how will New US schools affect the better caribb schools?

[boobird]

My assumption is that the need for FMGs to fill residency slots will be decreased as the number of US med grads increase. I know there were a handful of new US schools that opened in 06-08. Not to mention increasing class sizes for existing schools.

Anyone from the class of 2011 is unaffected. Is anyone starting in aug08 or Jan 09 worried about this potential problem?





Developing medical schools

These medical schools are still in the process of undergoing accreditation and are not yet accepting student applications.
State School City Degree Anticipated opening date
California University of California, Merced School of Medicine Fresno MD Fall 2012
California University of California, Riverside School of Medicine Riverside MD Fall 2013
Idaho University of Idaho Boise MD Under Discussion
Michigan Oakland University Beaumont Medical School Rochester MD Fall 2010
Mississippi William Carey University College of Osteopathic Medicine Hattiesburg DO Fall 2009
New Jersey Touro University College of Medicine Hackensack MD Fall 2009
New York Hofstra University School of Medicine Hempstead MD Fall 2010 or 2011
Oregon Western University of Health Sciences College of Osteopathic Medicine of the Pacific Lebanon DO Fall 2011
Pennsylvania The Commonwealth Medical College Scranton MD Fall 2009
Pennsylvania Lake Erie College of Osteopathic Medicine at Seton Hill University[1] Greensburg DO 2011
Texas University of Houston Houston MD Under Discussion
Wisconsin University of Wisconsin-Milwaukee School of Public Health Milwaukee MD Fall 2011 or 2012
Virginia Virginia Tech Carilion School of Medicine Roanoke MD Fall 2010

[cavalletti]

Can you tell us where you got the list?

[OTF]

This has been beaten to death. It's been in 5 threads recently and another one just a day ago. THIS IS NOT NEWS OR WORTH REHASHING!!!!!! Search the old threads!

[kryptik]

Yes it really has been beaten to death, Please follow this thread http://www.valuemd.com/american-university-caribbean-auc/156658-true-fmgs-who-matriculate-after-2012-screwed.html
and here http://www.valuemd.com/residency-match-forum/158591-us-med-school-enrollment-increase-less-residency-spots-imgs.html#post855780

[boobird]

sorry i should have searched for the word 'screwed'.

[kryptik]

sorry i should have searched for the word 'screwed'.
or "effects of new MD schools on IMG"

[Coldfusion]

I guess residency slots could get more competitive 4 years after these begin to open. Guess we're fine as long as we start now.

[boobird]

It "Could"?

I dont think caribb kids realize that they are the ones who take the residency scraps of US grads. Unless obama increases medicare funding to increase # residency slots, there wont be any scraps left over.

[AngryBaby]

It "Could"?

I dont think caribb kids realize that they are the ones who take the residency scraps of US grads. Unless obama increases medicare funding to increase # residency slots, there wont be any scraps left over.
Uninformed/ignorant comment. Please read, educate yourself and re-post.

Thank you and good-day

[kryptik]

It "Could"?

I dont think caribb kids realize that they are the ones who take the residency scraps of US grads. Unless obama increases medicare funding to increase # residency slots, there wont be any scraps left over.
i wouldnt call IM and Radiology scraps....also one mans scraps is anothers treasure

[rokshana]

It "Could"?

I dont think caribb kids realize that they are the ones who take the residency scraps of US grads. Unless obama increases medicare funding to increase # residency slots, there wont be any scraps left over.

"scaps"? never knew that ortho, rads, optho, urology had "scraps"....

you have plastered the fora with this question, so either you are a noob who hasn't figured out how to search a topic or a troll just looking to stir up trouble....

the "issue" of whether there will be spots for F/IMGs because of increases in AMG numbers was being discussed when my father was looking for a residency spot.....in 1969.....

we "kids" as you put it are very well aware of the pros and cons of attending an offshore school and those that are truly seeking information on the idea come to places like vmd as well as the websites of the schools to become more informed...

while it is more difficult to get good residency spots as an IMG, don't fool yourself into thinking that there aren't IMGs that get spots over an AMG candidate (or else there would NEVER be a match in urology, neurosurg, derm, ortho, etc- specialties where anywhere only 60-80% of those applying - IMG AND AMG alike- actually match)- there are. I can GIVE examples of people I know who were accepted at programs where they pick the sgu grad over other (mostly AMG) applicants.

and remember what happens when you assume...

[boobird]

we "kids" as you put it are very well aware of the pros and cons of attending an offshore school and those that are truly seeking information on the idea come to places like vmd as well as the websites of the schools to become more informed...

.

Name a single Pro of attending an offshore (over a US).

[kryptik]

Name a single Pro of attending an offshore (over a US).
Dont get it wrong, we are not claiming for people to attend a caribb school over a US school. So a pro will be getting the opportunity(granted you work hard) to still achieve ones career goals.

[boobird]

i wouldnt call IM and Radiology scraps....also one mans scraps is anothers treasure

yep, nrmp 2008 data shows there were exactly 30 kids who got radiology from a us-img / caribb application pool of 3000

hmm..ooo here an interesting fact on page 9. 50% caribbs don't match (n=1500). it seems taboo to discuss that kinda scary stuffs, so lets skim that page.

lets focus instead on the 30 in rads, 50 in gas, 77 in obgyn, 30 in path, 1 rad-onc, 1 vascular, etc! WE CAN DO IT! hurray!

[kryptik]

yep, nrmp 2008 data shows there were exactly 30 kids who got radiology from a us-img / caribb application pool of 3000.

hmm..ooo here an interesting fact on page 9. 50% caribbs don't match (n=1500). it seems taboo to discuss that kinda scary stuffs, so lets skim that page.

lets focus instead on the 30 in rads, 50 in gas, 77 in obgyn, 30 in path, 1 rad-onc, 1 vascular, etc! WE CAN DO IT! hurray!
its not taboo to discuss "scary stuff", people discuss and even diss their own schools all the time here, the point was for you to discuss it in the thread that was started already. Also majority of students are aware the facts you quoted. Again i am yet to read anyone advice to attend a caribb school over a US school.

[DrFraud]

This has been beaten to death. It's been in 5 threads recently and another one just a day ago. THIS IS NOT NEWS OR WORTH REHASHING!!!!!! Search the old threads!


