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International Medical Schools

International Medical Schools: Considerations for Prospective Students There are many factors to take into consideration when US citizens or residents consider leaving the United States for medical education. 1. The reason for considering international programs: Many students are afraid of not getting into a US program, and so only apply out of the country Some students wish to leave the US to go to exotic places Many students have been rejected by US programs, and see international programs as a way to quickly gain entrance to medical school Before deciding on an international program, students should explore all options for gaining entrance to both allopathic and osteopathic programs in the United States. If students believe they are not competitive, they should honestly assess where their deficiency lies. If it is the science or overall GPA which is poor, students should consider taking additional courses, perhaps in a postbaccalaureate program. If the MCAT was poor, students should arrange to re-take the exam. If the student lacks professional or other volunteer experiences, then the student needs to make arrangements to remedy that deficiency. Perhaps it was the personal essay which put the student out of contention, or even the interview. Sometimes the student did not get to know faculty members well enough to get great recommendation letters. In short, the student needs to assess why they think that they are not competitive applicants for US programs, or why they were rejected by the schools to which they applied. 2. Criteria for admission The criteria for admission into international programs is extremely variable, depending on the school Some programs do not require the MCAT, and even accept students with less than a 3.0 undergraduate GPA. Students are encouraged to check the school requirements, keeping in mind that even if they are accepted, if they are lacking in the academic background and test-taking abilities, they will not only have a difficult time completing the program, but they will have an even harder time passing the USMLE steps 1 and 2, as well as ECFMG or Fifth Pathway certification in order to be able to obtain a residency. 3. Expenses   Although some international programs are less expensive than US programs, many are not. Wherever a student goes to medical school it will be expensive. Students must consider travel expenses to and from the country. Depending on the international school, students may be eligible for U.S. Government Guaranteed Student Loans. 4. Social and other problems It is a big step to go out of the country for medical school. You must keep in mind that you are leaving your family and friends behind--your support system. You also may be going to a country or island nation where communication via the internet or cell phones is very variable, and so you will be out of touch with what is going on back home. Students may find that there is not much by way of restaurants, entertainment and other things to do when one has time off, and even basic amenities such as banks and laundromats may be scarce. In some countries, English may not be the language of instruction, or the people in the clinics may not speak English, and so it is necessary to quickly learn another language. 5. Possibility of Transferring Students should not begin an international program with the intent of transferring to a US medical school. Firstly, very few US medical schools accept transfer students to begin with. Secondly, since the curricula may be different, students who are accepted may have to re-take a year or so of coursework. 6. Certification All international medical graduates (IMG's) must gain ECFMG certification in order to be eligible for ACGME accredited residency programs in the United States. According to the ECFMG website: "To apply for ECFMG Certification, you must be an international medical student or graduate. This means that your medical school is located outside the United States and Canada. U.S. citizens who graduate from such schools are considered IMGs and are eligible to apply for ECFMG Certification. Non-U.S. citizens who graduate from schools in the United States and Canada are not considered IMGs and are not eligible for ECFMG Certification. Additionally, your medical school must be listed in the International Medical Education Directory (IMED) of the Foundation for Advancement of International Medical Education and Research (FAIMER®). If you are a medical school graduate, your graduation year must be included in your school's IMED listing. If you are a student, the "Graduation Years" in IMED for your medical school must be listed as "Current." You can access IMED on the ECFMG website. To be eligible for certification, you must graduate from a medical school that meets the requirements described above, and fulfill the following additional medical education credential requirements: You must have had at least four credit years (academic years for which credit has been given toward completion of the medical curriculum) at a medical school listed in IMED. You must supply ECFMG with copies of your medical education credentials. These medical education credentials are listed in ECFMG's Reference Guide for Medical Education Credentials, available in the ECFMG Information Booklet on the ECFMG website. ECFMG sends medical education credentials to the medical school that issued them and must receive verification of these documents directly from the medical school. Applicants for ECFMG Certification must also satisfy the following examination requirements: Medical Science Examination. USMLE