Caribbean M.D. vs Mainland D.O.

I recently received this question from a friend deciding between med schools:

I got accepted to TCOM [a D.O. school in Texas] and Ross [an M.D. school] in the Caribbean. Which one do you think is a better option? Do you think I should reapply to MD schools again? I am very confused and don’t know what to do. Please give me some advice.

In all honesty, this isn’t a fair question. In a way, it’s questioning one’s definition of what it means to be a physician. Is it the M.D. after one’s name… or the actual calling? Is it the fact that you’re attending a mainland school… or just a prestige issue?

First of all, if you’re doing this for a particular degree, you should have some knowledge regarding the fundamental differences between allopathic (“M.D.”) and osteopathic (“D.O”) medicine. These days, to say that, “I’ve always dreamed of being a doctor” is very different than saying, “I’ve always dreamed of being an M.D.” What does osteopathic medicine offer in training that allopathic medicine misses? And vice versa?

When I first decided to become a physician, I hadn’t even heard of osteopathic medicine. I was under the naïve notion that “doctor = M.D.” myself, and unfortunately, a lot of cultures around the world are still firm proponents of that sentiment. Times have changed, D.O. physicians are permeating every residency, and in the majority of cases, patients couldn’t tell you if their physician has an M.D. or D.O. The lines are indeed blurring.

In my short time on the wards, I’ve come across several D.O. residents who, from my eager-to-learn medical student perspective, are better teachers and more friendly to patients compared to their M.D. counterparts. This isn’t to downplay the M.D.s who have taken the time to show me the art of medicine, but I’m trying to make the point that one’s degree (whether M.D. or D.O.) does not, by any means, reflect the quality of a physician. Judge them by the collective package, not just a degree.

In my opinion, when deciding between a Caribbean M.D. school and mainland D.O school, it’s more prudent to assess things which actually matter – the school’s board exam pass rate, cost of tuition/living, and the clinical training you’ll receive. Had I been in this position, I would have chosen TCOM (the only D.O. school in Texas) over any Caribbean M.D. school simply because of the in-state tuition, proximity to my home in Houston, and clinical opportunities in the Dallas/Fort Worth metropolis. Others may have chosen to go to the Caribbean because of the environment and fact that the M.D. degree is more globally recognized (useful if someone wants to practice international medicine).

So in closing, try picking the school based on parameters which can contribute to your success as a physician and future plans in practice.

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  1. I chose to go with medical school caribbean. UMHS in St. Kitts offer a lot for its students with a strong program, great staff, and state of the art campus. They really made the decision easy.

  2. I personally just went through a similar issue. I was accepted to SGU and AZCOM. I was initially torn but then spoke to close friends who read for US MD residency adcoms. They both told me that the odds of getting a residency as a d.o. are better. They both have worked with and were residents with d.o. Students but never Caribbean md students. This sold me. They spoke to me based off of opportunity and not the two letters after my name. I will be attending AZCOM next fall.

  3. Hmmm I do not think Joseph is correct. Caribbean MD Schools these days are getting better and more selective with their applicants. They have an excellent rate of placing their students into good residencies in the US. Please check your facts before writing anything. The fact that you attended AUC and probably did not get in a US residency does not mean Caribbean Schools are bad; you probably did poorly on your steps. By all means, if you score around average on your USMLE, you will get in a good US residency. Probably not Derm or Radiology but Internal Medicine or Surgery.. ETC

    Good luck!

  4. Go to the DO school.. hands down.. I graduated from AUC (Caribbean MD School) and while I think I received an excellent education with terrific clinical rotations the bottom line is you need to ask yourself one question: what school will help me obtain the residency I want.

    If you were making this decision in 2005 I would say go to either and have a good time.. but as it is 2011, and Med schools are actively trying to increase their enrollment in order to produce more doctors (5-10% increase per med school per AMA recommendation I believe) due to the pending shortage, this means that there will be increased competition for FMGs (Caribbean students included) for residency spots. True, residencies are also planning on increasing their program sizes (when they can obtain funding approval), but in the end most residencies will accept a US DO over a Caribbean MD (with everything else equal… scores, etc).. that’s just the way it is. Believe me.


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