Stop Feeling Sorry for Unmatched Caribbean MDs

If you get newsletter emails from Doximity, you might have noticed this article from the Skeptical Scalpel blog making the rounds recently. Contained within is a familiar sob story that can be summarized as follows: anon goes to Caribbean medical school, anon graduates from said Caribbean medical school, anon fails to match into a residency program. They graduated from medical school, how in the world could they not find a job? If this were all there was to the story, the average reader/outsider to medicine, at this point, would probably be picking up a pitchfork and start complaining about how the system is broken.

But of course, as with just about everything else in life, nothing is ever as simple as it's made out to be. The anon acknowledges that he/she has "failed attempts and many gaps" with the "deep dark hole" they've dug themselves into ultimately culminating in a failing score on Step 3, the last of the major USMLE exams required for medical licensing. Yet in light of this string of failures, anon somehow has the gall to proclaim "I know I will be a great physician". It's a line we hear all too often from mainland medical school rejects who get suckered into going into the Caribbean. But why should we believe you over your continued, consistent record of academic failure?

It's no secret that Caribbean medical schools are for-profit diploma mills with huge class sizes, high attrition, subpar clinical education compared to domestic MD-granting institutions, and low match rates that saddle their graduates (if they even graduate) with huge, crippling amounts of debt. And sometimes, when your Caribbean medical school gets blown away by a hurricane, you're (un)lucky enough to go to class on a cruise ship. Surely anyone with a computer, five minutes on Google, and a small amount of common sense would see the folly of going to medical school in the Caribbean. Thus, for an already-subpar student to attend one of these schools is merely a perpetuation of delusion - a delusion that they are the special snowflake who will miraculously salvage his/her academic record and finally succeed in medical school. There is no reason to feel sorry for these types of folks who ignore all the chances they have to turn back and do things the right way, whether that be enrolling in a pre-medical master's program to shore up their academic ability and GPA, retaking the MCAT, taking a gap year or two to build additional clinical, research, or volunteer experience, or...going into a totally different line of work altogether.

Of course, Caribbean medical schools know this and happily prey on this subset of students. Considering that we live in a capitalist society, I can't say I really blame them. The inevitable result is that the reputations of Caribbean medical schools is defined by those of their students. So it's no wonder why so many residency program directors shun Caribbean grads - sure, some of them probably will make great physicians, but when medicine is such a risk-averse field to begin with, why take the chance on an unknown quantity when there's no shortage of tried-and-true US domestic candidates that have no blemishes on their academic record and will almost certainly make great physicians? The fact of the matter is that it shouldn't come as a surprise to a newly-minted Caribbean MD to fail to match into a residency, especially if they already have a history of academic failure. The deep, dark hole is one that they have dug all by themself - why should anyone else feel entitled to dig them back out?