Yes, similar statements were made by the op in other threads

It appears that most carribb grads are welcome to the residency positions that US grads cannot fill.

is it true that caribb grads pick up the scraps?

how difficult is anesthesia, emergency med, internal med in NJ, obgyn, and general surgery for auc/sgu/saba grads? must you rank in the top 10% and score 240?

do any residency programs actually distinguish SGU vs AUC vs Saba? it appears that all caribb schools fight for the scraps and that no school has an advantage. thoughts?



I do realize now that Independents (IMG/FMG/DO/ETC) exist to fill the slots that US grads do not take. 93% of all US meds match. The remaining spots are filled by various independents, such as AUC/FMG/ABC. 50% of independents do not match.


Whats the deal with the 50% who dont match? Are they qualified? Or Were they the bottom of the class? barely pass the boards?


and today's statement.........

It "Could"?

I dont think caribb kids realize that they are the ones who take the residency scraps of US grads. Unless obama increases medicare funding to increase # residency slots, there wont be any scraps left over.


Ae you trying to scare people or do you like to repeat the same statement over and over and over.....

[AngryBaby]

Seriously, guys...is the OP worth the trouble?

Really?

[boobird]

I must be paranoid. everythings gonna be fine.

[boobird]

Ae you trying to scare people or do you like to repeat the same statement over and over and over.....

The stats should scare the bottom half of caribb grads.

[kryptik]

boobird are you looking to attend a caribb school? if you are yes those stats should make you work hard to be able to match, if you think you cannot take that "risk" then you should try to get into a US school or consider a career change.

[argazul]

u mean its not all fun and parties in caribbean medical schools?:rolleyes:

[ScottsdaleIndian]

yep, nrmp 2008 data shows there were exactly 30 kids who got radiology from a us-img / caribb application pool of 3000

hmm..ooo here an interesting fact on page 9. 50% caribbs don't match (n=1500). it seems taboo to discuss that kinda scary stuffs, so lets skim that page.

lets focus instead on the 30 in rads, 50 in gas, 77 in obgyn, 30 in path, 1 rad-onc, 1 vascular, etc! WE CAN DO IT! hurray!

We've heard this discussed normally, but damnn, this guy's intent on something.
This person is:
1.)On the bottom of a waitlist trying to scare others so they give up their spots
or,
2.)Just got into a US School and was planning on a Caribb school, and now is full of it (as one should be, I would be myself, just not to this extent)

I dunno where this guy got the list, but none of the med schools he mentioned are even close to being open yet, or opening with classes of like 25 students each in like 2 years. This guy himself posted the potential dates of opening for these schools, and most of them are like 2012 and 2013 or actually say "Under discussion", it takes like 10 years from that point to actually get it running. I'm from Univ of Arizona, and they Just opened up a new satellite campus in Phoenix 10 years after starting it, it's taking like 20 students right now, and will increase by like barely 10 students a year until 2020 or something crazy like that. Unless he's actually looking out for his son in 5th grade, why does he care? Also some of the schools are D.O. schools, I'm not too familiar, but not every D.O. actually even tries to do MD residencies, right?

Plus, that "50% caribbs don't match" thing, I'm assuming is including ALL Caribb schools, like all 30 of em, what is it for SGU/Ross/AUC? . . .exactly. . .I mean of course if you're going to the others such as "Awesome Get Rich Quick Caribbean College of Medicine" with tuition of $2,000 a semester and online classes. . .

[boobird]

yes, i'm considering applying for jan 09.

rejected from us med schools.

i'm confident i could rank in the upper 1/2 of any caribb and perhaps score well on the boards. however, i've realized that its unrealistic to expect radiology at NYU or rad-onc at sloan coming from caribb, no matter your board scores.

i thought i had a good shot at IM/obgyn/surgery/psych/neuro/path at a decent, local hospital (which is not a bad deal at all). With this recent increase in US enrollment, I believe it is a legitimate concern for caribbs to worry about residency slots for '09 and beyond

[OTF]

yep, nrmp 2008 data shows there were exactly 30 kids who got radiology from a us-img / caribb application pool of 3000

hmm..ooo here an interesting fact on page 9. 50% caribbs don't match (n=1500). it seems taboo to discuss that kinda scary stuffs, so lets skim that page.

lets focus instead on the 30 in rads, 50 in gas, 77 in obgyn, 30 in path, 1 rad-onc, 1 vascular, etc! WE CAN DO IT! hurray!

A bit of advice. If you are going to go to a Carribean school learn to do your own research. One thing you will find in any good Carribbean student is self reliance, organization, and ability to find and discern info on their own, as the schools are often not that helpful.


First thing you could have found in a 2 minute google search.

http://www.aamc.org/workforce/workforceqa.pdf

On page 3 you would see the following.
How will this call for more U.S. medical students affect international
medical school graduates (IMGs)? Won’t this mean that fewer IMGs will be able to train in the US and practice in underserved communities?
• The new AAMC position statement calls for an end to the cap on graduate medical education positions reimbursed by Medicare and does not recommend a decrease in IMGs. The explicit goal of the new policy is to increase the number of physicians available to serve Americans which cannot be accomplished without an increase in residency training.

Or if you wanted the actual report plan from the AAMC on the new schools you could have found this
https://services.aamc.org/Publications/showfile.cfm?file=version111.pdf&prd_id=229&prv_id=279&pdf_id=111

Concerning your NRMP stats if you looked at the data since the enrollment increase intiiative started 2002-2003 academic years.
http://www.nrmp.org/data/resultsanddata2008.pdf page 21

US IMG match rate in 2003 was 54.6%
Non- US IMG's rate in 2003 was 55.7%

2008 US IMG rate is 51.9%
2008 Non-USIMG rate is 42.4%

So date appears to show that if this is having an affect on IMG's it's much more pronounced on Non-US IMG's.

However the AAMC has stated a goal to lobby towards increase residency spots.

Second point:
The bottom line is good US IMG's will match. Those with Step scores around 90/220+ will do fine. The people that aren't matching are those primarily with scores below 80 or that have some other difficulty such as multile transfers for academic reasons, submit paperwork alittle late and get less interviews, etc... Everyone who has done clinicals knows there are good Carribean students and bad ones. Bad ones try to do the least possible on the rotation, don't study as much as they should, and are looking to leave by noon everyday. They are less likely to match?

I know alot of people that matched in 2008 and they matched at good programs Case Western, U of Florida, U Wisc, U of Alabama, Rush, etc..In fact I know only one person that didn't match.

[kryptik]

^^ good theories...earlier in the OPs post he/she was inquiring about his/her chances in the AUC forum, and even posted his/her friend was in AUC and was doing well, so maybe he/she got into a US school.

