/Fail grading system, many medical schools overseas, including in the Caribbean, continue to use a traditional A-F system. Though all medical school curricula are challenging, some students may feel that such precise grading systems can sometimes add additional stress to an already competitive atmosphere.
3. Living in a different country / system can be challenging. This can be either a pro or a con, depending on your perspective. However, because many foreign medical schools popular with U.S. applicants tend to be located in developing countries, it's important to remember that many of the amenities of U.S. life may not be available. And if you're studying most of the day, this might be the time when you need those more than ever. Politics and weather differ, too—don't forget the 1983 coup in Grenada (St. George University) or the hurricanes.
Making the decision to apply overseas is tough. Whatever you decide, it is important to research your options carefully so your transition back to the U.S. is as smooth as possible.
Ibrahim Busnaina, M.D. is a graduate of the University of Pennsylvania School of Medicine and coauthor of "Examkrackers' How To Get Into Medical School." He has been consulting with prospective medical school applicants, with a special focus on minority and other nontraditional candidates, since 2006.