By G. Richard Olds
June 26, 2018
It’s growing ever more difficult to become a doctor. Last year, U.S. medical schools attracted more than 51,000 applications. But only about 21,000 students matriculated.
Scores of Americans who would make great doctors never even get the chance to start their medical education.
Some decide to pursue their dreams outside the United States, at international medical schools.
Doctors trained abroad are crucial in America — they account for more than a quarter of our physician workforce.
Yet international medical schools, and those in the Caribbean in particular, have an uneven reputation.
For instance, some international schools have a reputation for being unable to place their graduates into U.S. residency programs. Their alumni may return to the United States with significant student debt and uncertain career opportunities.
The quality of international medical schools does indeed vary widely. But that’s equally true of schools in the in the United States. And the data show that the best international schools are on par with top American programs.
Given America’s looming doctor shortage, we can’t afford to undervalue graduates of international medical schools.
At first glance, U.S. med schools seem to do a better job preparing their graduates for careers in medicine. Ninety-six percent of students from U.S. or Canadian medical schools passed the U.S. Medical Licensing Examination on the first try in 2016. Just 78 percent of students from schools outside the United States or Canada did so on their first go-round.
But the data from specific international schools tell a different story. In 2015, 97 percent of students at the University of Queensland’s Ochsner Clinical School in Australia passed step 1 of the exam on the first try. At my school, St. George’s University in Grenada, 96 percent passed in 2016.
The figures on residencies for international students look scary, too. In 2016, 94 percent of U.S. students matched for residencies. Just over half of students trained internationally did.
But again, there was wide variation among international schools. Some posted numbers on par with their U.S.-based counterparts. This year, all of the graduates of the Medical School for International Health at Ben-Gurion University of the Negev, in Israel, who entered the U.S. National Resident Matching Program secured residencies. Last year, 93 percent of American graduates of St. George’s who applied for residencies in the United States got them.
In some ways, these international medical schools’ stats are even more impressive because their students typically enter with lower grades or MCAT scores than their U.S.-educated peers. Many students attend international schools only because they were turned down stateside.
So international medical schools tend to invest in support services that help students succeed academically and personally. The School of Medicine at University College Cork in Ireland, for example, assigns each international student a senior faculty mentor to provide advice and support.
Research has also shown that international medical graduates deliver high-quality care — in some cases, higher-quality care than doctors educated in the States. One recent study found that Medicare patients admitted to a hospital were less likely to die within 30 days if treated by an internationally trained doctor rather than one educated in the United States.
Finally, international medical graduates tend to practice in locales and disciplines where the need is greatest. For example, in areas where per capita income is below $15,000 per year, international graduates account for 42 percent of doctors.
Or take primary care. By 2030, the United States could be short 43,000 primary care physicians. International medical graduates will be the ones who fill that shortage.
More than half of medical students educated in the Caribbean choose primary care, compared to one-third of U.S.-educated students. At some international schools, that share is even higher — about three-quarters of grads from St. George’s and almost 60 percent from the American University of the Caribbean head into primary care.
In other words, Caribbean medical schools are doing a better job addressing America’s doctor shortage than their counterparts in the States.
The region’s best medical schools provide the personalized training and support needed to turn promising students into top-notch physicians. And American patients benefit immensely.
G. Richard Olds, M.D., is president of St. George’s University. He was founding dean of the medical school at the University of California at Riverside.
Photo Caption: St. George’s University (Joshua Yetman)