[argazul]

unrealistic yes, but not impossible. And if you can't get into a top program directly, there are options like getting a good enough residency so that one can get a fellowship at a top program. Or work hard to get a faculty position at a good academic institution and establish themselves.

[boobird]

OFT, thx for the links. valuable info.


Figure 3. Concern over possible shortages of clinical training sites for
students

24.6%
Very concerned

44.7%
Moderately concerned

30.7%
Not concerned


I fall in the 24.6%.

[boobird]

who knows, maybe its a perfect time to go to caribb?

in the next 5 years, maybe residency slots will expand faster than enrollment, leaving more vacancies?

[argazul]

i think there will always be spots for top students whether they are AMGs, US-IMGs, or Non US IMGs. I fall in 30.7%.

[kryptik]

or EMG (extraterrestrial med graduate)

[OTF]

It's not a concern.

The reality is US grads can match with just passing Step exams..even if it's high 70's to 80. they will match somewhere however most average 215-220 and alot score much higher.

US IMG's need around 90/220 to match, they have a very good chance at that test range. DO YOU'RE WORK AND BE IN THIS RANGE AS A US IMG AND YOU WILL BE FINE!!

Non-USIMG's have like 95 to 99 step scores. Every non-USIMG I have worked with said they had high scores and they said they were told by their home country schools they needed them to match in the US. Places aren't going to sponsor Visas for people that aren't at towards the top.

[PikachuMan]

i think there will always be spots for top students whether they are AMGs, US-IMGs, or Non US IMGs. I fall in 30.7%.

I think that's the bottom line. Why worry about this stuff when all you have to do is what you should be doing anyway (that is, working your butt off in medical school).

[cooolguy]

damn u need a 90/220? What percentile are we looking at there?

[med etudiant]

I'm just glad to hear that the AMA is lobying for an increase in residency spots.

[rokshana]

yep, nrmp 2008 data shows there were exactly 30 kids who got radiology from a us-img / caribb application pool of 3000

hmm..ooo here an interesting fact on page 9. 50% caribbs don't match (n=1500). it seems taboo to discuss that kinda scary stuffs, so lets skim that page.

lets focus instead on the 30 in rads, 50 in gas, 77 in obgyn, 30 in path, 1 rad-onc, 1 vascular, etc! WE CAN DO IT! hurray!

you looked at the wrong data- you looked at just the catagorical spots- look at the advanced position data- its more than 30 i assure you (ross and sgu alone would account for 24 or 25 spots then).
again you did the same thing for anesthesia- the majority are 2,3,4 spots not catagorical.
There were 2 rad-onc (stephw confirmed!) at sgu alone, so the one would not be correct data.

and well lets face it THREE THOUSAND people did not apply to rads or to anes...common enough mistake that some people make- the true number you need to know is how man people actually applies and got a competitive residency- of the 12 or 13 people that got rads-were they the only ones (which i doubt) or were there 50 people (which again i doubt) applying for rads and only 12 got it?

OBVIOUSLY the ROADS residencies are harder to get coming out of the caribbean- if someone thinks its easy, then well, to be honest, they are a taco short of a combo plate, but it is not impossible and not even improbable....you just have to be at the top of your game (and frankly IMHO these are the people that were on the cusp of getting into a US school to begin with)...

also you have to remember that that number 50% includes ALL FMGs- those from every country not the US or Canada-numbers that i have seen out of sgu sit at around 70% of those who end up aprticipating in the match actually match. Now now some withdraw because they accept a pre-match, some withdraw because they didn't take all their exams on time, and still others just don't match- from my experience with my class- i would say about 30 or so (out of 300) in my term didn't match- they may eventually get something, they may not, can't really say.

the pro you ask??? Well the fact that I am a doctor- an MD in a university-based residency program would be my biggest pro....i wait listed 2 years in a row in the US with no realistic chance of getting a school to accept me if i applied a 3rd time...my choices would have been to be 4 years older- one option was to be Dr. Rokshana, the other to be Ms. Rokshana... THAT is the big pro....

If you have read ANY of my post, you would see that I am definitely NOT an advocate for coming down to the caribbean (or any other foreign school) before you have exhausted any and all possiblities of getting in a US school, but if you can't, well the carribean will allow you to become a doctor....

so I can say I HAVE done it ...you well...that is to be seen....

[Phospholipid]

my choices would have been to be 4 years older- one option was to be Dr. Rokshana, the other to be Ms. Rokshana... THAT is the big pro....



whoah, you're a girl? For the longest time i thought u were a guy. Well that changes everything.

[Kongakut]

What does it change?

[rokshana]

whoah, you're a girl? For the longest time i thought u were a guy. Well that changes everything.


LOLOLOLOLOLOLOL!!!!

don't worry hon, I've made the same mistake with other posters (thought nyladoo was a girl for the longest time!)!!:D:D

[BrendaB_MD]

The NRMP match rate for USIMGs who partcipate in the match is about 50%. The numbers are:


A: 1541 participated, matched
B: 1458 participated, failed to match
C: 929 withdrew
D: 659 no rank list
T: 4557 in total = A + B + C + D


You can look at these data a lot of ways, depending on the assumptions you make about categories B, C and D. For example, if you make a generous assumption that all those in category C and D got a prematch, you still only get an overall match rate of about 70% ((T-B)/T).

I have always had a difficult time reconciling these gloomy data with the match rates I see posted from the major schools. Perhaps there is a large cohort that never even registers for the NRMP or those in category B have a high success rate in the scramble. The numbers are not encouraging yet I would expect to see posts from a large angry cohort of people issuing warnings if 30% of USIMGs fail to match. It is a puzzle .....

It would be interesting to see data on the final number of USIMGs who take a residency position via any route (prematch, match, scramble)and compare that to the total number who register for NRMP (category T).

[BrendaB_MD]

Here is data from an article published by the ECFMG in Academic Medicine:

Educational Commission for Foreign Medical Graduates Certification and Specialty Board Certification Among Graduates of Caribbean Medical Schools. Academic Medicine 2006;81(10 Suppl)S112-S115.


The data cover US citizen graduates of carib med schools for the period between 1980 and 2000. The time lag is sufficient to allow those who registered for a USMLE exam to obtain ECFMG certification and obtain a license in the US.


The data (Table 1 of the paper) show that during the period 17049 carib students started the ECFMG process (registered for an exam) and only 74% obtained a ECFMG certificate. The best overall rate of ECFMG success was 86%. Of those who obtained ECFMG certificates only 61% obtained a license of any kind (i.e. are listed in the AMA database).