Step 1 and Step 2 Clinical Knowledge (Step 2 CK) are the exams currently administered that satisfy this requirement. Applicants register for these exams with ECFMG and take these exams worldwide at test centers of Prometric, a division of Thomson Learning, Inc. ECFMG also accepts certain former medical science exams to fulfill this requirement. Refer to the ECFMG Information Booklet for more information. Clinical Skills Requirement. USMLE Step 2 Clinical Skills (Step 2 CS) is the exam currently administered that satisfies this requirement. Applicants register for Step 2 CS with ECFMG and take the exam at one of several regional Clinical Skills Evaluation Centers in the United States. Applicants who have both passed the former ECFMG Clinical Skills Assessment (CSA®) and achieved a score acceptable to ECFMG on an English language proficiency test (such as the Test of English as a Foreign Language™ [TOEFL®] or the former ECFMG English test) can use these passing performances to fulfill this requirement. Refer to the ECFMG Information Booklet for more information." Fifth Pathway- In many other countries, students normally go to medical school directly from secondary school. As such, their programs in the medical school are 5 or 6 years, and include at least a year of community service. American students who go to such medical programs, such as UAG, are eligible to substitute a year of clinical experience in the US after the 4 years of medical school, instead of the required community service. Students who successfully complete a Fifth Pathway program, pass the USMLE Steps 1 and 2, as well as all other requirements, can be eligible for residency programs. According to the American Medical Association's website on the Fifth Pathway: "Who can qualify for a Fifth Pathway? Only students who: Graduated from an accredited American college or university; Studied medicine at a medical school located outside the United States that is listed in World Health Organization's World Directory of Medical Schools and which requires a year or more of internship/social service (beyond the four years of medical school) before receiving a medical degree; Completed all formal requirements of their foreign medical school EXCEPT the final year(s) of clinical work/social service. How are Fifth Pathway students different from International Medical Graduates? Fifth Pathway students do NOT graduate from a foreign medical school. They leave early, and complete a final year of medical training in the U.S. Fifth Pathway students receive NO medical diploma from the U.S. medical school sponsoring their Fifth Pathway year of clinical education. They receive a ‘Certificate of Completion,’ which is accepted in lieu of a diploma in virtually all U.S. licensing jurisdictions. The Fifth Pathway certificate IS the Fifth Pathway physician’s medical credential. Program policy is governed by the AMA, which also serves as the national, primary source credential verification for these physicians." 7. Residency Matching In the US, there are currently many more residencies than graduates of American medical schools to fill them. As a result, graduates of international medical schools do get residencies, even if they do not match with their first choice programs. In order to increase the chances of obtaining the residency, students should: attend a well-established international program with a good track record of residency matches do well on Steps 1 and 2 of the USMLE try to arrange clinical rotations in the US in the particular field as well as in hospitals in which they would like to do a residency Students considering international medical schools should do their homework regarding the particular medical school under consideration. The following are questions adapted from an article by Crosby and Cannon in The Advisor, Vol 24, 1, pp.36-41, 2004. How long has the International Medical School (IMS) been in existence? How can I contact the IMS? What are the admissions requirements? Is a bachelors degree required? Are there specific residency or foreign language requirements? In what language is the instruction? Is the MCAT required or optional? If interviews are required, where are they held? What are the mean Science and overall GPA's for the previous entering class? How many classes enter each year, and when are the application deadlines? What are estimated annual expenses, including tuition, fees, books, supplies, study materials, housing, food, travel and other living costs? How do students fund their education? What loans and scholarships are students eligible for? How many students are enrolled in each class, and what is the attrition rate? Why do students drop out? How is the curriculum structured? What are the academic credentials of the teaching faculty? Where do students do their clinical training? How do students perform on USMLE I and II? Must all students take the USMLE I and II? How many students graduate each year? Where have students recently matched for residency? In what specialties? How can I contact some graduates who are practicing in the US in my area? There are numerous International Medical Schools in the Caribbean, Mexico, Europe and Australia to which American students apply. Here are links to some Caribbean Medical Schools (in alphabetical order) All Saints (Aruba) AISM (Guyana) American University of Antigua Antigua (Antigua) AUC (St. Maarten) CAHSU (Belize) Grace (Belize) IUHS (St. Kitts) MUA (Nevis) Ross (Dominica) Saba (Saba) Spartan (St. Lucia) St. Eustasius (St. Eustasius) St. George (Grenada) St. Martinus (Curacao) St. Matthews (Grand Cayman) UAG (Mexico) UNIBE (Dominican Republic) Windsor (St. Kitts)