If you are wondering how to match residency in the US and Canada as a Caribbean medical school grad, you are not alone. There is a common perception that if you graduate from one of the Caribbean medical schools then you have zero to no chance to practice in the US or Canada. This is not true! We are here to help you increase your chances of matching! Read on to find out what you are up against, what you can do to bolster your application, and expert tips to prepare the best ERAS or CaRMS application. 

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What is the Challenge of Being a Caribbean Medical School Grad? What Can You Do to Bolster Your Chances of Matching in the US or Canada? Top 5 Tips to Match Your Chosen Residency in the US or Canada as a Caribbean Medical School Grad Final Thoughts FAQs

What is the Challenge of Being a Caribbean Medical School Grad?

Medical school acceptance rates in the US and Canada lead many hopefuls to look for medical training elsewhere. Medical schools in Canada, of which there are only 17, and over 150 medical schools in the US are incredibly competitive; but more than this, the healthcare landscape in both countries is very exclusive. In other words, it is truly difficult to become a doctor in the US and Canada if you do not receive your education there.

This is a hurdle for any international medical graduate, but it seems to be especially serious for graduates of the Caribbean medical schools. These institutions have become an attractive option for medical school applicants who receive medical school rejection from Canadian and US med schools. But why are they popular? And why do American and Canadian residency programs hesitate to accept Caribbean med school grads?

Firstly, based on medical school requirements and statistics, many of the Caribbean schools have lower admissions standards than American and Canadian med schools. Caribbean schools are some of the easiest medical schools to get into based on Caribbean medical school GPA requirements and MCAT score thresholds. They also typically do not have any requirements when it comes to coursework or extracurriculars. Essentially, they have no real requirements, and this is why they are popular with students who do not make the cut for American and Canadian schools. And also why residency programs are skeptical about these grad’s skills, qualifications, and experience. 

Just to clarify, this skepticism applies to many other international medical graduates as well and most of them worry about how to get into residency programs as an IMG, whether they completed their education via the Atlantic Bridge program in Ireland or gained years of practice in their home country before moving to Canada or the US. But Caribbean schools tend to have a poorer reputation, and therefore lower matching rates in Canada and the US.

For the most part, many of the Caribbean schools are completely legitimate and accredited. But if you do decide to attend a Caribbean school then you should definitely check their accreditation online. There are schools that have really good reputations and produce grads who go on to match and practice in the US and Canada; these include St. George’s University School of Medicine, American University of the Caribbean School of Medicine, Saba University School of Medicine, and Ross University School of Medicine. But even if you are a graduate of one of these schools, you will need to work extra hard to match your chosen residency.

Want more tips? Check out our infographic below:

What Can You Do to Bolster Your Chances of Matching in the US or Canada?

But all is not lost! Remember, the best residency programs in the US and best residency programs in Canada may have a general skeptical perception of Caribbean grads, but you have the power to change their minds when they see your residency application. You will have plenty of opportunities to show that you have taken all the necessary and extra steps to prepare yourself for residency training in the US or Canada. Let’s review some of the items you must do to increase your chances of matching your desired residency in the US or Canada as a Caribbean med school grad.

Gain Clinical Experience in the US or Canada

As we already mentioned, one of the reasons US and Canadian residency programs are skeptical of Caribbean grads’ qualifications is because they are skeptical of the standards of education Caribbean schools provide. To convince them that you understand the expectations, you must do your absolute best to gain clinical experience in Canada or the US. Not only will this show that you went above and beyond the “requirements” of your medical school, but it will also demonstrate that you have worked and experienced the quality of practice that is expected in the US and Canada.

If you are still in school, research any electives that you may apply for in the US and Canada. Remember, a big part of learning how to prepare for your residency applications is to learn how to choose medical school electives that will impress the program directors. Try to find electives you are eligible for and that would contribute to your chances of matching your chosen specialty. For example, if you are looking to pursue an internal medicine residency, it would be best if your elective in the US and Canada was in this field. However, other primary specialties like family medicine residency or pediatrics would be appropriate as well. Speak with your peers and professors to ask if they know of any elective opportunities in the US or Canada, and make sure to do your own research. Remember, a medical school advisor could also help you in this search and in your attempt to qualify for the elective.

