DO from a US med school vs MD from the Caribbean

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It sounds like he first only matched for his prelim year. Then what? He didn't have a successful SOAP last year, so this year he had to go thru Match again for his PGY2?

Correct. He graduated in 2016 and only matched into a prelim surgery year, the kind of program people do before optho or some other surgical subspecialty (which is what he wanted). He had to apply again this year for PGY2 spots in order to have a job in July 2017.

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Yes, familiar. My son is doing a prelim/trans (forget which one) this year, and then onto diag radiology for PGY2

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If I'm understanding, and he matched for PGY2, why wouldn't that be for a PGY2, 3, 4, and however long that residency is? Do doctors get booted out of residencies? I guess it's possible if someone is flaky, but is it really likely it could happen to this person?

He had not matched for PGY2+. But to answer your other questions, doctors could get booted out of residencies. This particular person has not been “booted” from anything. He was simply not accepted as an MS4 into anything other than a dead end 1 year position.

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Oh wow…awful. Wouldn’t he already know if he matched somewhere for PGY2++

It’s a sickening feeling that these kids might have 300k of med school debt.

Do these Americans going med abroad get to use fed loans?

RE: loans

Yes, students attending the foreign medical school listed below are eligible to take out federal student loand and federal Grad Plus loans in the same amounts as US medical students.

https://studentaid.ed.gov/sa/prepare-for-college/choosing-schools/types/international#get-degree

Additionally those ineligible Caribbean med schools have formed arrangements where its students will enroll simultaneously in US college for MA program.

http://www.cleveland.com/metro/index.ssf/2013/12/us_students_in_caribbean_medic.html

“Since 2000, 24 medical schools opened in the region, according to a 2010 report in Academic Medicine, the journal of the Association of American Medical Colleges. Only four Caribbean schools qualify for federal loans.”

The number of medical schools in the Caribbean is astounding. Looks like a very profitable business.
Looks like an easy way out for students to get into medical school. Do they ever reject any student that applies?

RE: doctors can and do get booted from residency, but it usually is drawn out process with multiple attempts at remediation unless the issue is so serious there’s no other choice but immediate terminations— criminal charges for a violent or sexual offense; reporting for work impaired (drugs or alcohol); stealing prescription drugs (esp opiods); or a major HIPAA or privacy violation (like reading a celebrity’s medical file and selling the info to the press or, as in a recent incident in upstate New York, putting video cameras in staff bathrooms)

[The Cost of Training Doctors Offshore](https://www.bloomberg.com/view/articles/2013-09-10/the-cost-of-training-doctors-offshore)

From Bloomberg Business.

The article is from 2013, since then Saba Medical School on St Maarten has also been declared eligible for federal student loans.

Considering their dropout rates, providing loans is scary business.

I think drop out rate is the norm even in US UG private schools. I just notice some private Universities has 4 year graduation rate of under 50% and 6 year graduation rate of 75%. So, if you are borrowing and fall into the 25% category after 6 years, the debt amount will skyrocketed and I think it will take a LONG time to pay off the loan.

So, if some one wants to take the risk of going to the Caribbeans, let them do it. Nothing can stop them. At least not from postings on CC.

There are solid universities on this list - McGill, Dublin, Sydney, Royal Surgeons, Imperial - all legit and excellent.
There’s now one in Malta that I’m not sure about but it’s associated with a reputable British university.
Why don’t students apply to these rather than Carribean schools?

The medical school in Malta is associated with Queen Mary University of London
https://www.timeshighereducation.com/news/queen-mary-to-open-private-medical-school-in-malta/2019529.article

Not sure about all of medical schools you mentioned, but admission to University of Sydney and McGill is extremely competitive for internationals. Certainly not any less difficult than getting into a US med school.

For students who want to attend an international medical school–Sackler in Israel or U Queensland Oschner SOM in Australia are better choices. Both offer 2 years of full time clinical rotations in the US. Sackler has multi-decades long agreements in place with many NYC hospitals. (A lingering legacy from when US med schools capped the number of Jewish students they accepted.) UQ sends its US students to do all of their clinical rotation at the Oschner Medical Center in New Orleans.

Both have NMRP match rates comparable to US DO schools ( >85%)

A CC member contacted me to ask if I would contribute to this discussion because I serve on a medical school faculty. Specifically, the member asked for my assessment of the comparative value of an American DO degree versus an MD from a Caribbean worked medical school. I actually think this has been adequately dealt with in the previous posts, so I’ll try to be brief. American DOs receive comparable training to MDs; the curricula are essentially the same except that DOs receive (or are offered) additional training in osteopathic manipulation. They are eligible for the same residencies and although MD graduates have a competitive advantage in securing some residency slots, DO graduates are treated equally once accepted. I have served on residency selection committees and I can tell you that we always sought to fill our slots with American graduates (MD or DO) over FMGs (foreign medical graduates). Exceptions would be graduates from the UK, Ireland, or British Commonwealth nations such as Canada, Australia, and New Zealand. I would certainly recommend that a student accept a place in an American DO school rather than pursuing an MD degree from a Caribbean school.

As of mid-March, yes he knows whether or not he matched; however, my surgery rotation was before that so in all my interactions with him, he did not know.

I understand there are two kinds of residency programs, Preliminary and Categorical.