These are sobering statistics.

On the upside, the probability of matching once you have obtained an ECFMG certificate is high (~ 95% at the top schools). Still, even at the top schools, a significant number of students fails to obtain an ECFMG certificate once they have completed their basic sciences. The best overall success rate of getting an ECFMG certificate was 86%.

A second paper in the same issue of Academic Medicine looks at USMLE pass rate data for USIMGs for 1995-2004. In 2004, only 56% if USIMGs passed Step I on the first attempt and 84% ultimately pass step I. The Step II pass rate for USIMGs in 2004 was 69% and 89% of USIMGs ultimately pass Step II. 98.6% of USIMGs ultimately pass Step II CS. Overall, using the 1995-1999 cohort (lag included to allow time for people to complete the process) only 73% of USIMGs who initially register for a USMLE exam obtain ECFMG certification (this does not even include those who drop out prior to taking USMLE I). Note this data only includes US citizens.

[BrendaB_MD]

More interesting data from the ECFMG:

[names not permitted]. The International Graduate Pipeline: Trends in Certification and Residency Training. Health Affairs 2006; 25(2):469-477.

They break out data for USIMGs vs FMGS. For the period 1995-2003 61% of USIMGs who obtained an ECFMG certificate obtained a residency. Once again, this is not too far off the 50% match rate reported by the NRMP. This would suggest that the number of prematches is pretty small.

[BrendaB_MD]

ECFMG certificates issued to USIMGs 1983-2002

By school:
SGU 3296
Ross 2563
AUC 2008
Sackler 911
Universidad Central Del Este, DR 840
Universidad C.E.T.E.C, DR 370
Universidad Tecnologica de Santiago DR 352
Saba 343
UAG 336 (Surprisingly low ......)
Spartan 280
UA Ciudad Juarez MX 226
RCSI 133
Technion 126

About 10 other schools in Italy, Phillipines and DR contributing a total of roughly 1000.

USIMGs By region:
65% from carib and Mexico
10% Asia
15% Middle East

This data is interesting because I have always wondered about the distribution of USIMGs and to what extent the match statistics, overall USMLE pass rates, etc reflect the Big 4 vs all the others. The big 4 are "big" for a reason: they account for 65% of all USIMGs.

Source:

[edited for names] MB et al, US Citizens who Graduated from Medical Schools Outside the US and Canada and Received Certification from the ECFMG, 1983-2002. Academic Medicine 2005;80(5):473-478.

[stephew]

be careful of talking heads. There are some fascinating and hilarious peer reviewed papders on the end of the world coming due to sgu. check pubmed from the 1980's.

[stephew]

also im sorry but no names are permitted here.

[AngryBaby]

LOLOLOLOLOLOLOL!!!!

don't worry hon, I've made the same mistake with other posters (thought nyladoo was a girl for the longest time!)!!:D:D
same here.

[OTF]

ECFMG certificates issued to USIMGs 1983-2002

By school:
SGU 3296
Ross 2563
AUC 2008
Sackler 911
Universidad Central Del Este, DR 840
Universidad C.E.T.E.C, DR 370
Universidad Tecnologica de Santiago DR 352
Saba 343
UAG 336 (Surprisingly low ......)
Spartan 280
UA Ciudad Juarez MX 226
RCSI 133
Technion 126

About 10 other schools in Italy, Phillipines and DR contributing a total of roughly 1000.

USIMGs By region:
65% from carib and Mexico
10% Asia
15% Middle East

This data is interesting because I have always wondered about the distribution of USIMGs and to what extent the match statistics, overall USMLE pass rates, etc reflect the Big 4 vs all the others. The big 4 are "big" for a reason: they account for 65% of all USIMGs.

Source:

[edited for names] MB et al, US Citizens who Graduated from Medical Schools Outside the US and Canada and Received Certification from the ECFMG, 1983-2002. Academic Medicine 2005;80(5):473-478.

The Foreign medical school scene has changed greatly since 2002. There are schools like St. Matthews, MUA that are graduating and matching 100+ students a year, as will places like AUA in the near future. The entire thing was thrown upside down starting around 2000 with the explosion of schools. For most of the time 1983-2002 AUC, ROSS, SGU were the only real player, so ofcourse they had the most ECFMG certificates. They will continue to b/c they have the benefit of having huge classes since they are more established.

[OTF]

More interesting data from the ECFMG:

[names not permitted]. The International Graduate Pipeline: Trends in Certification and Residency Training. Health Affairs 2006; 25(2):469-477.

They break out data for USIMGs vs FMGS. For the period 1995-2003 61% of USIMGs who obtained an ECFMG certificate obtained a residency. Once again, this is not too far off the 50% match rate reported by the NRMP. This would suggest that the number of prematches is pretty small.

Getting a ECFMG certificate means you passed the step exams, that's all. People with poor scores on those steps aren't going to match, it's that simple. USIMG's with good scores match. Those with 90 or above will match, those with 85-89 have a good chance those in the 70's aren't going to match most likely. You seem to be drawing conclusions in your posts without all the data, the data is not really available(atleast I haven't seen it) on the score range of USIMG's and match rates. My personal experience with friends(30 or so matched this year), those with scores 90/220 which is essentilaly the average for US grads, they all matched(the ones in the high to mid 80's matched too) except one who wanted radiology which is pretty competitive.

[Wh0Kares]

LOLOLOLOLOLOLOL!!!!

don't worry hon, I've made the same mistake with other posters (thought nyladoo was a girl for the longest time!)!!:D:D

what?! nyladoo is a guy?!

[BrendaB_MD]

I agree that students with better scores will far better; however, the point of my series of posts was to address the question of whether the NRMP reported match rate for USMIGs is accurate. The NRMP says 50% of USIMGs are successful in the match; however, everyone argues that the NRMP data seriously underestimates the USIMG match rate because it fails to take into account prematches. The ECFMG/AMA data indicate that the NRMP data is not far off the mark.

The puzzling thing to me is that the carib schools have expanded and thrived despite such poor performance.

Getting a ECFMG certificate means you passed the step exams, that's all. People with poor scores on those steps aren't going to match, it's that simple. USIMG's with good scores match. Those with 90 or above will match, those with 85-89 have a good chance those in the 70's aren't going to match most likely. You seem to be drawing conclusions in your posts without all the data, the data is not really available(atleast I haven't seen it) on the score range of USIMG's and match rates. My personal experience with friends(30 or so matched this year), those with scores 90/220 which is essentilaly the average for US grads, they all matched(the ones in the high to mid 80's matched too) except one who wanted radiology which is pretty competitive.