Secure at Least One Letter of Reference from a Physician in the US or Canada

If your clinical experience in the US and Canada is successful, make sure that someone agrees to vouch for your abilities and suitability. This will further prove that you can work in the required environment and can meet and exceed the standards set by healthcare fields in the US and Canada. It’s important that your letter of reference outlines why you would be a great addition to the specialty you are pursuing. Keep in mind that ERAS letters of recommendations and CaRMS reference letters are usually ranked among the top 3 factors that program directors consider when selecting applicants for interviews.

Just a final reminder recording your references: make sure that your writers agree to write you very strong letters. As a Caribbean school grad, you will need a letter that impresses the reader with details of your strengths, diversity of your experiences, and your ability to be a great addition to any program. Therefore, if your American or Canadian writers seem hesitant to give you a glowing recommendation, you might need to reconsider who you ask. This is why it is especially important for you to make an amazing impression on your supervisors and colleagues during your clinical experiences in the US and Canada.

Ace Your USMLE or COMLEX Exams

Your USMLE Step 1 and COMLEX Level 1 scores are the most important factors that program directors consider when choosing candidates for interviews. This is great news for you! While gaining clinical experience in the US and Canada and receiving quality references from your American and Canadian colleagues may depend on factors outside of your control, getting a stellar exam score is up to you!

Firstly, of course, you need a great medical school study schedule to plan your rotations and study sessions for the exams, but you can also always look into enrolling in a USMLE Step 1 prep course. These courses can be incredibly helpful in scheduling your review sessions and helping you with practice tests.

Remember, if you can impress the program directors with your USMLE or COMLEX score you will seriously boost your chances of being invited to an interview!

Check out our tips for acing USMLE Step 1:

Give Yourself Time to Write an Impressive Personal Statement

Your residency personal statement needs to wow the readers. Simple as that. Yes, your USMLE scores and support from American and Canadian peers will check off the necessary boxes to alleviate any doubts the program directors may have about your qualifications, but it’s not enough. Remember, your personal statement is about your journey to this point, so you can and should create a compelling narrative to demonstrate how you ended up applying to your chosen programs and specialty. You thought long and hard about how to choose a medical specialty, so make sure that your personal statement also demonstrates the steps you took to learn why you want to pursue your chosen field.

And if you think you can create a convincing and strong narrative that includes the reasons why you ended up in a Caribbean school, that's even better. While your letter should focus on your strengths and triumphs, it is also very powerful to read a story of setbacks that were turned into victories. So, if your reason for attending a Caribbean medical school was rejection from Canadian or American schools, then demonstrate what you learned from this setback and what you did to become even a better candidate than your peers studying in Canada and the US.

Top 5 Tips to Match Your Chosen Residency in the US or Canada as a Caribbean Medical School Grad

What else can you do to increase your chances of matching your chosen residency programs in the US and Canada? Check out our expert tips below:

Work Hard in Your Clerkships

Your clerkships are not only the prime opportunity to learn the ins and outs of your profession and hone your medical skill, but also your chance to build connections, as well as secure references and a strong MSPE. Your MSPE or MSPR, if you are applying via CaRMS, usually indicates every score you received in each of the core rotations and electives – but it can also include comments from the attendings in charge. While most attendings will simply score you after each rotation, you have the power to approach and ask them for detailed comments on your performance when they fill out the ITER (in-training evaluation report). These comments will then appear in your MSPE/MSPR! So if you do really well in your rotations and electives, then you can really impress US and Canadian program directors with your performance, so make sure you learn how to prepare for clinical rotations and how to ace the hardest rotations in medical school.

Interview Prep

If after all your hard work you are invited to an interview, you are on the right track to becoming a medical resident in the US or Canada. Keep in mind that while it’s important to go through and practice with residency interview questions, there is a lot more to IMG residency interview prep than the content of your answers. Your behavior, demeanor, and suitability will be evaluated as well. According to the latest NRMP survey, interactions with faculty during the interview and visit and interpersonal skills are the most important factors when ranking applicants. This means that your performance in the interview can really make or break your chances to become a resident in your desired programs.

Be prepared to talk about your IMG status. There is nothing wrong with being an IMG, but you must be able to give an account of this aspect of your journey. Don’t be surprised if you are openly asked about how you ended up in a Caribbean med school or what prevented you from being a medical student in Canada or the US. And do not be afraid to infuse your answer to “tell me about yourself” residency interview question with some details of why you chose to pursue your medical education in the Caribbean. And if you are not sure how to best approach this subject, do your best to hire professional help for your ERAS interview prep or CaRMS interview prep.


