How are the exams?
I do not think the exam questions you take during the basic sciences portion of your Caribbean medical school experience differ much from your LCME-based student population. The textbooks used are similar to the recommended ones for US schools.
The big difference is that I do not think the Caribbean students cover as much material. Often times there is either no syllabus or it is not followed. Classes are sometimes canceled due to meetings scheduled for the instructors.
Basically, when the semester comes to an end, you will not have covered the material you should have and need to. In addition, to try to recover, often times the professor will cram a bunch of material right before the exam. They go slow at the beginning and ramp up right before the exam. Somehow I think it should go the other way or ideally be constant. The last thing you need right before exams is 3 weeks worth of new material crammed into one week’s time.
So once you are done with the semester, ideally you should match up what you went over with a USMLE Step 1 topic specific book like the Kaplan book or the corresponding First Aid Section and study the information you are missing. This will never happen though because the next semester will be upon you soon enough not leaving any time to fill the gaps of the previous semester.