[boobird]

The puzzling thing to me is that the carib schools have expanded and thrived despite such poor performance.

if there is any money to be made, entrepreneurs will take risks and open up schools for profit. students will attend these schools out of naive hope, desperation, or stupidity. i'm not surprised that half fail. for christs sake, can you really expect an 18 mcat to pass the boards?

[OTF]

I agree that students with better scores will far better; however, the point of my series of posts was to address the question of whether the NRMP reported match rate for USMIGs is accurate. The NRMP says 50% of USIMGs are successful in the match; however, everyone argues that the NRMP data seriously underestimates the USIMG match rate because it fails to take into account prematches. The ECFMG/AMA data indicate that the NRMP data is not far off the mark.

The puzzling thing to me is that the carib schools have expanded and thrived despite such poor performance.

You present no data after 2002 so I still feel you are drawing conclusions not on pertinent data. Carribbean scene has chaged dramatically starting in 2000. The base of your conclusion is from data from the 80's and 90's which gives no indication of the current situation. If you can find data from 2000-2008 you might be able to support your conclusions. I haven;t looked for data on prematch numbers or looked for ECFMG data more recent for 2000-2008 or similiar certificate data like you showed for 1982-2002.

[BrendaB_MD]

There is a good reason for the delay. It often takes people several years to obtain ECFMG certification or to match. Thus, by cutting off the data at 2002 they were able to insure that most people who began the ECFMG process would be able to complete ECFMG certification and obtain a match. So, in terms of a research design, there is really no way they could use more recent data because a significant portion of those who started in 2004 would not have entered residency by 2006 (the time of the publication.

I agree that an update would be interesting; however, I am not so sure that things changed dramatically from 2000-2008. Perhaps the ECFMG will create an update in the next year or so.

I think it is interesting that the carib schools are so resilient. Given the poor match rates (60% of ECFMG certified), I would think that the word would get out that going to the carib is a very risky proposition (Less than 50% of USMIGs who start at a carib school make it to residency!!). Thus, it would seem that demand would decline and only the stronger schools would survive. Instead, we have seen a proliferation of schools. Thus, it makes me suspect that the carib schools will endure even if competition increases signficantly due to US med school expansion. It seems people are willing to take the risk despite quite daunting odds.


You present no data after 2002 so I still feel you are drawing conclusions not on pertinent data. Carribbean scene has chaged dramatically starting in 2000. The base of your conclusion is from data from the 80's and 90's which gives no indication of the current situation. If you can find data from 2000-2008 you might be able to support your conclusions. I haven;t looked for data on prematch numbers or looked for ECFMG data more recent for 2000-2008 or similiar certificate data like you showed for 1982-2002.

[boobird]

There is a good reason for the delay. It often takes people several years to obtain ECFMG certification or to match. Thus, by cutting off the data at 2002 they were able to insure that most people who began the ECFMG process would be able to complete ECFMG certification and obtain a match. So, in terms of a research design, there is really no way they could use more recent data because a significant portion of those who started in 2004 would not have entered residency by 2006 (the time of the publication.

I agree that an update would be interesting; however, I am not so sure that things changed dramatically from 2000-2008. Perhaps the ECFMG will create an update in the next year or so.

I think it is interesting that the carib schools are so resilient. Given the poor match rates (60% of ECFMG certified), I would think that the word would get out that going to the carib is a very risky proposition (Less than 50% of USMIGs who start at a carib school make it to residency!!). Thus, it would seem that demand would decline and only the stronger schools would survive. Instead, we have seen a proliferation of schools. Thus, it makes me suspect that the carib schools will endure even if competition increases signficantly due to US med school expansion. It seems people are willing to take the risk despite quite daunting odds.


brenda b, one of the few rational voices on valuemd.

[AmericanIMG]

I think it is interesting that the carib schools are so resilient. Given the poor match rates (60% of ECFMG certified), I would think that the word would get out that going to the carib is a very risky proposition (Less than 50% of USMIGs who start at a carib school make it to residency!!). Thus, it would seem that demand would decline and only the stronger schools would survive. Instead, we have seen a proliferation of schools. Thus, it makes me suspect that the carib schools will endure even if competition increases signficantly due to US med school expansion. It seems people are willing to take the risk despite quite daunting odds.

yes, but if you think about it, even with the new schools in abundance, the match rates remain equivalent. new schools tend to bring in worse students just to fill spots. so the older school's match rate MUST be getting better and better to even out the carib schools.

also, the carib schools have high rates of attrition. this is no surprise. lots of people are simply not strong enough mentally to handle living outside the US.

lastly, i am surprised they have carib only match rates. this needs to be clarified. there are a lot of schools in the carib that don't service US students typically (example = UWI). are these included? hmm...

[boobird]

also, the carib schools have high rates of attrition. this is no surprise. lots of people are simply not strong enough mentally to handle living outside the US.
.

thats one theory. another could be that a student who scores an 18 mcat can't handle a MD's workload.

[AmericanIMG]

thats one theory. another could be that a student who scores an 18 mcat can't handle a MD's workload.

i dont know a lot of students w/ 18s...but i know a lot of students that had problem areas in MCAT, or who had a bad year or two in college. its a common myth that EVERY student at a carib school wasn't a good one, when in fact many were good just not good enough. on the west coast the competition is incredibly fierce with the small number of schools, and many students who i went to undergrad with ended up at carib schools. these students scored 215+ on their step1 and seem to be quite capable.

[Tipton]

thats one theory. another could be that a student who scores an 18 mcat can't handle a MD's workload.

LOLOL

For some reason I don't think that's what the MCAT measures. But of course I could be wrong. Verbal Reasoning, Life Science, Physical Science, Writing and...work ethic/endurance? I know...they make you do pushups, pullups and run 2 miles with the MCAT.:D

[OTF]

yes, but if you think about it, even with the new schools in abundance, the match rates remain equivalent. new schools tend to bring in worse students just to fill spots. so the older school's match rate MUST be getting better and better to even out the carib schools.

also, the carib schools have high rates of attrition. this is no surprise. lots of people are simply not strong enough mentally to handle living outside the US.

lastly, i am surprised they have carib only match rates. this needs to be clarified. there are a lot of schools in the carib that don't service US students typically (example = UWI). are these included? hmm...

