Is Medical School Abroad the Best Choice for You?
by Ashley Frye
Applying to medical school is intimidating, to say the least. The pressure of maintaining a fantastic GPA, displaying a commitment to research and demonstrating leadership in multiple organizations can be incredibly overwhelming for many pre-med students. The fact that only about half of applicants actually matriculate into medical school is more than a little demoralizing, even for the most competitive applicants. Mid-tier applicants who are on the fence as to whether they will gain acceptance to medical school with their first application may be drawn to apply to foreign schools. They often believe that this will increase their chances of being accepted, so that they can begin their medical education sooner than they would in the United States. But is that really the best plan?
An immediately obvious benefit of applying to foreign medical schools is that they often have lower admissions standards than schools in the United States. The top medical schools in the US have around 2-3 percent acceptance rates, and it’s difficult to find a school with an acceptance rate greater than 10 percent. Alternatively, some medical schools on the Caribbean Islands have acceptance rates approaching 40 percent. As a result of higher acceptance rates, the GPA and MCAT scores required for acceptance are significantly lower. Upon first consideration, this is a compelling argument for a mid-tier American applicant to apply to foreign schools.
However, there are some drawbacks. After attending a foreign medical school, actually becoming a practicing physician in the U.S. can be incredibly difficult. To apply for and be accepted to residency in the U.S., applicants are first required to take the three-part Board exam, and may need to take the Test of English as a Foreign Language (TOEFL) exam as well. Those who complete their residences abroad but plan on a career in the United States are often required to complete an additional two years of residency; obtaining this residency can be quite difficult. Nearly 100 percent of U.S. medical school graduates are accepted into residencies, but a little under half of those applying from foreign countries are accepted each year. This makes the process of transitioning to the U.S. extremely challenging.
There are difficulties within medical schools abroad versus domestically as well. One obvious difference is the grading systems employed by different countries. The United States has shifted almost entirely to a pass/fail grading system, while maintaining class rank. Most foreign medical schools, however, remain with the A-F scale. This tends to increase performance pressure on medical students. This additional stress of focus on grades can be detrimental to the medical school experience and is a potential barrier to learning.
Perhaps as a result of the increased stress in foreign medical schools, the graduation rate among Caribbean medical schools is roughly half of the students, whereas the United States boasts a graduation rate of greater than 90 percent. The dropout rate among medical students at what are considered the top medical schools in the Caribbean is astonishing, with some reaching as high as 40 percent.
It is also an unfortunate reality that patients tend to prefer American-trained physicians to those that were internationally educated. Though a study by the Foundation for Advancement of International Medical Education and Research found no significant difference between level of care provided by international or domestically trained doctors, patients and other physicians can be quick to judge or look down on an international degree.
While opting to attend a foreign medical school and immediately beginning a career as a physician may seem like an appealing option, the more strategic decision may be to wait and reapply the following year. Many applicants take jobs in the gap years before they enter medical school, and admissions committees often look favorably upon additional professional experience and a few years’ maturity. Coupled with the fact that foreign trained graduates are often overlooked even after recertification in the US, attending a foreign medical school may only be the right decision for those who plan on keeping their degree abroad.