Your clinical experience in the US and Canada, your letters of reference from your American or Canadian colleagues, as well as your MSPE will certainly provide the program directors with some idea of your clinical skills. However, you must also be prepared to demonstrate your clinical skills via OSCE exams and shelf exams that you might face. These are just another opportunity to prove that you can meet the clinical and knowledge standards of the US and Canadian healthcare systems.

If you are applying to residency programs in Canada as an IMG, be prepared for the NAC OSCE. It is a mandatory exam all international medical graduates in Canada must pass to be eligible for residency. If you are applying to residency in the US, you will need to research the requirements of the state you are applying in. Many medical schools in the US require their students to complete an OSCE before they can graduate, so be sure to find out what kind of requirements are applicable in your case and for the programs you are applying to.

You will need to look into how to prepare for an OSCE exam as an IMG because there might be slight differences in practice or behavior that you might not be aware of. This does not mean that you have to start your clinical training from scratch! Absolutely not! But an OSCE prep course can really help you feel confident as you walk into that exam.

Getting ready for your NAC OSCE? Check this out:

Rank Order List (ROL)

Whether you are applying to some of the most competitive or least competitive residency programs in the US and Canada, you must carefully plan how to create your residency rank order list. This very intricate process keeps many applicants up at night, but we do have some tips that may help you:


Don’t Give Up

Becoming a doctor in the US and Canada is a huge undertaking. If you do not succeed right away in matching your desired residency in the US or Canada, do not give up. If you did not receive any interviews, first, take a pause and learn how to improve your residency application after going unmatched. Take a year to bolster your application by gaining more clinical experience in the US and Canada, for example. Don’t be afraid to use resident career counseling to identify what you could improve on in your application.

If you went unmatched after an interview, you should still be proud of yourself. Take this time to work on your candidacy and your interview skills. Look for other programs where you might be a better fit. Remember, as an IMG, you might have to increase how many residency programs you apply to.

And remember, before you start your application process, make sure to use our Residency Match Calculator to see how competitive you are as a candidate!

Final Thoughts

Being a Caribbean medical school graduate should not deter you from applying to your desired residency programs in the US or Canada. While there may be slightly bigger obstacles to overcome, it is only up to you to make sure you stand out as a candidate. The tips and strategies we outlined above should have you plan your future as a resident, so make sure to follow them and reach out to us if you need help with getting into your dream residency programs!


1. Is being a Caribbean med school graduate a disadvantage for matching residency in Canada or the US?

To some extent yes. Canadian and American medical schools and healthcare systems are very exclusive, so anyone who does not train in Canada or the US needs to prove that their knowledge and clinical skills are up to standards. However, being a Caribbean grad does not mean you cannot become a doctor in the US and Canada.

2. What is an IMG?

An IMG stands for international medical graduate. Typically, these are residency applicants who received their medical school education abroad. However, in the US, there are also non-US citizens who received their education in one of the medical schools that accept international students in the US. They are considered non-US IMGs. 

3. How to match residency in the US and Canada as a Caribbean med school grad?

Firstly, try to gain some clinical experience in the US and Canada. This can also lead to reference letters from your US or Canadian colleagues. Having this kind of support is very important. Plus, make sure to ace your USMLE and write a stellar personal statement. Please review our entire blog for more tips and strategies. 

4. If I am already graduated, how can I gain more clinical experience in the US or Canada?

It might be more difficult, but you can find programs and observerships that can later lead to clinical work. Be sure to check out institutions in the state or city where you want to attend the residency. 

5. Do I have to write USMLE, COMLEX, or MCCQE as an IMG?

Yes, you do.

6. Am I eligible to participate in CaRMS if I am a Caribbean med school grad?

Yes, if you are a Canadian citizen and permanent resident.

7. What is the difference between US IMG and non-US IMG?

US IMGs are students who complete their medical school education abroad, including in the Caribbean. Non-US IMGS are students who completed their education in the US but are not citizens of America. They need visas to stay and continue their residency training. 

8. For the match, is it better to be a US citizen but receive med school education abroad; or be a non-US citizen who receives their education in America?

As we mentioned already, US medical residencies and healthcare system outs a greater value on your training, so therefore non-US IMGs who get their education in the US might have an advantage over someone who is a US citizen who completed their education in the Caribbean, for example. 

To your success,

Your friends at BeMo

BeMo Academic Consulting 

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