Keng: MD/PhD programs are for people who want to have a research-focused career and already have a strong research background – many even have publications from major journals by the time they apply for medical schools. Those programs usually last 6+ years, which means more time in school before you can start applying for residency. However, most programs are fully funded (they pay for your living expenses in addition to free tuition), so they can be an attractive option. They are usually more competitive than regular MD programs, so you need make sure that you are a strong applicant (not just GPA/MCAT). Nevertheless, it is not necessary to have a PhD in order to do medical research as a career. Many researchers have a MD and maybe a MPH (Master of Public Health), but they do just fine.
Andy: If you really like research and see a career in it, go for it. Any other reason is not going to cut it because it will drag on you.
Early Decision Programs
Keng: I would not recommend applying to a medical school’s EDP. Why?
AMCAS EDP only allows you to apply to exactly one school, and you may not hear the final decision (assuming you got an interview) until October 1. If you don’t get an outright acceptance, you will either become a reapplicant the next year or submit very late applications to other schools in the same cycle. If you are lucky enough to get an acceptance, you will have to either attend or suffer the consequences (e.g. reapply and have to explain to other schools why you didn’t accept the early decision offer).
But, if you think it’s worth the risk, you should contact the school’s admissions office first to express your interest in applying through the EDP, and see if you can speak to the admissions director before moving forward. Remember that every school receives many strong applications, so you will have to be excellent in all criteria for the school to be willing to offer you an early acceptance.
Caribbean Medical Schools
Keng: Personally, I think there are more cons than pros when it comes to Caribbean schools, but I will try to stay objective.
The pros: Caribbean schools will teach you the basic knowledge needed to receive an MD and to legally practice in the US. Schools such as Ross University and St. George’s University send a large number of graduates to great residency programs in North America, and many go on to become doctors and professors at major universities. In addition, Caribbean schools will help you to secure clinical rotations in both the Great Britain and the US, so you will have the opportunity to experience medicine under various types of health care systems and meet instructors from around the world. Since the medical curriculum often focuses on the USMLE Step 1, students tend to do fine in those professional examinations. Furthermore, a lot of med school students from the Caribbean also appreciate the opportunity to live off-shore and to enjoy the tropical weather.
The cons: you may not get clinical rotations in the US, and even if you do, their quality can vary significantly. Low-quality clinical rotations during your last two years of medical school can be detrimental to your residency application. Competition is also intense: even some students describe it as a “sink or swim” environment because, believe it or not, Caribbean schools expect a LOT of people to drop out in the first two years of medical school so that they can keep your tuition without having to invest in arranging rotations for you. The high cost of attendance is an issue, but it’s not as bad as the fact that the chances of you getting into a competitive residency program will be slim (because of limited space, poor clinical rotations, lack of research and other opportunities, and stigma). Additionally, if you graduate from a Caribbean medical school and wish to obtain an American residency, you will be considered a “foreign medical graduate,” which will make it even more difficult to obtain a residency.
Caribbean schools used to be a good option for those who could not gain a medical school acceptance in the US, but right now, I would say it’s becoming a less attractive choice because the number of US medical school graduates is increasing, while the number of residency program spots available is essentially the same. You are better off spending your time on improving your application and applying very broadly within the US than attending schools in the Caribbean. After all, those schools won’t disappear anytime soon, so you can always have that backup option if you REALLY want to become a physician.