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.

Week 3

Week three is over. This was a more tiring week than the first two. We dove into the science this week; that wasn’t too bad actually. What made the week tiring was all of the COVID news. COVID fatigue is real and right now, Texas is more or less back where we were last year at this time during the shutdown. The zip code that UIWSOM is the most heavily impacted by COVID, so the school sent us home for the latter half of last week and for Monday of this week. They bought us back on campus, but we’ve all got to wear N95s indoors and outdoors (if we’re in groups of three or more) and we have to get COVID testing every week, irrespective of vaccine status, on Thursday or Friday. I understand the precautions and I am SOOOO appreciative that our Dean, Dr. Robyn Phillips-Madson, has a public health background and is a strong administrator (And personally speaking, after working in academia for so many years, I am THRILLED that there is a strong woman in charge!) but honestly, I am so over COVID right now. Earlier this week, one of my mentees who attends another osteopathic medical school that I won’t name because they are NOT taking any real public health measures to protect students, staff and faculty, told me that she contracted COVID from most likely, unvaccinated faculty or staff. So, on top of dealing with the changes here, Eboni and I were worried about our mentee. Despite that, I was able to mostly stay caught up with work and this weekend, I will be catching up on anything that remains undone over these two weeks as well as meeting with two study groups.

In terms of what was covered this week, in DOCS, we spent more time learning about the Osteopathic Structural Exam (OSE) and palpating to look for asymmetries in patients. We also started learning how to properly use our medical instruments and take vital signs during a patient encounter. In SIGS, we did two case studies, one covering a patient with Turner Syndrome and the other, Cystic Fibrosis. The cases were really interesting, and I loved working with the group as we worked our way through the cases. STRX saw us continue with histology/make up of cells and we started working on the cadavers for the first time as we continued our understanding of the skeleton, its joints, and got an introduction to the integumentary system. Large group saw us dive into biomolecules and basic enzymology. Of course, the EMT course continues; that also contributed to my tiredness; we have five to six quizzes to do each week in that program and while it is online, the quizzes are time consuming. I’m fortunate that I’ve been an EMT and have taken the NREMT exam in the past so none of this is new to me, but it’s still time consuming.

Other than that, my chair and ottoman arrived today. My office is almost complete. I want to get a filing cabinet or small decorative table and a lamp for my office. I thought about getting a TV for the office but I think that will be a distraction, especially during football season so I’ll likely not get one. The chair is comfortable and will make a nice spot to read when I’m. not on the computer. It also makes for a nice sleeping spot (Yeah, I napped today) when I doze off… I want to do something super nice for Eboni; she bought me the chair and ottoman because she wanted my office to be comfy as I don’t like studying on campus. She’ll be returning to school on the 19th for PhD number two so I want to do something nice for her to make sure that she starts off with a nice, comfortable, and inviting study space. Time to go take some EMT quizzes!