Not all international medical schools are created equally

I just got off the phone with a friend of mine whom I haven't spoken to in probably five years. He was at one time, a student at St. George's University and was doing well. However, after an illness, some shadiness on SGUs part, and a threatened lawsuit by my buddy, he withdrew and enrolled in another international medical school, Oceania University of Medicine. The school has an online basic medical sciences curriculum but most disturbingly, the school does not have any affiliated hospitals in the United States. North American students who pursue a degree from this school only have access to outpatient rotations at private doctors’ offices and affiliated outpatient surgical centers. Elective rotations are very limited, and students must pass an insanely difficult in-house exam at the end of their basic science years, to sit for the USMLE Step 1. Students also have to complete one rotation at a hospital in Samoa.

My buddy wants to apply to match this year, so he asked me to proofread his personal statement for ERAS. He shared some of the hardships that led him to Oceania, and he didn't sound at all certain that matching is going to be in his cards. In fact, he is very fortunate that he had a career as a family nurse practitioner before starting medical school; if he doesn't match, he still has a career that he can lean into.

I won't comment on the online aspect of the education but any medical school that does not have hospital affiliations should be a no-go in your book. My buddy had 15-20 year’s experience as an FNP and home health nurse so I'm sure that he was able to translate that experience to many of the outpatient clinics that he rotated in, but I can't help thinking about everything that he missed by not being able to rotate in a hospital. Further, from a financial standpoint, since the school is not able to give U.S. Federal loans, they *urge* students to enroll in online masters or doctorate programs to get the financial aid. The idea is that they take out the max loans that they are eligible for and then use the financial aid refund to pay for their medical school. That in and of itself sounds sketchy.

I told my friend that I will keep him in my prayers in the hopes that he can get a residency and I told him that I would assist him with getting on as a research RA with my lab; Oceania does not have any sort of research experiences or student leadership activities that a student may take advantage of to build their CV in preparation to apply to the Match. I'm no clairvoyant but I know that my friend faces a steep climb to earn a residency spot. Is it even possible to earn a residency if you have not done any hospital rotations?

Why am I telling this story? Not all international programs are created equally. For U.S. pre-meds, there are some good programs in Australia, Europe, and Israel and there are some that, while not great, will give you a fighting chance at earning a residency in the Caribbean and Central/South America and Mexico. And then... there are the rest that will take your money and leave you holding an empty bag. I believe that every student can make it to medical school, preferably in the U.S. or Canada, but if you must go abroad, PLEASE DO YOUR HOMEWORK! Not all international schools are created equally, and most will take anyone with a pulse. What I have seen is that the students who do get out of the international schools and successfully match, they tend to be very strong students who could have gotten into a U.S. program but for some blip in their application or a lower test score on the MCAT or something. These are students who are very tough minded, have good study skills/habits, and are determined to get what they came for. They tend not to spend a lot of time playing around. The students who tend not to make it out of these programs aren't bad students, but they could stand time in a post bacc or SMP program working on their skills. Or maybe they were impatient regarding the MCAT. Some were trying to avoid the MCAT altogether and viewed going abroad as a shortcut to their goals. Whatever the case, these students tend not to graduate or if they do, they frequently do not earn a residency. So, if you are going to attend an international school, before you go, research the school(s) and make sure to give an honest assessment of yourself as a student. My buddy isn't as old as I am, but he does have a son who is entering college and I know that his wife is starting to get tired of the constant international adventure. Time does not sit still, and I would hate for him not to match as that is going to impact his family as well. Don't let this be your story. If you are going to head abroad, do your homework.