My questions are:

  1. Why some one will take a Preliminary Residency position knowing that he may or may not have a job in one year. And if he can’t be matched again, what are the options?
  2. What is the purpose of a Preliminary Residency? The PD knows this student will most likely not with him and will not be fully prepared for his specialty, then why they offer a program as such.
  1. if all you have is a 1 year prelim offer, you take it because you have no other choices. You have the opportunity to work your buns off and maybe get a good recommendation that will help you match into a categorical program the next year. Better than being unemployed and in debt. Also the longer you are out of med school without a medical position, the harder it is to match because your medical skills atrophy.

UD MD and DO grads can get a unrestricted medical license and are able to practice medicine as a GP with just 1 year of residency training. (Graduates of foreign medical schools need 3 years of residency to get a license.)

  1. Some specialties require a prelim year before the in-depth specialty training starts (derm, rads, neuro, anesthesia, ophtho, rad onc). Because these programs want their residents to have broader exposure to medicine or general surgery before they start in depth training in one very specialized area because they need their residents/doctors to be able to recognize & deal with issues/problems that arise outside the area of their narrow expertise.

There are tons of prelim surgery positions available–far more than are needed to train surgeons. The cynical among us would say these positions are used to exploit desperate medical grads with no other options by using them as cheap labor.

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I understand there are two kinds of residency programs, Preliminary and Categorical.


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I don’t think that’s right.

I think the two types are Advanced and Categorical.

Advanced residencies (there are several of these) require an intern/prelim/trans year first, as PGY1. Advanced residency training begins with PGY2.

My son had to match into TWO places in March’s match…one for his trans year and one for his actual specialty residency PGY2+. So, his Match paper had two matches listed on it. One for his trans year, and one for his advanced residency

No one tries to only match into the first year. The attempt is to match into both. A partial match would mean doing SOAP and if failing that, applying again.

following may help clarify terminology (ie intern/prelim/trans)
http://www.doctorsintraining.com/blog/figuring-out-the-transitional-preliminary-and-categorical-year-for-residency-application/

Some hospitals do prelim or transitional years specifically to attract higher caliber talent than they would normally be able to get. They often do this by offering these kids easier call schedules or more elective time or other benefits. Kind of like how most BS/MD programs are at lower tier UGs. My school for example is considered an “undesirable prelim program” because the prelims are treated exactly like categoricals. For a caribbean student trying to land a spot - that’s probably better for them. For the future derm resident looking to coast through a general medicine year after a grueling med school run, they’d rather avoid us.

I remember being told a few years ago that University of Hawaii’s hospital has an incredibly competitive prelim program.

^^^’ @iwannabe_Brown

That is very true. I was looking at the “mini bios” that some of the top Advanced Residency programs post about their residents and a number of those residents spent their internship year at good-but-lesser-known-hospitals.

https://radiology.ucsf.edu/education/residency-programs/diagnostic/residents

And you’re right, those hospitals offer bennies, like free meals, free Starbucks, concierge dry cleaning, better hours, etc, to get that talent.

Also, it can be tricky when ranking your internship year and your advance residency programs. No one wants to move twice, especially criss-crossing the country. My son faced this. He didn’t know if his residency would be West Coast, Midwest, MidAtlantic or NE…so he needed to limit the geography choices for his internship year to either Alabama (so staying put for the internship year) or Calif (and free rent from one of my siblings). Since he matched at MGH, it was good that his internship year allows him to stay put at a very good, private, but not crazy intense hospital, and not move twice.

An article in WSJ “Overseas Medical Schools Offer Remedy for Shortage of U.S. Doctors”. Needs subscription to read this article. Light weight info article.

Since there are posts in this thread related to Caribbean and Australia, thought of making this post.

https://www.wsj.com/articles/overseas-medical-schools-offer-remedy-for-shortage-of-u-s-doctors-1497021507

A) can’t believe my school doesn’t provide us a free subscription to the WSJ (I’m on a school computer in the library)
B) The physician in the photo for this article which can be seen on the section page (https://www.wsj.com/news/us) is Brown 2010. We were lab partners in a class once and had many mutual friends.

Yes. She is a Brown UG and did her MD in Queensland-Ochsner program and in her 2nd year residency at Louisiana State University rural family medicine program.

Article gist as requested:

  1. AAMC forecast shortage of Docs around 50-100k by 2030 though US medical schools increased enrollment by 1/4 over past 15 years. (this year 21030 students)
  2. Demand outstrips supply of seats in US campus. Also shortage of Docs in rural/underserved areas like Nevada to Wyoming to Louisiana/Tennesse. That is where overseas schools are stepping in.
  3. 2016, 3298 US citizens from international medical schools (up from 1858 in 2006). That graph also shows # of students from India decreased from 2700 to 1150 and students from Pakistan increased from 550 to 750 or so.
  4. Though these schools carry stigma, pricey and lax in admission standards, they claim they fill the vital gap and also polishing their image to attract more students (especially due to tighter immigrations rules under the Trump admin.)
  5. Only 54% of students accepted in to residency compared to 94% of US domestic students. But QC-Ochsner had 95% and 85% for (Caribbean - Ross, American univ, St-Georgia and few others).
  6. In 2016, 15% US citizens from foreign medical school, double the share from 2000 for residency match.
  7. PD in SUNY Syracuse said they are high quality and you have to take a chance. There half of 59 first year US students are from Caribbean schools.
  8. QC-Ochsner is non-profit but Caribbean schools are for-profit. Ross and American Univ owned by same company Adtalem Global Education.