The question to ask isn't what specialties St James grads can't obtain because TECHNICALLY with an MD any specialty is possible. It is what specialties are so competitive that carib grads (& especially low-tier schools like St James) have no shot for ....

Far as I understand it, rads/anesthesiology (competitive) IS possible (but DIFFICULT) from the high-end carib schools (SGU, Ross, AUC, SABA). Derm/orthopedic surgery (the REALLY competitive residencies) etc are essentially impossible. Then again, you could get 280 on your USMLE steps 1 & 2 & then doors MIGHT open up for you (I don't know - I'm not even in MD1 yet)

Unfortunately, St James match list on the website is very (VERY) sparse (but most ppl seem to match in FM with some in IM) - I did hound a very nice IM resident in Chicago & she said she got 25 interviews with a step 1 in the high 80s. She also mentioned that other St James grads didn't have much trouble matching into a residency.

I know that doesn't directly answer your question, but it might help you orient yourself better.