I did alittle research and the article the original poster pulled their info is this ACADEMIC MEDICINE - Fulltext: Volume 81(10) October 2006 p S116-S119 A Comparison of the Characteristics and Examination Performances of U.S. and Non-U.S. Citizen International Medical Graduates who sought Educational Commission for Foreign Medical G (http://www.academicmedicine.org/pt/re/acmed/fulltext.00001888-200610001-00029.htm;jsessionid=L26JhrQmxDwJy3LnvZpvW2rByJQPn 3G02jTjhbgL1HTcFXJ0V1hV!-127489179!181195628!8091!-1?index=11&database=ppvovft&results=1&count=10&searchid=3&nav=search)

Draw your own conclusions as the original poster(boobird) is taking some liberties in interpretation and drawing conclusions IMO. Based on their posts in this and other threads they have an agenda or may be a troll.

[AmericanIMG]

Currently, IMGs make up over 25% of the U.S. practicing physician workforce12 (http://www.academicmedicine.org/pt/re/acmed/fulltext.00001888-200610001-00029.htm;jsessionid=L21bLhh0HX59H1h20HFyBvcGpwGbc 2ysBHd77fsLqhzGPHsFlwFM%21-127489179%21181195628%218091%21-1?index=11&database=ppvovft&results=1&count=10&searchid=3&nav=search#P55) and nearly 27% of all GME residency positions.13,14 (http://www.academicmedicine.org/pt/re/acmed/fulltext.00001888-200610001-00029.htm;jsessionid=L21bLhh0HX59H1h20HFyBvcGpwGbc 2ysBHd77fsLqhzGPHsFlwFM%21-127489179%21181195628%218091%21-1?index=11&database=ppvovft&results=1&count=10&searchid=3&nav=search#P56) Although efforts are under way to expand enrollment at U.S. medical schools,15 (http://www.academicmedicine.org/pt/re/acmed/fulltext.00001888-200610001-00029.htm;jsessionid=L21bLhh0HX59H1h20HFyBvcGpwGbc 2ysBHd77fsLqhzGPHsFlwFM%21-127489179%21181195628%218091%21-1?index=11&database=ppvovft&results=1&count=10&searchid=3&nav=search#P58) it is likely that the need for IMGs, both in residency and practice positions, will continue for some time.

Even though performance differences were found between USIMGs and non-USIMGs, especially more recently, relatively little is known about their academic training programs. Interestingly, the analysis of first-time pass rates for USIMGs at individual schools was quite variable. For both Step 1 and Step 2 CK, there was over a 60% difference in first attempt pass rates between the highest and lowest ranked schools.

both paragraphs are straight from the article. looks like the troll was skewing the info. perhaps he's a lawyer?

[Genossa maximillian]

It is going to be business a susual, I don't forsee any huge impact in terms of enrollment.


My assumption is that the need for FMGs to fill residency slots will be decreased as the number of US med grads increase. I know there were a handful of new US schools that opened in 06-08. Not to mention increasing class sizes for existing schools.

Anyone from the class of 2011 is unaffected. Is anyone starting in aug08 or Jan 09 worried about this potential problem?





Developing medical schools

These medical schools are still in the process of undergoing accreditation and are not yet accepting student applications.
State School City Degree Anticipated opening date
California University of California, Merced School of Medicine Fresno MD Fall 2012
California University of California, Riverside School of Medicine Riverside MD Fall 2013
Idaho University of Idaho Boise MD Under Discussion
Michigan Oakland University Beaumont Medical School Rochester MD Fall 2010
Mississippi William Carey University College of Osteopathic Medicine Hattiesburg DO Fall 2009
New Jersey Touro University College of Medicine Hackensack MD Fall 2009
New York Hofstra University School of Medicine Hempstead MD Fall 2010 or 2011
Oregon Western University of Health Sciences College of Osteopathic Medicine of the Pacific Lebanon DO Fall 2011
Pennsylvania The Commonwealth Medical College Scranton MD Fall 2009
Pennsylvania Lake Erie College of Osteopathic Medicine at Seton Hill University[1] Greensburg DO 2011
Texas University of Houston Houston MD Under Discussion
Wisconsin University of Wisconsin-Milwaukee School of Public Health Milwaukee MD Fall 2011 or 2012
Virginia Virginia Tech Carilion School of Medicine Roanoke MD Fall 2010

[BrendaB_MD]

Since you have the article, using the data in Table 1 calculate the percentage of people who register for an USMLE exam who ultimately make it to the AMA database (i.e., enroll in a registry). This number will tell you the success rate of people who complete basic sciences.

What is the performance of the best carib school on this measure?

We can check each other's work....



Currently, IMGs make up over 25% of the U.S. practicing physician workforce12 (http://www.academicmedicine.org/pt/re/acmed/fulltext.00001888-200610001-00029.htm;jsessionid=L21bLhh0HX59H1h20HFyBvcGpwGbc 2ysBHd77fsLqhzGPHsFlwFM%21-127489179%21181195628%218091%21-1?index=11&database=ppvovft&results=1&count=10&searchid=3&nav=search#P55) and nearly 27% of all GME residency positions.13,14 (http://www.academicmedicine.org/pt/re/acmed/fulltext.00001888-200610001-00029.htm;jsessionid=L21bLhh0HX59H1h20HFyBvcGpwGbc 2ysBHd77fsLqhzGPHsFlwFM%21-127489179%21181195628%218091%21-1?index=11&database=ppvovft&results=1&count=10&searchid=3&nav=search#P56) Although efforts are under way to expand enrollment at U.S. medical schools,15 (http://www.academicmedicine.org/pt/re/acmed/fulltext.00001888-200610001-00029.htm;jsessionid=L21bLhh0HX59H1h20HFyBvcGpwGbc 2ysBHd77fsLqhzGPHsFlwFM%21-127489179%21181195628%218091%21-1?index=11&database=ppvovft&results=1&count=10&searchid=3&nav=search#P58) it is likely that the need for IMGs, both in residency and practice positions, will continue for some time.

Even though performance differences were found between USIMGs and non-USIMGs, especially more recently, relatively little is known about their academic training programs. Interestingly, the analysis of first-time pass rates for USIMGs at individual schools was quite variable. For both Step 1 and Step 2 CK, there was over a 60% difference in first attempt pass rates between the highest and lowest ranked schools.

both paragraphs are straight from the article. looks like the troll was skewing the info. perhaps he's a lawyer?

