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Caribbean medical schools -- most far from glamorous -- may not be an aspiring doctor's first choice for his or her education, but they can be viable options for those that make the most of the experience.

"We don't sip Mai Tais on the beach at all," said Cathy Hwang, a 1999 College graduate who is currently attending Ross University School of Medicine in Dominica.

"There are no movie theaters, bowling alleys, [or] American-type restaurants ... in some ways [it's] a perfect study environment," she said.

After applying unsuccessfully for admission to various medical schools in the United States in 2002, and then again in 2003, Hwang decided that Ross University was her best option.

Like Hwang, many others do not gain admission to medical school on their first try, especially to schools in the United States.

Of the Penn students who applied to medical school in the fall of 2004, 17 percent were not accepted anywhere, according to Penn's Career Services. These students must either reapply to schools in the United States, or consider submitting applications elsewhere.

Caribbean medical schools such as Ross University and St. George's University in Grenada are considered good choices for American students, according to Christiana Fitzpatrick, pre-health advisor at Career Services.

Fitzpatrick cited the schools' modern facilities, adequate funding and low costs as merits of the "off-shore" institutions. Furthermore, she said these schools cater to American students.

Hwang said that her textbooks are the same as those used by American medical students and that she completes clinical rotations alongside Americans students in American hospitals as part of Ross's program.

At St. George's Medical School, 76 percent of the entire student body, as of fall 2003, were U.S. citizens -- most of whom intend to practice in the United States -- according to the school's admissions office.

Jonathan Macknin, a 2004 College graduate and current first-year student at Penn's School of Medicine, said that he would only have considered Caribbean medical schools as, "a last resort, especially since the end goal is coming back to the U.S."

Macknin said that it is much more difficult to get into American residency programs coming from medical schools abroad. He chose to attend Penn because of its faculty, reputation, curriculum and student body.

Fitzpatrick agreed that there are more obstacles for abroad students to overcome when trying to gain acceptance to residency programs in the United States. Abroad students must also pass the United States Medical Licensing Examination in order to practice in the United States.

Keith Monchik, a Ross graduate, serves as an example that abroad students can successfully compete with the rest for residency positions.

Monchik is currently one of five second-year residents at Brown University's prestigious Department of Orthopaedics.

Affiliation of residency programs may even be more important than where a student attended medical school, Fitzpatrick said.

"In the medical world, it's not where you've been, but where you were last," Fitzpatrick said.

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