Why Caribbean Students Fail Step 1
Caribbean students typically do not do well on the USMLE step 1 exam. I know the stats show 60% of IMGs pass step 1 but I think this number is raised by true foreigners who take the exam after studying in their respective countries and lowered by Caribbean students who are American or Canadian citizens who studied abroad. I rarely meet a person who was raised in India who failed Step 1.
The only exception to this is if you went to any of the big 3 caribbean schools such as Ross University, Saba University, and St. George’s University. Every other school whether it is in the Caribbean, some other group of islands, Poland, Hungary or anywhere else falls in this category if it primarily consists of Americans and Canadians.
One of the more obvious reasons why Caribbean students fail step 1 is because they are a dumber pool of students. Many of the students would never have gotten into an LCME-based school. Worse is the student who comes straight out of high school. These students, not only do not pass step 1, but essentially only end up with a useless high school degree to show for it.
A second obvious reason is the poor teaching. Most of the professors are licensed doctors who are looking to get a residency in the United States. None of them have prior teaching experience and none of them aspire to be great professors. All of them have one foot out the door while teaching and it shows in their teaching. Of course, they are not well paid. All in all, it adds up to a poor quality of teaching.
A less obvious reason for failing is that with American universities, you never move after your basic sciences are done. Usually your hospital is in the same area, or relatively close by. There is a natural continuance. Coming back from the Caribbean, one is relieved to back home, with 24-hour grocery stores, central air conditioning, familiar people and all the conveniences we have grown accustomed to since most of us are ABCDs. There is a natural tendency to relax since you feel like you survived the island when in reality the hardest part is yet to come.
Most Caribbean students think they can magically take a Kaplan course and learn everything they need to pass. That won’t happen. Buzz words will not get you anywhere. LCME-based students had better professors, better labs and studied harder than you and they pour their hearts into studying for Step 1. So for you, Mr Caribbean Student, you need to make up for the poor teaching and poor labs and quickly get over your relief of being home.