[AmericanIMG]

you can't really compute that because you aren't taking in attrition rates for students in basics. also, what defines best?

if you take a school like Ross, who takes in FAR more students per term then any of the other schools, then by sheer numbers alone you will get more students that will score +230. does this make it the best school? or does the high attrition rate make it one of the worst schools? hmm...

[BrendaB_MD]

The point of the calculation is, ignoring attrition in basic sciences, what is the best residency placement rate in the caribbean? It is actually a pretty interesting number to calculate because it gives a picture of the probability of getting a residency given that you survived basic sciences. It is relevant because it gives a good measure of the overall match rate counting prematches. People always say the NRMP data underestimates the match rate because it does not include prematches. Now we have a chance to get a much clearer picture.

It is not a question of which school is best (the data is disguised, but we could probably figure out which is which) but to get a clearer picture of the match rate of carib schools.

Are you game?




you can't really compute that because you aren't taking in attrition rates for students in basics. also, what defines best?

if you take a school like Ross, who takes in FAR more students per term then any of the other schools, then by sheer numbers alone you will get more students that will score +230. does this make it the best school? or does the high attrition rate make it one of the worst schools? hmm...

[AmericanIMG]

am i game on what? doing the math? haha i don't like stats, but u can go ahead. plus i don't even see where they list specific schools and their matches.

also, its kind of moot, because lots of carib schools REQUIRE an attempt at the USMLE to continue education. your calculation would simply take all the students who want to practice outside the US and assume they failed out or didn't make it (ex - students who end up practicing in Canada or elsewhere)

[BrendaB_MD]

From the following article:

Educational Commission for Foreign Graduates Certification and Specialty Board Certification Among Graduates of the Caribbean Medical Schools.
Academic Medicine 2006; 80(10)S112-S115.

The table shows the percentage of US citizens from carib schools who started the ECFMG process and are listed in the AMA database. The data is broken down by school. Schools 4 and 7 have the best performance: 70%. The average, including all 12 schools is 60%.

The point of all this is that the NRMP match data are not too far off. The NRMP match rate is 50%; however, we all know that is an underestimate because it does not include prematches. The ECFMG/AMA data indicate that about 10% of carib USIMGs who register for the NRMP prematch.
So that solves a mystery.

You are correct that the AMA database would not include US citizens who started the the ECFMG process but who completed a residency and practice in another country. So what percentage of US citizens at carib schools end doing residencies in other countries? I suspect that it is a trivial number.


am i game on what? doing the math? haha i don't like stats, but u can go ahead. plus i don't even see where they list specific schools and their matches.

also, its kind of moot, because lots of carib schools REQUIRE an attempt at the USMLE to continue education. your calculation would simply take all the students who want to practice outside the US and assume they failed out or didn't make it (ex - students who end up practicing in Canada or elsewhere)

[OTF]

From the following article:

Educational Commission for Foreign Graduates Certification and Specialty Board Certification Among Graduates of the Caribbean Medical Schools.
Academic Medicine 2006; 80(10)S112-S115.

The table shows the percentage of US citizens from carib schools who started the ECFMG process and are listed in the AMA database. The data is broken down by school. Schools 4 and 7 have the best performance: 70%. The average, including all 12 schools is 60%.

The point of all this is that the NRMP match data are not too far off. The NRMP match rate is 50%; however, we all know that is an underestimate because it does not include prematches. The ECFMG/AMA data indicate that about 10% of carib USIMGs who register for the NRMP prematch.
So that solves a mystery.

You are correct that the AMA database would not include US citizens who started the the ECFMG process but who completed a residency and practice in another country. So what percentage of US citizens at carib schools end doing residencies in other countries? I suspect that it is a trivial number.

You have a fundamental flaw in your possible calculation. The data shows "US citizens from carib schools who started the ECFMG process". Starting the ECFMG process means they took a Step Exam, for instance just step 1. You need the number who actually took and passed step2 CS and CK. Even then you can't account for many students who decided to practice in other countries. Read the limitations cited in the article and you will see the inherent problems in your calculation. Btw, once again the date is old, several schools in the study aren't even open anymore and atleast 10 new schools have opened since 2000. The Caribbean scene has changed greatly. The other poster has also pointed pointed out flaws.

Btw, where did you get 10% of the Carib USIMG's prematch?

The only way to find out what the true match rate is would be for schools to actually publish their rates of students ECFMG certified and eligible form match that match and also the prematch data. Many schools with bad results ofcourse aren't going to put that out on their website, just like many schools don't put out their Step 1 pass rates. Trying to use NRMP data and assume or guess what happened to the nearly 1,500 students yearly who start the match and withdraw or don't rank order is impossible.There is no way to tell how many prematch or just fail step2 and can't retake before match. Prematch stats are impossible to find, thus the true rate of USIMG success in getting a residency is impossible to determine currently(maybe in the future id the schols and students are better about giving data). Schools are dependent on the students for match results as it isn't centralized like US schools.

One thing if you look at the data from the articles there is great variance in the quality of schools, nothing we all didn't know. Also, the step pass rates have declined over time, so that would seem to show as the number of schools increased throughout the last 20+ years, the quality of the students declined.

" Although USIMGs and non-USIMGs had similar pass rates on first attempts between 1995 and 1999 (not shown), starting in 2000, non-USIMGs were much more likely than USIMGs to pass Step 1 on their first attempt. In 2004, nearly 6,300 (72%) of the 8,733 initial Step 1 attempts of non-USIMGs resulted in a pass; for USIMGs, only 56% passed on the first attempt."

With the boom of the schools just since 2003 (6 or 7 new schools) the pass rates are probably even lower, but we have no data yet.

[AmericanIMG]

You have a fundamental flaw in your possible calculation. The data shows "US citizens from carib schools who started the ECFMG process". Starting the ECFMG process means they took a Step Exam, for instance just step 1. You need the number who actually took and passed step2 CS and CK. Even then you can't account for many students who decided to practice in other countries. Read the limitations cited in the article and you will see the inherent problems in your calculation. Btw, once again the date is old, several schools in the study aren't even open anymore and atleast 10 new schools have opened since 2000. The Caribbean scene has changed greatly. The other poster has also pointed pointed out flaws.

Btw, where did you get 10% of the Carib USIMG's prematch?

