Most U.S. and Canadian students would like to go to medical school in their home country. But due to very low medical school acceptance rates, many are unable to attend medical school at home. In 2018 -2019, for example, 52,777 applicants vied for only 21,622 seats in U.S. medical schools. In Canada, 13,929 prospective medical students competed for only 2,951 available seats.

Caribbean medical schools are the most popular alternate path to becoming an M.D. in the United States and Canada. There are more than 50 medical schools in the Caribbean – of widely varying quality. How should an interested pre-medical student choose among all these Caribbean medical schools?

External Recognition of Quality – Accreditation and Licensing

It is essential for prospective students to select a Caribbean medical school that will allow them to become licensed to practice medicine in North America. Unless a school is appropriately accredited, graduates of the school can be precluded from medical licensure in the U.S. and/or Canada. At both the federal and state/provincial level, licensing authorities in North America have become increasingly stringent in their assessment of foreign medical schools and their graduates. It is critical that the school you choose is appropriately accredited and recognized.

The Educational Commission for Foreign Medical Graduates (ECFMG) certifies which students from foreign schools may take the United States Medical Licensing Exams. Students must take and pass these exams in order to practice medicine in the United States. Beginning in 2023, ECFMG certification is only available to students from schools that are accredited by an accrediting agency that is officially recognized by the World Federation of Medical Education (WFME). Currently, there are only three accrediting agencies working in the Caribbean that are recognized by WFME:

  1. Accreditation Commission on Colleges of Medicine (ACCM)
  2. Accreditation Organization of the Netherlands and Flanders (NVAO)
  3. Caribbean Accreditation Authority for Education in Medicine and Health Professionals (CAAM-HP)

Likewise, the U.S. National Committee on Foreign Medical Education and Accreditation (NCFMEA) assesses which foreign countries and their accreditors use standards that are comparable to the standards used to accredit medical schools in the United States. This means that the curriculum, faculty, resources and the schools themselves are held to comparable standards to U.S. medical schools.

Some states in the U.S. independently review the quality of foreign medical schools, and these reviews can affect the ability of foreign medical students/graduates to participate in clinical rotations and/or practice medicine in that state. By the end of 2019, when California will discontinue its reviews of foreign medical schools, New York and Florida will be the two key states independently approving foreign medical schools. Students from unapproved schools cannot participate in clinical rotations in Florida. In New York, students from unapproved schools cannot earn a residency in the state and can only participate in limited clinical rotations.

It would be unwise and potentially career-limiting to attend a Caribbean medical school whose accreditation is not fully recognized by WFME, NCFMEA, New York and Florida. Currently there are only eight Caribbean medical schools recognized by all of these organizations:

  1. American University of Antigua
  2. American University of the Caribbean
  3. Medical University of the Americas
  4. Ross University
  5. Saba University
  6. St. George’s University
  7. St. Matthew’s University

External Recognition of Quality -- United States Federal Loan Programs

In order for students from Caribbean medical schools to receive U.S. federal loans, the United States Department of Education must assess and approve the quality of the school. The criteria used by the Department of Education include:

  1. Accreditation recognized by NCFMEA
  2. USMLE pass rates of students and graduates
  3. Quality of clinical rotations

Currently, there are only eight Caribbean medical schools that are approved by the Department of Education for participation in the U.S. federal loan programs:

  1. American University of Antigua
  2. American University of the Caribbean
  3. Medical University of the Americas
  4. Ross University
  5. Saba University
  6. St. George’s University
  7. St. Matthew’s University

These are the same seven Caribbean medical schools whose accreditations are recognized by both WFME and NCFMEA, and which are approved by the licensing authorities of both New York and Florida. Among the many Caribbean medical schools, these seven schools stand out as having the external recognition necessary for their students and graduates to practice medicine in the United States and to obtain access to U.S. federal loans. As such, students reviewing Caribbean medical schools should consider limiting their evaluation to these seven schools.

Choosing Among the Caribbean Medical Schools with Sufficient External Recognition of Quality

How should a prospective student choose among the seven Caribbean medical schools that meet the necessary external standards for quality?

These schools vary widely in size and the attendant level of personal attention afforded to students, so students should look for a school that will match their personal preference for learning style. Schools such as St. Matthew’s University strictly limit the size of their incoming cohorts, while others have extraordinarily large class sizes. St. George’s University has had incoming cohorts of nearly 1,000 medical students, while class sizes of greater than 500 medical students are not uncommon at Ross University.

The cost of these schools differ greatly, with some charging more than virtually all US medical schools, and others being much more affordable.

Finally, the settings of the schools are very varied. Some Caribbean countries are poor – often with high crime rates – while other Caribbean islands have all the comforts of home.

What follows is a table of information to help you compare the seven schools across some of these dimensions. For reference, it also includes the data for the median U.S. public medical school.

School Location Cost (1) Wealth of Country (2)
American Univ. of Antigua Antigua $211,540 $14,803
American Univ. of Caribbean St. Maarten $228,015 $15,400
Medical Univ. of the Americas Nevis $174,075 n/a (3)
Ross University Barbados $251,385 $16,494
Saba University Saba $186,317 $24,200
St. George's University Grenada $288,705 $10,451
St. Matthew's University Cayman Islands $164,908 $65,472
U.S. Public Medical School (Median) United States $234,932 $60,055

(1) Four year tuition & fees as of 2018-19. Source: American Association of Medical Colleges, individual school websites
(2) GDP per capita. Source: United Nations Statistics Division, CIA World Factbook, Statistics Netherlands
(3) Data unavailable for island of Nevis