The only way to find out what the true match rate is would be for schools to actually publish their rates of students ECFMG certified and eligible form match that match and also the prematch data. Many schools with bad results ofcourse aren't going to put that out on their website, just like many schools don't put out their Step 1 pass rates. Trying to use NRMP data and assume or guess what happened to the nearly 1,500 students yearly who start the match and withdraw or don't rank order is impossible.There is no way to tell how many prematch or just fail step2 and can't retake before match. Prematch stats are impossible to find, thus the true rate of USIMG success in getting a residency is impossible to determine currently(maybe in the future id the schols and students are better about giving data). Schools are dependent on the students for match results as it isn't centralized like US schools.

One thing if you look at the data from the articles there is great variance in the quality of schools, nothing we all didn't know. Also, the step pass rates have declined over time, so that would seem to show as the number of schools increased throughout the last 20+ years, the quality of the students declined.

" Although USIMGs and non-USIMGs had similar pass rates on first attempts between 1995 and 1999 (not shown), starting in 2000, non-USIMGs were much more likely than USIMGs to pass Step 1 on their first attempt. In 2004, nearly 6,300 (72%) of the 8,733 initial Step 1 attempts of non-USIMGs resulted in a pass; for USIMGs, only 56% passed on the first attempt."

With the boom of the schools just since 2003 (6 or 7 new schools) the pass rates are probably even lower, but we have no data yet.

good post here

[BrendaB_MD]

You are right -- the numbers I reported show the overall success rate starting from registering for a USMLE exam to appearing in the AMA database. This is still an interesting number and it is surprisingly low.

We can still estimate the match rate because the table gives the percentage of those who successfully complete ECFMG certification. For example, for school 1:

Number who registered with ECFMG: 3324
Percent who obtained ECFMG certificate: 86
Number in AMA database: 2057

So, the number that got an ECFMG certificate is
0.86 x 3324 = 2858
estimated match rate = 2057/2858 = 72%

Repeating that calculation for each school, the match rates range from 59% to 97% with an overall average of 83%. There are four schools with match rates above 90%.

Note that this is for US citizens only. You are correct that it is possible that some USIMGS may not be included in the AMA because they did their residency training in another country; however, I can't imagine that is a significant number.

So the match rates look pretty good -- particularly at the top schools. This indicates that the NRMP match rate (~50%) is low either because of prematches or people make more than one attempt. In any case, it appears that most people who obtain an ECFMG certificate eventually match.

Getting an ECFMG certificate remains a significant hurdle. Overall, the best overall success rate from completing basic sciences to (registering for a USMLE) to appearance in the AMA database is 70%. It is possible that things may have changed in recent years -- we will have to await more data.



You have a fundamental flaw in your possible calculation. The data shows "US citizens from carib schools who started the ECFMG process". Starting the ECFMG process means they took a Step Exam, for instance just step 1. You need the number who actually took and passed step2 CS and CK. Even then you can't account for many students who decided to practice in other countries. Read the limitations cited in the article and you will see the inherent problems in your calculation. Btw, once again the date is old, several schools in the study aren't even open anymore and atleast 10 new schools have opened since 2000. The Caribbean scene has changed greatly. The other poster has also pointed pointed out flaws.

Btw, where did you get 10% of the Carib USIMG's prematch?

The only way to find out what the true match rate is would be for schools to actually publish their rates of students ECFMG certified and eligible form match that match and also the prematch data. Many schools with bad results ofcourse aren't going to put that out on their website, just like many schools don't put out their Step 1 pass rates. Trying to use NRMP data and assume or guess what happened to the nearly 1,500 students yearly who start the match and withdraw or don't rank order is impossible.There is no way to tell how many prematch or just fail step2 and can't retake before match. Prematch stats are impossible to find, thus the true rate of USIMG success in getting a residency is impossible to determine currently(maybe in the future id the schols and students are better about giving data). Schools are dependent on the students for match results as it isn't centralized like US schools.

One thing if you look at the data from the articles there is great variance in the quality of schools, nothing we all didn't know. Also, the step pass rates have declined over time, so that would seem to show as the number of schools increased throughout the last 20+ years, the quality of the students declined.

" Although USIMGs and non-USIMGs had similar pass rates on first attempts between 1995 and 1999 (not shown), starting in 2000, non-USIMGs were much more likely than USIMGs to pass Step 1 on their first attempt. In 2004, nearly 6,300 (72%) of the 8,733 initial Step 1 attempts of non-USIMGs resulted in a pass; for USIMGs, only 56% passed on the first attempt."

With the boom of the schools just since 2003 (6 or 7 new schools) the pass rates are probably even lower, but we have no data yet.

[paulja]

I know this thread has been beaten to death!

I was planning on applying to several European programs for the fall of 2009. However, if congress does not approve an increase in funding for residency slots, my years in medical school could be a complete waste of time and money.

Any ideas on a good back-up career:mad:

[GeorgeMD2B]

New MD and DO schools will mean competition for residencies will get harder.

[paulja]

Bill S 588 was introduced before the finance committee back in 2/2007. If that does not get pushed through, foreign medical schools will see some hard times.

I wished I would have started school earlier so that I could have avoided this increase in US medical school enrollment.

[AmericanIMG]

New MD and DO schools will mean competition for residencies will get harder.

i completely disagree with this statement.

new MD/DO schools will be sending more students out, but also opening up more residencies as well.

[coolkidd123]

For those of you who are from NJ, did you guys happen to read the Star Ledger newspaper article about how there is going to be a huge shortage in primary care. Most med school grad students are uninterested in it due to rising med school tuition and lower salaries therefore they want a residency in a higher paying specialty.I guess most of the Caribbean medical school grads will be getting a lot more internal medicine residencies in the future since they need to find a way to ease the shortage.

[rokshana]

i completely disagree with this statement.

new MD/DO schools will be sending more students out, but also opening up more residencies as well.

there will definitely be an increase in residency spots... my program has increased in size and there are plans for there to be more in the future...

its fine and dandy to have more US grads, but without an increase in residents, the shortage will remain the same...

[AmericanIMG]

there will definitely be an increase in residency spots... my program has increased in size and there are plans for there to be more in the future...

its fine and dandy to have more US grads, but without an increase in residents, the shortage will remain the same...

plus, many current docs are nearing or at retirement age. not many people tend to talk about this

[Genossa maximillian]

So without more residency spots combined with many docs retiring or changing careers, status quo, another placebowith the creation of new US medical schools.

Besides all this, and answering the core of the question, and myself seeing the extraordinary development of Medical schools in the Caribbean since the days early days of St. Georges (I was part of the military during the invasion of 1983, and SGU / ROSS were already 5 years old and a joke of a school back then) I don't see much of them being affected. There will always be customers for the Caribbean schools.